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ONCOLOGISTS' BARRIERS AND FACILITATORS FOR ONCOTYPE DX USE: QUALITATIVE STUDY
Megan C Roberts1, Amy Bryson2, Morris Weinberger1
1Health Policy Management,Gillings School of Global Public Health,UNC.
International Journal of Technology Assessment in Health Care
|December 14, 2016
Summary
Oncotype DX (ODX) testing for early-stage breast cancer shows low uptake due to organizational, interpersonal, and intrapersonal factors. Understanding these barriers is key to improving ODX use in treatment decisions.
Area of Science:
- Oncology
- Genomics
- Clinical Decision Making
Background:
- Oncotype DX (ODX) is a gene profiling test for early-stage, hormone receptor-positive breast cancer.
- Clinical guidelines recommend ODX for adjuvant chemotherapy decisions.
- Less than half of eligible patients in the U.S. receive ODX testing, with reasons for low usage unclear.
Purpose of the Study:
- To understand U.S. oncologists' adoption of ODX.
- To explore how oncologists utilize ODX in adjuvant chemotherapy decision-making.
Main Methods:
- Semi-structured phone interviews with 30+ oncologists in one U.S. state.
- Purposive sampling of oncologists seeing ≥5 breast cancer patients weekly.
- Thematic analysis of recorded and transcribed interviews.
Main Results:
- Organizational factors (department, marketing, guidelines) impact ODX use.
- Interpersonal factors (peer influence, normative beliefs) affect oncologist practices.
- Intrapersonal factors (attitudes, perceived barriers, research gaps) were identified; challenges include interpreting intermediate scores and explaining results to patients.
Conclusions:
- Multi-level factors influence ODX uptake in clinical practice.
- Identifying facilitators and modifiable barriers can improve ODX utilization.
- Understanding ODX use is crucial as more genomic tests enter cancer care.
