Author of

• 11946

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  P2.24 - Poster Session 2 - Supportive Care (ID 157)

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

  • 11989

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    P2.24-043 - Developing an optimal best practice model of care for the management of lung cancer in Australia: a national approach (ID 2598)

    09:30 - 09:30  |  Author(s): S. Hirst
    • Abstract

    Background
    In 2007, lung cancer was the leading cause of cancer-related mortality and morbidity in Australia for both men and women. Only 14% of those diagnosed with lung cancer survive five years beyond their diagnosis. People living in rural areas, those from lower socio-economic status or from certain cultural and linguistic backgrounds have poorer outcomes. Factors contributing to differences in survival and outcomes are varied. Cancer Australia is developing a best practice model of care for the management of lung cancer that has national relevance and can be implemented locally, with the aim of achieving consistency in approach and improving lung cancer outcomes. This abstract describes how the evidence base has been built to inform the model of care.

    Methods
    A systematic review of international and national literature on patterns and models of care for lung cancer informed themes explored through qualitative and quantitative research. A tiered approach to data collection included: (i) mapping of lung cancer services across Australia; (ii) health service consultation through interviews and site visits; and (iii) consumer consultation through a national survey and targeted interviews. Findings were presented and discussed at a national workshop with clinical leaders, consumers, researchers and service delivery experts to review and define principles and elements of best practice care.

    Results
    The patterns of care literature for lung cancer identified variations in time to diagnosis, access to active treatment, re-treatment and palliative care. Service delivery themes identified through the review and research included multidisciplinary care, specialist involvement in diagnosis and treatment, care coordination, early integration of palliative care, uptake of guidelines and quality measures, involvement of primary care and consideration of supportive care needs. Lung cancer service mapping identified 192 services across Australia providing some elements of lung cancer care. Approximately two-thirds were public and one third private. Multidisciplinary teams were identified in 58 services (30%), the majority in metropolitan locations (n=41, 71%). Consumer consultation identified variations in time to first specialist appointment (two weeks to two months), definitive diagnosis (two weeks to three months); and treatment (one week to two months). Consumers identified that improvements could be made in the way information about lung cancer is communicated across all stages of lung cancer. Health service consultation highlighted challenges and best practice approaches along with a range of systemic issues that influence how care is delivered. Challenges included streamlining a complex diagnostic pathway, managing multidisciplinary teams that include cancer and non-cancer specialists, early referral to palliative care, coordinating care, involvement of primary care, and a lack of standard guidelines for follow-up care. Best practice examples were identified across the diagnostic and treatment pathway. Results informed a set of national principles including: patient-centred care; timely diagnosis and staging; multidisciplinary care; appropriate treatment and supportive care; coordinated care; and collection and monitoring of data.

    Conclusion
    This research identified gaps and variations in the delivery of lung cancer care and has built the evidence base to inform the development of best practice approaches to support the consistent diagnosis and management of lung cancer in Australia.