Multidisciplinary Clinics in Lung Cancer Care: A Systematic Review

Stone, Christopher; Vaid, Haris; Selvam, Rajajee; Ashworth, A.; Robinson, Andrew; Digby, Geneviève C.

doi:10.1016/j.cllc.2018.02.001

Cited by 21 publications

(20 citation statements)

References 22 publications

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“…In our clinic, patients perceived the care received as high quality and able to facilitate positive lifestyle changes. This is similar to qualitative studies of multidisciplinary physician clinics where increased patient satisfaction, increased collaboration and appreciation of patient-centred care have been reported [ 32 , 33 ]. Overall, patients appreciated the integrated team-based approach to their care.…”

Section: Discussionsupporting

confidence: 84%

Implementation of a Multidisciplinary Allied Health Optimisation Clinic for Cancer Patients with Complex Needs

Ray

Beaumont

Loeliger

et al. 2020

JCM

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This study examined the feasibility of implementing a multidisciplinary allied health model of care (MOC) for cancer patients with complex needs. The MOC in this retrospective study provided up to eight weeks of nutritional counselling, exercise prescription, fatigue management and psychological support. Implementation outcomes (acceptability, adoption, fidelity and appropriateness) were evaluated using nine patient interviews, and operational data and medical records of 185 patients referred between August 2017 and December 2018. Adoption, including intention to try and uptake, were acceptable: 88% of referred patients agreed to screening and 71% of eligible patients agreed to clinic participation. Fidelity was mixed, secondary to inpatient admissions and disease progression interrupting patient participation. Clinician compliance with outcome assessment was variable at program commencement (dietetic, 95%; physiotherapy, 91%; occupational therapy, 33%; quality of life, 23%) and low at program completion (dietetic, 32%; physiotherapy, 13%; occupational therapy, 10%; quality of life, 11%) mainly due to non-attendance. Patient interviews revealed high satisfaction and perceived appropriateness. Adoption of the optimisation clinic was acceptable. Interview responses suggest patients feel the clinic is both acceptable and appropriate. This indicates a multidisciplinary model is an important aspect of comprehensive, timely and effective care. However, fidelity was low, secondary to the complexities of the patient cohort.

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Section: Discussionsupporting

confidence: 84%

Implementation of a Multidisciplinary Allied Health Optimisation Clinic for Cancer Patients with Complex Needs

Ray

Beaumont

Loeliger

et al. 2020

JCM

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“…Some patients will not live near specialist units, in which case there must be a structure in place to enable discussion of patient management in teleconferences with an expert centre. • Lung cancer is one of the few cancers for which systematic reviews of multidisciplinary management have been published [83,84], but there was a lack of evidence of a causative effect on outcomes. Benefits for patients of MDTs include concordance with guidelines, an increase of treatment rates, and better patient satisfaction and quality of life, particularly important in patients with metastatic disease.…”

Section: Lung Cancer Units/centres and Mdtsmentioning

confidence: 99%

European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Lung cancer

et al. 2020

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European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC) are written by experts representing all disciplines involved in cancer care in Europe. They give patients, health professionals, managers and policymakers a guide to essential care throughout the patient journey. Lung cancer is the leading cause of cancer mortality and has a wide variation in treatment and outcomes in Europe. It is a major healthcare burden and has complex diagnosis and treatment challenges. Care must only be carried out in lung cancer units or centres that have a core multidisciplinary team (MDT) and an extended team of health professionals detailed here. Such units are far from universal in European countries. To meet European aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.

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“…4 Additionally, patients may perceive better service quality when seen by groups of physicians over a single specialist alone. 2,5…”

Section: Introductionmentioning

confidence: 99%

“…Evidence supports effectiveness of multidisciplinary clinics across a wide spectrum of conditions. Benefits include improving the timeliness of care and patient satisfaction in treating malignant conditions, 2 better achieving of desired targets in chronic kidney disease among children, 3 and obtaining better prognoses in patients treated for amyotrophic lateral sclerosis. 4 Additionally, patients may perceive better service quality when seen by groups of physicians over a single specialist alone.…”

Section: Introductionmentioning

confidence: 99%

“…4 Additionally, patients may perceive better service quality when seen by groups of physicians over a single specialist alone. 2,5 In a health care ecosystem increasingly focused on value, novel approaches to improve care of complex conditions should be studied for their financial feasibility to promote buy-in across stakeholders. Although patient satisfaction of multidisciplinary clinics is evident, there is a paucity of evidence supporting the financial feasibility of such clinics.…”

Section: Introductionmentioning

confidence: 99%

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Cost Analysis of a Multidisciplinary Vascular Anomaly Clinic

Straughan

Mudd

Silva

et al. 2019

Ann Otol Rhinol Laryngol

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Objective: Multidisciplinary vascular anomaly clinics (VACs) offer important value to pediatric patients with complex vascular anomalies whose care overlaps specialties. These clinics are labor intensive and costly to operate since providers see fewer patients compared to their individual specialty clinic. Our North American tertiary care institution’s VAC specialists include a pediatric otolaryngologist, pediatric surgeon, pediatric plastic surgeon, pediatric dermatologist, and interventional radiologist. To assess financial feasibility, we conducted a cost analysis of our VACs comprised of 2 half-day multidisciplinary physician attended clinics (5 specialists at our main campus and 2 specialists at a satellite clinic) and a half-day nurse practitioner clinic. Method: Assessment of net revenue based on net collections for clinic, professional, operative, hospital setting, and facility charges generated during 12 consecutive monthly VACs beginning July 1, 2015. Expense calculations included provider and staff salaries, benefits, supply costs, and clinic leasing costs. Results: There were 469 clinic visits, of which 202 were new patient evaluations. Sixty-eight patients underwent 93 procedures under general anesthesia, including procedures performed by our interventional radiologist, most commonly sclerotherapy or embolization (n = 37), surgical interventions including endoscopy (n = 36), or laser procedures (n = 20). Three patients were admitted. Fifty-seven patients received a new diagnosis different from that for which they were referred. Gross revenue was $1 810 525, and net revenue was 42.5%, or $783 152. Expenses totaled $453 415 for a net positive revenue of $329 737. Conclusion: When including direct downstream revenue, particularly from operative procedures, our VAC program operates on a net positive margin, making the program financially feasible.

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Multidisciplinary Clinics in Lung Cancer Care: A Systematic Review

Cited by 21 publications

References 22 publications

Implementation of a Multidisciplinary Allied Health Optimisation Clinic for Cancer Patients with Complex Needs

Implementation of a Multidisciplinary Allied Health Optimisation Clinic for Cancer Patients with Complex Needs

European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Lung cancer

Cost Analysis of a Multidisciplinary Vascular Anomaly Clinic

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