Dr Burke on CLL Treatment Challenges in Community vs Academic Health Care Settings

“There’s likely a difference in patient demographics between community practice and academic centers.… But I think there are a lot of similarities—even academic doctors face the same sort of challenges when prescribing these medicines.”

John M. Burke, MD, a hematologist and medical oncologist at Rocky Mountain Cancer Centers, discussed the different challenges associated with venetoclax (Venclexta) administration in chronic lymphocytic leukemia (CLL) that health care practitioners (HCPs) face between community and academic oncology settings.

A community-based survey used insights from US HCPs to inform best practices for overcoming challenges associated with initiating first-line venetoclax treatment in patients with CLL. This survey gathered responses from 103 HCPs who were currently treating at least 1 patient with CLL with venetoclax. In total, 91% of responders were physicians, and 94% reported initiating venetoclax in their practice.

Overall, the surveyed HCPs reported that in their experience, the best practices to overcome venetoclax administration challenges include providing patient support, managing laboratory logistics, intentionally selecting laboratory locations, managing workflows, and coordinating their entire health care teams. Additionally, most HCPs who implemented venetoclax were using these best practices, changing their infrastructure, or using educational resources to successfully support the initiation of this CLL management strategy.

Some of the most notable differences between academic and community oncology settings that may affect patient care are those regarding patient populations and geographic distribution, Burke stated. Academic medical centers are typically located in urban areas and tend to manage a high volume of patients, whereas community practices are more often situated in rural or less densely populated regions, he explained. Consequently, receiving care in community settings may require longer travel times for patients, according to Burke.

Despite these differences between the 2 settings, core challenges—including navigating insurance approvals, managing treatment logistics, and ensuring patient access to novel therapies—are shared across both practice environments, Burke explained. Overall, academic HCPs, like those in community practice, frequently encounter obstacles when attempting to prescribe venetoclax to patients with CLL, he concluded.