Optimal Care Pathways for People with Lung Cancer- a Scoping Review of the Literature

Abstract

Introduction: Much of the existing work around implementation of cancer optimal care pathways (OCP) has either focused exclusively on the clinical elements of care or has targeted individual stages in the cancer trajectory, rather than using a patient-centred or service delivery lens to inform the integration of care across the continuum. This review aimed to identify and summarise the available literature on lung cancer OCP. Methods: A scoping review was conducted, with literature across multiple databases and grey literature searched. Articles were included if the OCP was being used to manage adult patients with lung cancer and reported on either the development process and outcomes and/or barriers and facilitators associated with optimal care pathway development and/or uptake. Results: Of the 381 references screened, 32 articles were included. The lung cancer pathways reviewed varied significantly. A number of themes were identified including the development and implementation of the OCP; the use of quality indicators to audit the OCP; and studies on outcomes of the OCP incorporating timeliness of care delivery, patient experiences and health care utilisation and costs. Conclusions: The limited number of relevant articles found in this review may suggest that an OCP for lung cancer is still in its preliminary stages across the broader health systems.

Prognostic value of symptoms at lung cancer diagnosis: a three-year observational study

“…Our lung cancer FDT is an optimal care pathway. These are structured multidisciplinary care plans for specific clinical conditions, which describe the tasks to be pursued, their timing, sequence and the professionals involved (14). In brief, these pathways chart the optimal journey of patients with suspected lung cancer.…”

“…Our work has been carried out and coordinated from the lung cancer Fast Diagnostic Track (FDT), the optimal care pathway where all patients from our region with suspicion of lung cancer are centralized to perform the diagnosis process. This consists of a structured care plan that aims to provide a management according to the up-to-date evidence with a special focus on tasks, its timing and sequence, to ensure a timely care for lung cancer patients (14). Moreover, this pathway positions us in front of a general lung cancer population from a geographic area, allowing us to perform studies with a "real-life" perspective of healthcare.…”

Improving the quality of patient care in lung cancer: key factors for successful multidisciplinary team working

“…MDT meetings are considered the best practice in management and decision-making for cancer patients worldwide [ 45 ], but this does not automatically turn into improved quality of care [ 46 , 47 ]. Cancer patients utilize a wide range of services from multiple providers at various points during their cancer pathway, requiring integrated care across different organizations and settings over time.…”

Implementing Optimal Care Pathways for Aboriginal and Torres Strait Islander People With Cancer: A Survey of Rural Health Professionals’ Self-Rated Learning Needs

“…From a patient perspective, integrated care enables cancer patients to work with care providers to achieve the outcomes of importance to them [11]. However, OCPs are often defined more narrowly with reference to discrete points in the pathway, focusing more on the sequencing of activities and delineation of professional roles than patient-centred elements [8,12]. In the Australian context, OCPs are currently available for 18 tumour types and map the care pathway with due consideration to current best practice, clinical guidelines, research and clinical consensus.…”

“…OCPs, also known as critical care pathways or integrated care pathways, are complex interventions that support mutual decision-making as well as organisation and standardisation of care to decrease fragmentation and variation in care [7,8]. The European Pathway Association states that OCPs should feature: alignment of care with best practice, patient expectations, and characteristics; facilitate communication between providers, patients, and families; define, sequence and coordinate care roles and activities; track outcomes; and identify appropriate resources [7,9].…”