PMID- 30303759
OWN - NLM
STAT- Publisher
LR  - 20240227
IS  - 1935-469X (Electronic)
IS  - 1554-7477 (Linking)
DP  - 2018 Oct 10
TI  - Investigating the Association Between Advanced Practice Providers and 
      Chemotherapy-Related Adverse Events in Women With Breast Cancer: A Nested 
      Case-Control Study.
PG  - JOP1800277
LID - 10.1200/JOP.18.00277 [doi]
AB  - PURPOSE: The effect of advanced practice provider (APP) involvement in oncology 
      care on cancer-specific outcomes is unknown. We examined the association between 
      team-based APP-physician care during chemotherapy and chemotherapy-related 
      adverse events (AEs) among women with breast cancer. METHODS: We performed 
      separate nested case-control analyses in two national cohorts of women who 
      received chemotherapy for incident breast cancer. Cohorts were identified from 
      Medicare (>/= 65 years of age) and MarketScan (18 to 64 years of age) data. Cases 
      experienced a chemotherapy-related AE (emergency room visit and/or 
      hospitalization). Controls were matched 1:1 on the basis of each patient's age, 
      comorbidities, census region, state's APP scope of practice regulations, and 
      observation period from chemotherapy initiation to first AE. APP exposure (any 
      outpatient claim billed by an APP during the observation period) was assessed for 
      each matched pair member. RESULTS: Among the 1,948 cases in the Medicare cohort, 
      225 (12%) had APP exposure before the first chemotherapy-related AE, compared 
      with 213 controls (11%; P = .54). Among the 725 cases in the MarketScan cohort, 
      52 (7%) had APP exposure compared with 65 controls (9%; P = .21). In the matched 
      case-control analysis, there was no association between outpatient APP exposure 
      during chemotherapy and AEs in either cohort (Medicare: OR, 1.06 [95% CI, 0.87 to 
      1.30]; MarketScan: OR, 0.76 [95% CI, 0.50 to 1.14]). CONCLUSION: Our results 
      suggest that team-based APP-physician care that includes an APP who is billing 
      independently, at least for certain patients receiving chemotherapy, may be a 
      viable strategy to safely leverage the scarce oncology workforce to increase 
      access and delivery of cancer care.
FAU - Yen, Tina W F
AU  - Yen TWF
AD  - Medical College of Wisconsin, Milwaukee, WI.
FAU - Nattinger, Ann B
AU  - Nattinger AB
AD  - Medical College of Wisconsin, Milwaukee, WI.
FAU - McGinley, Emily L
AU  - McGinley EL
AD  - Medical College of Wisconsin, Milwaukee, WI.
FAU - Fergestrom, Nicole
AU  - Fergestrom N
AD  - Medical College of Wisconsin, Milwaukee, WI.
FAU - Pezzin, Liliana E
AU  - Pezzin LE
AD  - Medical College of Wisconsin, Milwaukee, WI.
FAU - Laud, Purushottam W
AU  - Laud PW
AD  - Medical College of Wisconsin, Milwaukee, WI.
LA  - eng
GR  - R01 CA170945/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20181010
PL  - United States
TA  - J Oncol Pract
JT  - Journal of oncology practice
JID - 101261852
EDAT- 2018/10/12 06:00
MHDA- 2018/10/12 06:00
CRDT- 2018/10/11 06:00
PHST- 2018/10/11 06:00 [entrez]
PHST- 2018/10/12 06:00 [pubmed]
PHST- 2018/10/12 06:00 [medline]
AID - 10.1200/JOP.18.00277 [doi]
PST - aheadofprint
SO  - J Oncol Pract. 2018 Oct 10:JOP1800277. doi: 10.1200/JOP.18.00277.