Disparities in the Use of Oral Anticancer Agents in Kidney Cancer

肾癌口服抗癌药物使用的差异

• 批准号: 10376266
• 负责人: Michaela Ann Dinan
• 金额: $ 37.87万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10376266
• 关键词: Address; Adherence; Adoption; Age; American Medical Association; Antineoplastic Agents; Area; Cancer Patient; Censuses; Chronic; Cities; Clinical; Clinical Data; Clinical Trials; Complex; Data; Data Set; Data Sources; Diagnosis; Disease; Education; Emerging Technologies; Ethnic Origin; Future; Geography; Goals; Health Status; Healthcare Systems; Hospital Referrals; Hospitals; Improve Access; Income; Insurance; Insurance Coverage; Intervention; Intravenous; Investigation; Knowledge; Link; Locales; Malignant Neoplasms; Medical Technology; Medicare; Minority Groups; Modeling; North Carolina; Oral; Outcome; Ownership; Patient-Focused Outcomes; Patients; Pattern; Pharmaceutical Preparations; Physicians; Population; Population Heterogeneity; Privatization; Provider; Race; Randomized Clinical Trials; Registries; Renal Cell Carcinoma; Renal carcinoma; Reporting; Research; Socioeconomic Status; Source; System; Technology; Training; Treatment outcome; Unemployment; United States; Urogenital Cancer; anti-cancer; base; care outcomes; clinical care; comorbidity; cost; data resource; effective therapy; improved; improved outcome; metropolitan; network architecture; novel; patient population; peer influence; population health; provider adoption; provider factors; provider networks; racial disparity; rural area; sex; system architecture; years of life lost; Address; Adherence; Adoption; Age; American Medical Association; Antineoplastic Agents; Area; Cancer Patient; Censuses; Chronic; Cities; Clinical; Clinical Data; Clinical Trials; Complex; Data; Data Set; Data Sources; Diagnosis; Disease; Education; Emerging Technologies; Ethnic Origin; Future; Geography; Goals; Health Status; Healthcare Systems; Hospital Referrals; Hospitals; Improve Access; Income; Insurance; Insurance Coverage; Intervention; Intravenous; Investigation; Knowledge; Link; Locales; Malignant Neoplasms; Medical Technology; Medicare; Minority Groups; Modeling; North Carolina; Oral; Outcome; Ownership; Patient-Focused Outcomes; Patients; Pattern; Pharmaceutical Preparations; Physicians; Population; Population Heterogeneity; Privatization; Provider; Race; Randomized Clinical Trials; Registries; Renal Cell Carcinoma; Renal carcinoma; Reporting; Research; Socioeconomic Status; Source; System; Technology; Training; Treatment outcome; Unemployment; United States; Urogenital Cancer; anti-cancer; base; care outcomes; clinical care; comorbidity; cost; data resource; effective therapy; improved; improved outcome; metropolitan; network architecture; novel; patient population; peer influence; population health; provider adoption; provider factors; provider networks; racial disparity; rural area; sex; system architecture; years of life lost

We have long known that real-world black-white racial disparities have existed in the treatment and outcomes of patients with renal cell carcinoma (RCC). However, it is unclear how these disparities will change with the recent introduction and widespread adoption of oral anticancer agents (OAAs). As with any advance in medical technology, the introduction of these agents has the potential to significantly improve patient outcomes, but also has the potential to exacerbate current disparities if these advances in OAAs are not equally available or do not provide the same benefit to all patients. The proposed study addresses this critical gap in our knowledge by investigating a mix of nationally representative, yet diverse populations of patients with kidney cancer in the United States. Unfortunately, no single dataset of patients with kidney cancer exists that is able to capture nationally-representative data on patients of all ages and all insurance status within the United States. However, by using three complementary data sources we are able to include patients of all ages, insurance, geography, and race to investigate the current and future utilization, outcomes, and costs associated with emerging OAAs in patients with kidney cancer. Aim 1 – Investigate patient-level disparities in OAA use in RCC patients Aim 2 – Investigate provider- and system-level disparities in OAA use in RCC patients.. Aim 3 – Investigate the impact of patient-provider networks (PPNs) on OAA adoption and identify pockets of late or non-adopting providers. The proposed research will (1) assess and describe the current state of oral anticancer medication utilization, delivery, and adherence; (2) identify patient, provider, structural, and systemic barriers to adherence and disparities in outcomes; and (3) develop models and strategies to improve safe and effective delivery of these agents in order to improve access to optimal clinical care and outcomes. .

我们早就知道，治疗中存在现实世界中的黑白种族分布 肾细胞癌（RCC）患者的结果。但是，目前尚不清楚如何 差距将随着最近的介绍和宽度采用口服抗癌的变化而改变 代理商（OAA）。与医疗技术的任何进步一样，这些代理商的引入 有可能显着改善患者的预后，但也有可能 如果OAAS中的这些进步不同样可用或不适用，则会加剧当前分布 为所有患者提供相同的好处。拟议的研究解决了我们的这一关键差距 通过调查国家代表性但潜水员的患者种群的混合来了解知识 在美国患有肾癌。不幸的是，没有肾脏患者的单个数据集 存在癌症，能够捕获有关所有年龄段患者的全国代表性数据 美国境内的保险状况。但是，使用三个完整的数据源 我们能够包括所有年龄，保险，地理和竞赛的患者，以调查 患者的当前和未来利用，结果以及与新兴OAA相关的成本 患有肾癌。 AIM 1 - 研究RCC患者中OAA使用的患者级分布 AIM 2 - 研究RCC患者中OAA使用的提供商和系统级分布。 AIM 3 - 研究患者提供者网络（PPN）对OAA采用和 识别晚期或非补习提供商的口袋。 拟议的研究将（1）评估并描述口服抗癌的当前状态 用药，递送和依从性； （2）确定患者，提供者，结构和 对结果的依从性和分布的系统性障碍； （3）开发模型和 改善这些代理的安全有效交付的策略，以改善获取 最佳的临床护理和结果。 。