Author of

• 11905

  +

  P2.20 - Poster Session 2 - Early Detection and Screening (ID 173)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Imaging, Staging & Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11913

    +

    P2.20-008 - Investigating symptoms of lung cancer: an evidence-based guide for general practitioners (ID 2632)

    09:30 - 09:30  |  Author(s): P. Hastings
    • Abstract

    Background
    Early diagnosis and referral to specialist treatment are critical factors in the management of lung cancer. Survival is improved when lung cancer is diagnosed at an early stage and the patient is referred to a multidisciplinary specialist lung cancer team for diagnosis, staging and treatment planning. However, as symptoms can be non-specific and often present similarly to other chronic health issues, an early diagnosis of lung cancer may be missed. Patients with symptoms of lung cancer are likely to present to their general practitioner (GP). Therefore, it is important to enhance awareness of the risk factors, signs and symptoms of lung cancer, and provide GPs with the most recent evidence to facilitate timely and effective assessment and appropriate referrals. Cancer Australia commissioned Monash University (MU) to develop an evidence-based guide for GPs (the Guide), and to develop strategies for promoting uptake of the Guide.

    Methods
    An Expert Advisory Panel (EAP) was established to oversee development of the Guide, using the ADAPTE framework for guideline adaptation. Following a search of the literature to identify potentially relevant guidelines and shortlisting using the Appraisal of Guidelines for Research and Evaluation instrument (AGREE), three international guidelines (UK, NZGG, USA) were selected to inform development of the GP Guide. MU conducted interviews with GPs to assess the feasibility of incorporating the Guide into a computerised decision support tool for the GP setting. An evidence-based, multifaceted approach to promoting the Guide and supporting uptake of best practice cancer care within the general practice setting is ongoing, in consultation with a Project Working Group. The approach includes development and implementation of an Active Learning Module (ALM) and workshops for primary care providers and organisations.

    Results
    The Guide includes 24 recommendations focusing on key topics including: risk factors and symptoms of lung cancer; appropriate investigations in primary care; and effective referral to a specialist linked to a lung cancer multidisciplinary team and services. The Guide was published on the Cancer Australia website and disseminated to GPs throughout Australia. The feasibility assessment found that GPs’ consultation styles did not support additional online ‘pop-up’ reminders, preferring to access the Guide external to patient consultations. Incorporation of the Guide into an appropriate format is ongoing. The ALM provides a structured learning activity in an online, interactive format, providing further detail and context to using the Guide in the primary care setting. The ALM includes case-based learning, literature for further reading, and reflection and reinforcing activities. Workshops for GPs have been held to promote and support implementation of the Guide, including strategies to adopt the Guide’s recommendations in practice. Train-the-Trainer workshops have commenced with primary care providers. Evaluation of the uptake of the Guide into clinical practice is currently unavailable.

    Conclusion
    A new evidence-based guide is available to support GPs to assess symptoms that may be lung cancer, to undertake appropriate investigations, and to support rapid referral into the cancer care pathway. The evidence-based, multifaceted implementation strategy supports the translation of the evidence into best practice cancer care.