scholarly journals Lung cancer care trajectory at a Canadian centre: an evaluation of how wait times affect clinical outcomes

2017 ◽  
Vol 24 (5) ◽  
pp. 302 ◽  
Author(s):  
G. Kasymjanova ◽  
D. Small ◽  
V. Cohen ◽  
R.T. Jagoe ◽  
G. Batist ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Patient Outcomes ◽  
Cancer Care ◽  
Wait Time ◽  
Treatment Modalities ◽  
Wait Times ◽  
Model Of Care ◽  
Time Intervals ◽  
Lung Cancer Patients

Background Lung cancer continues to be one of the most common cancers in Canada, with approximately 28,400 new cases diagnosed each year. Although timely care can contribute substantially to quality of life for patients, it remains unclear whether it also improves patient outcomes. In this work, we used a set of quality indicators that aim to describe the quality of care in lung cancer patients. We assessed adherence with existing guidelines for timeliness of lung cancer care and concordance with existing standards of treatment, and we examined the association between timeliness of care and lung cancer survival.Methods Patients with lung cancer diagnosed between 2010 and 2015 were identified from the Pulmonary Division Lung Cancer Registry at our centre.Results We demonstrated that the interdisciplinary pulmonary oncology service successfully treated most of its patients within the recommended wait times. However, there is still work to be done to decrease variation in wait time. Our results demonstrate a significant association between wait time and survival, supporting the need for clinicians to optimize the patient care trajectory.Interpretation It would be helpful for Canadian clinicians treating patients with lung cancer to have wait time guidelines for all treatment modalities, together with standard definitions for all time intervals. Any reductions in wait times should be balanced against the need for thorough investigation before initiating treatment. We believe that our unique model of care leads to an acceleration of diagnostic steps. Avoiding any delay associated with referral to a medical oncologist for treatment could be an acceptable strategy with respect to reducing wait time.

scholarly journals Wait times in the management of non–small cell lung carcinoma before, during and after regionalization of lung cancer care: a high-resolution analysis

2021 ◽  
Vol 64 (2) ◽  
pp. E218-E227
Author(s):  
Saad Shakeel ◽  
Mankeeran Dhanoa ◽  
Omar Khan ◽  
Pooya Dibajnia ◽  
Noori Akhtar-Danesh ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Carcinoma ◽  
Cancer Care ◽  
Physician Visit ◽  
Small Cell Lung Carcinoma ◽  
Wait Time ◽  
Small Cell ◽  
Wait Times ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma

Background: Timeliness can have a substantial effect on treatment outcomes, prognosis and quality of life for patients with lung cancer. We sought to evaluate changes in wait times for patients with non–small cell lung carcinoma (NSCLC) and to identify bottlenecks in cancer care. Methods: We included patients who received treatment with curative intent or palliative treatment for NSCLC, diagnosed through mediastinal staging by a thoracic surgeon. Data were collected from 3 cohorts over 3 time periods: before the regionalization of lung cancer care (2005–2007, C1), immediately postregionalization (2011–2013, C2) and 5 years after regionalization (2016–2017, C3). Total wait time and delays along treatment pathways were compared across cohorts using multivariate Cox proportionality models. Results: Our total sample size was 299 patients. Overall, there was no significant difference in total wait time among the 3 cohorts. However, wait time from symptom onset to first physician visit significantly increased in C3 compared with C2 (hazard ratio [HR] 0.41, p < 0.01) and C1 (HR 0.43, p < 0.01). Time from first physician visit to computed tomography (CT) scan significantly decreased in C3 compared with C2 (HR 1.54, p < 0.01). Time from abnormal CT scan to first surgeon visit also significantly decreased in C2 (HR 1.43, p < 0.01) and C3 (HR 4.47, p < 0.01) compared with C1, and between C3 and C2 (HR 2.67, p < 0.01). In contrast, time from first surgeon visit to completion of staging significantly increased in C2 (HR 0.36, p < 0.01) and C3 (HR 0.24, p < 0.01) compared with C1, as well as between C3 and C2 (HR 0.60, p < 0.01). Time to first treatment after completion of staging was significantly shorter for C3 than C1 (HR 1.58, p < 0.01). Conclusion: Trends toward a reduction in wait time are evident 5 years after the regionalization of lung cancer care, primarily led by shorter wait times for CT scans and thoracic surgeon consults. However, wait times can further be reduced by addressing delays in staging completion and patient and provider education to identify the early signs of NSCLC.

scholarly journals Examining the Association Between Referral Quality, Wait Time and Patient Outcomes for Patients Referred to an IBD Specialty Program

2019 ◽  
Vol 3 (4) ◽  
pp. 154-161
Author(s):  
Holly Mathias ◽  
Courtney Heisler ◽  
Julia Morrison, ◽  
Barbara Currie ◽  
Kelly Phalen-Kelly ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Wait Time ◽  
Wait Times ◽  
Poor Patient ◽  
Appropriate Care ◽  
Timely Access ◽  
High Quality Information ◽  
Inflammatory Bowel ◽  
To Receive

Abstract Background Most speciality inflammatory bowel disease (IBD) care can only be accessed through a referral. Timely access to specialty care has been associated with improved disease-related outcomes. To receive appropriate care, the referral needs to include high-quality information. To date, no research has explored the association between referral quality and IBD patient outcomes. The study objectives were to determine if the quality of referrals to a collaborative IBD program influenced triage accuracy, wait times and patient outcomes. Methods Two hundred referrals to a collaborative IBD program in Canada for patients with confirmed or suspected IBD were reviewed. Referral quality was evaluated using an evidence- and consensus-based metric. The association between referral quality and patient outcomes (wait time, hospitalizations, disease flares and additional referrals) for semi-urgent referrals was assessed through multivariate analysis. Results The majority of referrals for IBD speciality care were categorized as being low quality. Referral quality was not significantly associated with any of the patient outcomes; however, longer wait times significantly increased the occurrence of disease flares, hospitalizations and additional referrals while waiting for an IBD specialist appointment. Conclusion Prolonged wait times for IBD patients are significantly associated with poor patient outcomes and increased costs for the health care system. Although there is literature that suggests that referral quality may be associated with wait time, it is still unclear how it relates to wait time and patient outcomes. Moving forward, the current referral process needs to be critically addressed in order to improve wait times and patient outcomes.

Patient and caregiver’s satisfaction with multidisciplinary vs. serial lung cancer care in a community setting.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 200-200
Author(s):  
Huibo Shao ◽  
Nicholas Faris ◽  
Meghan Brooke Taylor ◽  
Carrie Fehnel ◽  
Anita Patel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Care Delivery ◽  
Financial Burden ◽  
Treatment Plan ◽  
Hospital System ◽  
Team Members ◽  
Lung Cancer Patients

200 Background: Few existing studies examined lung cancer patients and caregivers’ satisfaction with the team-based multidisciplinary care (MD) in comparison to the usual serial care (SC). We hypothesized that MD, by providing early and concurrent input from key specialists collaborating as a team with patients and caregivers to develop a consensus care plan, can improve patients and caregivers’ satisfaction with care, compared to SC, in which multiple specialists independently screen, diagnose, and treat patients through a fragmented sequence of referrals. Methods: Data on newly diagnosed lung cancer patients, enrolled in a prospective matched cohort comparative effectiveness trial of MD or SC between Oct. 9th, 2014 and July 5th, 2017 in a Mid-South community hospital system, were collected at baseline, 3- and 6-month periods to assess patient and caregiver’s satisfaction with these two care-delivery models. Measures of satisfaction were adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Multivariate mixed linear models were used to examine the cross-group differences, the time-related variances, and how the interaction between groups and time-periods influenced patients’ and caregivers’ satisfaction. Results: Compared with SC (N = 297), patients in MD (N = 159) were older (66 vs. 69 years), more in an early cancer stage (33% vs. 41% in stage I or II), and lower in performance score (35% vs. 45% asymptomatic). Demographic and social-economic characteristics of caregivers in MD (N = 97) and SC (N = 122) were not significantly different. Patients and caregivers in MD were more likely than those in SC to perceive their care to be better than that received by other patients (p =.003 and p <.001 respectively). Greater satisfaction with their treatment plan at 6-month was observed among the MD patients (p =.004). Also, MD patients reported better overall satisfaction with team members (p =.038). Consistent with the findings among the patients in MD, caregivers in MD were more satisfied with the quality of care (p <.001) and with care received from team members (p <.001) than that reported by caregivers in SC. Conclusions: Coordinated MD care improved patients and caregivers’ satisfaction with lung cancer care in a community healthcare system. Further research will compare the quality of life and financial burden on patients in the MD and SC treatment models to provide more evidence for stakeholders to refine cancer care models.

'I had to tell my GP I had lung cancer': patient perspectives of hospital- and community-based lung cancer care

2020 ◽  
Vol 26 (2) ◽  
pp. 147
Author(s):  
Tara Nababan ◽  
Anke Hoskins ◽  
Emily Watters ◽  
Jeanie Leong ◽  
Christobel Saunders ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Treatment ◽  
Cancer Care ◽  
Healthcare Providers ◽  
Phenomenological Approach ◽  
Active Member ◽  
Community Based ◽  
Lung Cancer Patients ◽  
Healthcare Settings

Lung cancer care spans both hospital- and community-based healthcare settings, and suboptimal communication between healthcare providers impacts on continuity and quality of care. Patients’ experiences regarding: (1) communication between healthcare providers; and (2) the role of their GP during cancer treatment was explored in interviews with 47 Western Australian lung cancer patients. Thematic analysis using a phenomenological approach was undertaken to derive key themes regarding participant experiences. Poor communication between hospital cancer specialists (HCSs) influenced participants’ treatment choices and perceptions of the quality of their care. Information provided by HCSs to GPs was often delayed or incomplete, and many participants perceived themselves as a messenger between healthcare settings. Participants’ opinions about the GP role during cancer treatment ranged from ‘no role’ to an ‘active member of the treating team’. A new model of cancer care is needed where the GP is considered part of the treating team. Early involvement of GPs and two-way communication between hospital and primary care during the disease continuum is required for this to occur.

Role of Erlotinib in Influencing the Quality of Life of Cancer Patients

2020 ◽  
Vol 07 ◽  
Author(s):  
Deepika Purohit ◽  
Parijat Pandey
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Cancer Patients ◽  
Kinase Inhibitors ◽  
Treatment Modalities ◽  
Pancreatic Cancers ◽  
Review Reports ◽  
Causes Of Deaths

Background:: Cancer is one of the significant causes of morbidity and mortality in patients globally. Lung cancer, among other cancers, remains to be one of the principal causes of deaths in both men and women. The most common type of lung cancer is the non-small-cell lung cancer (NSCLC). Apart from lung cancer, pancreatic cancer is also one of the common cancers currently. Objective:: The assessment of QoL in erlotinib-treated patients can also prove to be very useful in the establishment of this drug as the main treatment option for the patients with pancreatic and lung cancer. Methods:: Therapies that target EGFR-mediated signalling are the latest keystones for treating these two types of cancers. They comprise of two main treatment modalities: firstly, against the extracellular fields, that include monoclonal antibodies and secondly, mechanisms that create interferences in the signalling pathways, primarily the small molecule tyrosine kinase inhibitors. Results:: Quality of life (QoL) is one of the key advantages in erlotinib therapy over chemotherapy. Conclusion:: The present review reports the role of erlotinib in improving the quality of life of cancer patients especially in NSCLC and pancreatic cancers. The studies or trials establishing the relations between erlotinib and QoL are discussed in detail in this review.

Selecting a PRO-CTCAE based subset for patient reported symptom monitoring during lung cancer treatment (Preprint)

2020 ◽  
Author(s):  
Evalien Veldhuijzen ◽  
Iris Walraven ◽  
Jose Belderbos
Keyword(s):  
Lung Cancer ◽  
Clinical Practice ◽  
Cancer Patients ◽  
Treatment Modalities ◽  
European Organization ◽  
Specific Patient ◽  
Symptom Monitoring ◽  
Lung Cancer Patients ◽  
Wide Range ◽  
Patient Reported

BACKGROUND The Patient Reported Outcomes Version of the Common Terminology Criteria of Adverse Events (PRO-CTCAE) item library covers a wide range of symptoms relevant for oncology care. To enable implementation of PRO-CTCAE-based symptom monitoring in clinical practice, there is a need to select a subset of items relevant for specific patient populations. OBJECTIVE The aim of this study was to develop a PRO-CTCAE subset relevant for patients with lung cancer. METHODS The PRO-CTCAE-based subset for lung cancer patients was generated using a mixed methods approach based on the European Organization for Research and Treatment of Cancer (EORTC) guidelines for developing questionnaires, consisting of a literature review and semi-structured interviews with both lung cancer patients and health care practitioners (HCPs). Both patients and HCPs were queried on the relevance and impact of all PRO-CTCAE items. Results were summarized and, after a final round of expert review, a selection of clinically relevant items for lung cancer patients was made. RESULTS A heterogeneous group of lung cancer patients (n=25) from different treatment modalities and HCPs (n=22) participated in the study. A final list of eight relevant PRO-CTCAE items was created: decreased appetite, cough, shortness of breath, fatigue, constipation, nausea, sadness, and pain (general). CONCLUSIONS Based on literature and both professional and patient input, a subset of PRO-CTCAE items has been identified for use in lung cancer patients in clinical practice. Future work is needed to confirm the validity and effectiveness of this PRO-CTCAE lung cancer subset internationally, and in the real-world clinical practice setting.

scholarly journals Integrative Treatment of Lung Cancer Patients: Observational Study of 57 Cases

2021 ◽  
Author(s):  
Lorenzo Anelli ◽  
Alessia Di Nardo ◽  
Massimo Bonucci
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Immune Status ◽  
Conventional Medicine ◽  
Integrative Therapy ◽  
Lung Cancer Patients ◽  
Retrospective Clinical Study

Abstract Introduction A retrospective clinical study was performed to identify the characteristics of patients with lung cancer treated with integrative cancer treatment in addition to conventional medicine. Materials and Methods We reviewed medical records for lung cancer patients who visited a single integrative setting in Rome, Italy. A total of 57 patients were included, and the majority had advanced-stage cancer. All of them underwent integrative therapy with nutrition and phytotherapy indications. The diet was designed to reduce most of possible factors promoting cancer proliferation, inflammation, and obesity. Foods with anti-inflammatory, prebiotic, antioxidant, and anticancer properties had been chosen. Herbal supplements with known effects on lung cancer were prescribed. In particular, astragal, apigenine, fucosterol, polydatin, epigallocatechin gallate, cannabis, curcumin, and inositol were used. Furthermore, medical mushrooms and other substances were used to improve the immune system and to reduce chemotherapy side effects. Five key parameters have been evaluated for 2 years starting at the first surgery: nutritional status, immune status, discontinuation of therapy, quality of life, and prognosis of the disease. Results A relevant improvement in parameters relative to nutritional status, immune status, and quality of life has been observed after integrative therapy compared with the same parameters at the first medical visit before starting such approach. Conclusion The results suggest that integrative therapy may have benefits in patients with lung cancer. Even though there are limitations, the study suggests that integrative therapy could improve nutritional status and quality of life, with possible positive effect on overall survival.

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