BPI20-007: Evaluation of Guideline Adherence in Colorectal Cancer Management in a Private Clinic, Lima – Peru

Background: Colorectal cancer (CRC) is the third most frequency cancer at AUNA and metastasic disease represents 21% of the cases. Many organizations have developed Colorectal Clinical Practice Guidelines (CPG) based on the best scientific evidence available, but few studies have been published evaluating the implementation of the recommendations through reliable indicators. The objective was to determine two process indicators to evaluate the recommendations adherence: Percentage of request for the RAS and BRAF mutational status to patients with metastatic CRC and percentage of patients who received recommended therapy according to the RAS and/or BRAF mutational status. Methods: A descriptive analysis was performed. Indicators were compared before and after the CPG development. The data were obtained from the medical records during January 2017 to July 2019 using Hospital Information System. A peer review process between two oncologists was made to establish the treatment accorder to the guidelines. Results: Forty-four patients diagnosed with metastatic CRC were identified and eight cases were excluded because the clinical information was not available. Thirty-two percent were male (n=12). The average age was 65.6 years (range 26-89 years). Thirty-six cases were analyzed where 27 (75%) patients were not any mutation, which are shown in table N° 1. After CPG publication, the percentage of patients whom tested for RAS and/or BRAF mutational status was 30.8% (n=11) and the global percentage of patients who received recommend treatment according to the RAS and/or BRAF mutational status was 66.7% (6/9). The percentage of colorectal guideline process indicator is shown in table N° 2. In the first indicator, the percentage variation between the two periods was + 0.4% (p 0.098). In the second indicator, no percentage variation was found. Conclusions: It´s necessary to determinate other variables that limit the request of RAS mutational status and target therapy. To improve the results is necessary to reforce the strategies of implementation through an Integral Plan Model.


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Corresponding Author: Karina Mayra Aliaga, MD