Coelho Sara, Rego Inês Brandão, Dionísio Maria Rita, Cavaco-Silva Joana, Semedo Patrícia Miguel, Pavão Francisco, Leite Ricardo Baptista, Costa Luís
Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal.
Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal.
Eur J Breast Health. 2020 Apr 1;16(2):91-98. doi: 10.5152/ejbh.2020.5144. eCollection 2020 Apr.
H360 aims to provide a comprehensive picture of breast cancer management in Portugal by retrieving real-world data from 10 Portuguese hospitals and deriving a snapshot from the medical interpretation of evidence-based data to patient perspective on the quality and effectiveness of medical care provided. This article reviews evidence on breast cancer clinical practice and quality of care and disease management in Portugal. A review of evidence on breast cancer clinical practice and quality of care over the last 10 years was performed in PubMed using the query "Organization and Administration"[Mesh] AND "breast cancer"[All Fields] NOT "Review" [ptyp]. National cancer initiatives relevant for quality of care and national and international guidelines and consensus were analyzed. Retrieved results showed that breast cancer incidence is still increasing, including in Portugal. Studies investigating disease outcomes seek to derive improvements to clinical practice and better financial resource allocation. Setting performance measures (KPIs) in institutions treating cancer is not a reality in Portugal yet, but has potential to leverage the quality of clinical performance. A multidisciplinary approach within one health structure is also desirable. More investment in clinical (including academic) research is key to optimize the quality of care. Implementation of clinical practice guidelines (largely based on ESMO guidelines in Portugal) is crucial to improve patient outcomes. Not less importantly, quality of life is a treatment goal on its own in breast cancer care. Breast cancer remains a health challenge and a multidimensional, 360-degree appraisal, beyond the exclusively clinical perspective, may provide new insights towards an optimal patient-centered approach.
H360旨在通过收集来自葡萄牙10家医院的真实世界数据，并从基于证据的数据的医学解读中得出一个快照，以患者视角了解所提供医疗服务的质量和有效性，从而全面呈现葡萄牙乳腺癌管理的情况。本文回顾了葡萄牙乳腺癌临床实践、医疗质量和疾病管理方面的证据。在PubMed上使用查询词“组织与管理”[医学主题词] AND “乳腺癌”[所有字段] NOT “综述”[出版类型]，对过去10年乳腺癌临床实践和医疗质量的证据进行了回顾。分析了与医疗质量相关的国家癌症倡议以及国家和国际指南与共识。检索结果显示，乳腺癌发病率仍在上升，包括在葡萄牙。调查疾病结果的研究旨在改进临床实践并优化财政资源分配。在葡萄牙，癌症治疗机构设定绩效指标（关键绩效指标）尚未成为现实，但有潜力提升临床绩效质量。在一个健康结构内采用多学科方法也是可取的。加大对临床（包括学术）研究的投入是优化医疗质量的关键。实施临床实践指南（在葡萄牙主要基于欧洲肿瘤内科学会指南）对于改善患者预后至关重要。同样重要的是，生活质量本身就是乳腺癌护理中的一个治疗目标。乳腺癌仍然是一项健康挑战，超越单纯临床视角的多维360度评估可能会为以患者为中心的最佳方法提供新的见解。
