Physicians’ attitudes and perceived barriers to adherence to the national breast cancer clinical practice guidelines in Mexico: a survey study

Bertha Alejandra Martinez-Cannon, Enrique Soto-Perez-de-Celis, Aura Erazo Valle-Solis, Claudia Arce-Salinas, Enrique Bargallo-Rocha, Veronica Bautista-Piña, Guadalupe Cervantes-Sanchez, Christian Haydeé Flores-Balcázar, Maria del Carmen Lara Tamburrino, Ana Lluch, Antonio Maffuz-Aziz, Victor Manuel Pérez-Sánchez, Adela Poitevin-Chacón, Efraín Salas-González, Laura Torrecillas Torres, Vicente Valero, Yolanda Villaseñor-Navarro, Jesús Cárdenas-Sánchez

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Adherence to clinical practice guidelines improves outcomes for patients with breast cancer. However, their implementation may not be feasible in low- and middle-income countries. This study aimed to evaluate physicians’ adherence, attitudes, and barriers towards the Colima Consensus, which is the Mexican national breast cancer clinical practice guideline. Methods: A cross-sectional, 31-item survey was e-mailed to Consensus attendees and members of the Mexican Society of Oncology and Mexican Mastology Association. Descriptive statistics, univariate, and multivariate analysis were used to analyze the associations between participants’ characteristics, adherence, attitudes, and barriers. Results: Of 439 respondents, 78% percent adhered to Consensus recommendations and 94% believed it was applicable to their clinical practice. Forty percent reported using the Consensus as their sole breast cancer guideline. This was associated with being a surgical oncologist (OR 3.3, 95% CI 2.0–5.3) and practicing at a public hospital (OR 2.1, 95% CI 1.2–3.7). The most common barriers to adherence were lack of resources and logistical problems. Regarding attitudes towards the Consensus, 90% considered it a good educational tool, 89% considered it a reliable source of information, and 90% thought it improved quality of care. Conclusions: We showed high levels of adherence and positive attitudes towards the Colima Consensus, with a significant proportion of physicians using it as their only guideline. Lack of resources and logistical issues were the main barriers to adherence. Our results highlight the relevance of local breast cancer guidelines and suggest a need for the creation of resource-stratified guidelines.

Original languageEnglish (US)
Pages (from-to)151-159
Number of pages9
JournalClinical and Translational Oncology
Volume25
Issue number1
DOIs
StatePublished - Jan 2023

Keywords

  • Adherence
  • Breast cancer
  • Clinical practice guidelines
  • Limited-resource settings
  • Low- and middle-income countries

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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