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Clinician-reported changes in octreotide prescribing for malignant bowel obstruction as a result of an adequately powered phase III study: A transnational, online survey

Journal Article


Abstract


  • Background: Translating research evidence into clinical practice often has a long lag time. Aim: To determine the impact of a phase III randomised controlled trial on palliative care clinicians��� self-reported practice change. Design: Online survey about use of octreotide in managing inoperable malignant bowel obstruction due to cancer or its treatments distributed in November 2016, 2 years after the first publication of the study in a peer-reviewed journal. Demographic, self-reported practice and the reasons underpinning this were collected. Responses were aggregated to ���practice modified��� or ���practice not modified���. A multinomial regression model explored predictors of practice change. Setting: Members of the Australian New Zealand Society of Palliative Medicine. Results: Response rate was 20.8% (106/509): 55.6% were aged >50 years, 56.5% were female and 77% had previously prescribed octreotide for this clinical indication. Out of 106 respondents, 52 (49.1%) indicated modified practice (60.9% of those who had previously prescribed octreotide in this setting). In those who reported practice change, most frequently octreotide was now used when other therapies failed; for not changing practice, ���more confirmatory evidence was needed��� was most often cited. In the regression model, older age (clinician age = 50���59 years; relative risk = 0.147; 95% confidence interval = 0.024���0.918; p = 0.04) and having practices with lower proportions of people treated with octreotide (0%���20%; relative risk = 0.039; 95% confidence interval = 0.002���0.768; p = 0.033) predicted greater self-reported practice change. Conclusion: Clinician-reported change in practice in the survey is seen in the majority of respondents. This suggests that there is a cohort of ���early adopters��� within palliative care practice as new evidence becomes available.

Publication Date


  • 2018

Citation


  • Campbell, R., McCaffrey, N., Brown, L., Agar, M. R., Clark, K., & Currow, D. C. (2018). Clinician-reported changes in octreotide prescribing for malignant bowel obstruction as a result of an adequately powered phase III study: A transnational, online survey. Palliative Medicine, 32(8), 1363-1368. doi:10.1177/0269216318778460

Scopus Eid


  • 2-s2.0-85047927153

Start Page


  • 1363

End Page


  • 1368

Volume


  • 32

Issue


  • 8

Place Of Publication


Abstract


  • Background: Translating research evidence into clinical practice often has a long lag time. Aim: To determine the impact of a phase III randomised controlled trial on palliative care clinicians��� self-reported practice change. Design: Online survey about use of octreotide in managing inoperable malignant bowel obstruction due to cancer or its treatments distributed in November 2016, 2 years after the first publication of the study in a peer-reviewed journal. Demographic, self-reported practice and the reasons underpinning this were collected. Responses were aggregated to ���practice modified��� or ���practice not modified���. A multinomial regression model explored predictors of practice change. Setting: Members of the Australian New Zealand Society of Palliative Medicine. Results: Response rate was 20.8% (106/509): 55.6% were aged >50 years, 56.5% were female and 77% had previously prescribed octreotide for this clinical indication. Out of 106 respondents, 52 (49.1%) indicated modified practice (60.9% of those who had previously prescribed octreotide in this setting). In those who reported practice change, most frequently octreotide was now used when other therapies failed; for not changing practice, ���more confirmatory evidence was needed��� was most often cited. In the regression model, older age (clinician age = 50���59 years; relative risk = 0.147; 95% confidence interval = 0.024���0.918; p = 0.04) and having practices with lower proportions of people treated with octreotide (0%���20%; relative risk = 0.039; 95% confidence interval = 0.002���0.768; p = 0.033) predicted greater self-reported practice change. Conclusion: Clinician-reported change in practice in the survey is seen in the majority of respondents. This suggests that there is a cohort of ���early adopters��� within palliative care practice as new evidence becomes available.

Publication Date


  • 2018

Citation


  • Campbell, R., McCaffrey, N., Brown, L., Agar, M. R., Clark, K., & Currow, D. C. (2018). Clinician-reported changes in octreotide prescribing for malignant bowel obstruction as a result of an adequately powered phase III study: A transnational, online survey. Palliative Medicine, 32(8), 1363-1368. doi:10.1177/0269216318778460

Scopus Eid


  • 2-s2.0-85047927153

Start Page


  • 1363

End Page


  • 1368

Volume


  • 32

Issue


  • 8

Place Of Publication