Effectiveness of Clinical Pathway in Breast Cancer Patients: A Meta-Analysis

Abstract

Purpose: To evaluate the use of clinical pathways (CPs) for breast cancer when compared with usual medical care. Methods: The Cochrane Library, PubMed, EMBASE, Web of science and four Chinese databases were searched from inception to November 2012 to identify randomized controlled trials (RCTs) that reported the effect of CPs for breast cancer. Two reviewers independently selected studies, extracted data and assessed included studies. The assessment of methodological quality of the included studies was based on the Jadad score. Meta-analyses were performed using RevMan software (version 5.2). Results: Six randomized controlled trials (597 patients) were included. There were 297 patients in the CPs group and 300 patients in the usual medical care group. The results showed that compared with usual medical care, CPs could significantly shorten the length of hospital stay (MD = -3.83d, 95% confidence interval [CI] [-5.20, -2.46]), decreased hospitalization costs (SMD = -3.44, 95%CI, [-4.79, -2.09]) and preoperative hospitalization (MD = -0.56d, 95%CI, [-0.77, -0.34]). There was no statistically difference in patients’ satisfaction (OR =2.39, 95%CI, [1.00, 5.70]) and postoperative complications (OR = 0.34, 95%CI, [0.11, 1.08]). Conclusions: The current evidence showed that CPs could effectively improve the quality of the care provided to the breast cancer patient. It may be able to shorten the length of hospital stay, decreased hospitalization costs and preoperative hospitalization.