Pearson Sally Anne, Taylor Sally, Marsden Antonia, Yorke Janelle
Division of Nursing, Midwifery and Social Work, University of Manchester, Oxford Rd, Manchester, M13 9PL, UK.
Christie Patient Centred Research, The Christie NHS Foundation Trust, 550 Wilmslow Road, Manchester, M20 4BX, UK.
Syst Rev. 2021 Jul 23;10(1):209. doi: 10.1186/s13643-021-01761-y.
It is well recognised that access and receipt of appropriate guideline recommended treatment with systemic anti-cancer therapies for secondary breast cancer is a key determinant in overall survival. Where there is disparity in access this may result in unwarranted variation and disparity in outcomes. Individual, clinical and wider contextual factors have been associated with these disparities, however this remains poorly understood for women with secondary breast cancer. The purpose of the review is to examine individual, clinical and contextual factors which influence access to evidence-based systemic anti-cancer therapies for women with secondary breast cancer. This will include barriers and facilitators for access and receipt of treatment and an exploration of women and clinicians experience and perspectives on access.
A mixed methods approach with a segregated design will be used to examine and explore factors which influence access to systemic anti-cancer therapies for women with secondary breast cancer. Electronic databases to be searched from January 2000 onwards will be EBSCO CINAHL Plus, Ovid MEDLINE, Ovid EMBASE, PsychINFO and the Cochrane Library and JBI database. This will include NHS Evidence which will be searched for unpublished studies and gray literature. Title and abstract citations and full-text articles will be screened by the author and second reviewer. Data will be extracted by the author and validated by the second reviewer. An overarching synthesis will be produced which brings together quantitative and qualitative findings. Methodological quality and risk of bias will be assessed using the Mixed Methods Appraisal Tool.
Understanding individual, clinical and wider contextual factors associated with access and receipt of systemic anti-cancer therapies for secondary breast cancer is a complex phenomenon. These will be examined to determine any association with access. Review findings will be used to guide future research in this area and the development of an evidence-based service level intervention designed to address unwarranted variation in access based upon the Medical Research Council (MRC) approach to the development, implementation and evaluation of complex interventions.
The review protocol has been registered in PROSPERO CRD42020196490 .
众所周知，获得并接受针对继发性乳腺癌的系统抗癌疗法的适当指南推荐治疗是总体生存的关键决定因素。在获得治疗方面存在差异的情况下，这可能导致结果出现不必要的差异。个体、临床和更广泛的背景因素与这些差异有关，然而对于继发性乳腺癌女性患者，这一点仍了解甚少。本综述的目的是研究影响继发性乳腺癌女性患者获得循证系统抗癌疗法的个体、临床和背景因素。这将包括获得和接受治疗的障碍与促进因素，并探索女性患者和临床医生在获得治疗方面的经历与观点。
将采用一种具有分离设计的混合方法来研究和探索影响继发性乳腺癌女性患者获得系统抗癌疗法的因素。从2000年1月起将检索的电子数据库包括EBSCO CINAHL Plus、Ovid MEDLINE、Ovid EMBASE、PsychINFO、Cochrane图书馆和JBI数据库。这将包括NHS Evidence，将检索其中的未发表研究和灰色文献。标题和摘要引文以及全文文章将由作者和第二位审阅者进行筛选。数据将由作者提取并由第二位审阅者进行验证。将进行一项总体综合分析，汇集定量和定性研究结果。将使用混合方法评估工具评估方法学质量和偏倚风险。
了解与继发性乳腺癌系统抗癌疗法的获得和接受相关的个体、临床和更广泛的背景因素是一个复杂的现象。将对这些因素进行研究以确定与获得治疗之间的任何关联。综述结果将用于指导该领域的未来研究以及基于医学研究理事会（MRC）开发、实施和评估复杂干预措施的方法设计循证服务水平干预措施，以解决获得治疗方面不必要的差异。
该综述方案已在PROSPERO注册，注册号为CRD42020196490 。
