Adherence to quality indicators low in chronic myeloid leukemia

For newly diagnosed chronic-phase chronic myeloid leukemia (CML) patients, adherence to guideline-based quality indicators is low, according to a study published online Nov. 11 in Leukemia & Lymphoma.

Geneviève I.C.G. Ector, M.D., Ph.D., from Radboud University Medical Center in Nijmegen, Netherlands, and colleagues obtained data from population-based registries in the Netherlands for 405 patients newly diagnosed with chronic-phase CML from January 2008 to April 2013. The study focused on adherence to seven quality indicators: one diagnostic, one therapeutic, and five monitoring.

The researchers found that for diagnostic and therapeutic indicators, the compliance rates were 83 and 78 percent, respectively. Compliance with monitoring indicators was lower: 21 to 27 percent for indicators concerning the first year and 58 and 62 percent for indicators concerning the second and third years, respectively. Noncompliance was mainly due to nontimely monitoring. Six percent of cases complied with all indicators, while 20 cases did not comply with any indicator. Overall survival rates did not differ significantly between the groups after adjustment for age.

"The lack of compliance offers room for improvement of clinical care and underscores the need for guidelines and their implementation tailored to real-life practice," the authors write. "To overcome this gap, we need a dynamic process of quality improvement in which compliance to process indicators can be used to evaluate the feasibility and subsequently adjust guidelines to clinical practice."