Evidence map›Paper›PMID 35134972›Full record

ArticleJournal of the National Cancer Institute2022

The Oncology Care Model and Adherence to Oral Cancer Drugs: A Difference-in-Differences Analysis.

Nancy L Keating, Gabriel A Brooks, Mary Beth Landrum, Pang-Hsiang Liu, Robert Wolf, Lauren E Riedel, Nirav S Kapadia, Shalini Jhatakia, Amanda Tripp, Carol Simon and 3 more

Open access · greenAbstract read
In one paragraph

Article in Journal of the National Cancer Institute, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. A Systematic Review and Meta-Analysis of Interventions to Promote Adjuvant Endocrine Therapy Adherence Among Breast Cancer Survivors.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023
    Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 1 country.

Nancy L KeatingDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-8274-4681
Gabriel A BrooksSection of Medical Oncology, Department of Medicine, Geisel School of Medicine, Lebanon, NH, USA.
Mary Beth LandrumDepartment of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Pang-Hsiang LiuDepartment of  Health Care Policy, Harvard Medical School, Boston, MA, USA.ORCID 0000-0001-8842-2264
Robert WolfDepartment of Health Care Policy , Harvard Medical School, Boston, MA, USA.
Lauren E RiedelDepartment of Health Care Policy,  Harvard Medical School, Boston, MA, USA.
Nirav S KapadiaSection  of Medical Oncology, Department of Medicine, Geisel School of Medicine, Lebanon, NH, USA.
Shalini JhatakiaThe Lewin Group, Falls Church, VA, USA.
Amanda TrippThe  Lewin Group, Falls Church, VA, USA.
Carol SimonThe Lewin Group , Falls Church, VA, USA.
Van Doren HsuGeneral Dynamics Information Technology, Falls Church, VA, USA.
Colleen M KummetGeneral Dynamics Information Technology, Falls Church, VA, USA.
Andrea HassolAbt Associates, Cambridge, MA, USA.
Harvard University · USLewin Group (United States) · USDartmouth College · USGeneral Dynamics (United States) · USAbt Global (United States) · USBrigham and Women's Hospital · US

Funding

Centers for Medicare & Medicaid Services (CMS) to evaluate the CMS Oncology Care Model HHSM-500-2014-00026I
6 · The paper itself

Abstract

backgroundAdherence to oral cancer drugs is suboptimal. The Oncology Care Model (OCM) offers oncology practices financial incentives to improve the value of cancer care. We assessed the impact of OCM on adherence to oral cancer therapy for chronic myelogenous leukemia (CML), prostate cancer, and breast cancer.

methodsUsing 2014-2019 Medicare data, we studied chemotherapy episodes for Medicare fee-for-service beneficiaries prescribed tyrosine kinase inhibitors (TKIs) for CML, antiandrogens (ie, enzalutamide, abiraterone) for prostate cancer, or hormonal therapies for breast cancer in OCM-participating and propensity-matched comparison practices. We measured adherence as the proportion of days covered and used difference-in-difference (DID) models to detect changes in adherence over time, adjusting for patient, practice, and market-level characteristics.

resultsThere was no overall impact of OCM on improved adherence to TKIs for CML (DID = -0.3%, 90% confidence interval [CI] = -1.2% to 0.6%), antiandrogens for prostate cancer (DID = 0.4%, 90% CI = -0.3% to 1.2%), or hormonal therapy for breast cancer (DID = 0.0%, 90% CI = -0.2% to 0.2%). Among episodes for Black beneficiaries in OCM practices, for whom adherence was lower than for White beneficiaries at baseline, we observed small improvements in adherence to high cost TKIs (DID = 3.0%, 90% CI = 0.2% to 5.8%) and antiandrogens (DID = 2.2%, 90% CI = 0.2% to 4.3%).

conclusionsOCM did not impact adherence to oral cancer therapies for Medicare beneficiaries with CML, prostate cancer, or breast cancer overall but modestly improved adherence to high-cost TKIs and antiandrogens for Black beneficiaries, who had somewhat lower adherence than White beneficiaries at baseline. Patient navigation and financial counseling are potential mechanisms for improvement among Black beneficiaries.

Indexed as

Antineoplastic AgentsBreast NeoplasmsLeukemia, Myelogenous, Chronic, BCR-ABL PositiveMouth NeoplasmsProstatic NeoplasmsAgedAndrogen AntagonistsHumansMaleMedicareMedication AdherenceUnited StatesAndrogen AntagonistsAntineoplastic Agents

Identifiers

PMID35134972
PMCPMC9194623
OpenAlexW4210253571

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.