BackgroundImproving access to better, more efficient, and rapid cancer diagnosis is a necessary component of a highquality cancer system. How diagnostic services ought to be organized, structured, and evaluated is less understood and studied. Our objective was to address this gap.
MethodsAs a quality initiative of Cancer Care Ontario's Program in Evidence-Based Care, the Diagnostic Assessment Standards Panel, with representation from clinical oncology experts, institutional and clinical administrative leaders, health service researchers, and methodologists, conducted a systematic review and a targeted environmental scan of the unpublished literature. Standards were developed based on expert consensus opinion informed by the identified evidence. Through external review, clinicians and administrators across Ontario were given the opportunity to provide feedback.
ResultsThe body of evidence consists of thirty-five published studies and fifteen unpublished guidance documents. The evidence and consensus opinion consistently favoured an organized, centralized system with multidisciplinary team membership as the optimal approach for the delivery of diagnostic cancer assessment services. Independent external stakeholders agreed (with higher mean values, maximum 5, indicating stronger agreement) that dap standards are
Background/Objective:
Collaboration between community pharmacists and physicians with respect to drug therapy management occurs relatively infrequently. There has been little research on physicians' views about such collaboration. The primary objective of this study was to assess Ontario family physicians' attitudes and readiness to collaborate with community pharmacists on drug therapy management.
Methods:
A 3-page survey instrument inquiring about 3 collaborative behaviours was distributed by fax or mail to a random sample of 848 family physicians and general practitioners across Ontario. Nonrespondents received 2 reminders.
Results:
The survey response rate was 36%. Most physicians reported conversing with a community pharmacist about a patient's drug therapy management 5 or fewer times per week, and very few said they used pharmacists as their primary source of medication information. Eighty-four percent reported that they regularly took community pharmacists' phone calls, while 78% reported that they sometimes sought pharmacists' recommendations regarding patient drug therapy. Only 28% reported that they sometimes referred their patients to community pharmacists for medication reviews, with 44% being unaware that such a service existed. Most comments were favourable, typically providing positive examples of collaboration with pharmacists. The most important identified advantage of collaborating with community pharmacists was more accurate medication lists. The main disadvantage identified was that pharmacists are constrained by not having access to key patient information (e.g., diagnosis, lab results, consultant reports). Additional barriers to collaboration reported by physicians included rotating pharmacists and perceived pharmacist interference with physicians' drug therapy plans.
Conclusion:
Overall, Ontario family physicians were engaged in limited collaboration with community pharmacists. By making an effort to increase the frequency of their direct professional interactions with physicians, pharmacists can enhance physician awareness of their willingness to provide patient-oriented services, thus facilitating collaboration.
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