Implementation of a multifaceted program to improve uptake of guideline recommendations for adolescent and young adults (AYAs) with acute lymphoblastic leukemia (ALL).

50Background: ALL is one of the most common malignancies in the AYA population (age 15-39) and is associated with poor survival in AYAs when compared with children. There is compelling evidence demonstrating a survival benefit for AYAs treated with pediatric regimens vs adult regimens, and guidelines from the National Comprehensive Cancer Network now recommend consideration of pediatric inspired treatment. However, uptake has been suboptimal, with only 25%-35% of AYAs with ALL receiving a pediatric regimen in the U.S. There are several potential barriers to uptake, including lack of knowledge and guidance about the recommendations. For this study, we implemented and evaluated a multi-faceted program to improve uptake in a large health care system, Kaiser Permanente Southern California (KPSC), with 14 medical centers across the region. Methods: The program was initiated regionally in 2013 across all 14 medical centers. Content included education of clinical leaders, rapid identification of newly diagnosed ...