Improving the timeliness of care for regional lung cancer patients through the implementation of a web-based lung cancer referral pathway.

IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Zulfiquer Otty, Sarah Larkins, Rebecca Evans, Amy Brown, Sabe Sabesan
{"title":"Improving the timeliness of care for regional lung cancer patients through the implementation of a web-based lung cancer referral pathway.","authors":"Zulfiquer Otty, Sarah Larkins, Rebecca Evans, Amy Brown, Sabe Sabesan","doi":"10.1111/imj.70138","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lung cancer remains a significant public health problem and a leading cause of cancer-related mortality worldwide. The delays in the diagnosis of lung cancer are more pronounced for rural and regional Australians compared to their urban counterparts. Implementing an online HealthPathway is one way to reduce delays in the diagnosis of lung cancer.</p><p><strong>Aim: </strong>The Townsville Lung Cancer Referral Pathway (TLCRP) was implemented to guide local general practitioners (GPs) in the referral process of people with suspected lung cancer. The aim of the study was to compare the time interval from initial GP consultation of the person with suspected lung cancer to the first specialist referral and from the first specialist referral to the initial specialist appointment, before and after implementation of TLCRP. Other lung cancer service outcomes were also compared between the pre- and post-implementation groups.</p><p><strong>Methods: </strong>A retrospective cohort study of 316 participants was conducted, and descriptive statistical analysis of the data was used to discern any difference in timelines and other clinical outcomes in the pre-pathway implementation group compared to the post-pathway implementation group.</p><p><strong>Results: </strong>The time interval from initial GP presentation to initial referral to specialist appointment was significantly reduced in the post-pathway group (15 days) compared to the pre-pathway group (8 days, P = 0.03). However, the time interval from GP referral to initial appointment with a specialist increased in the post-pathway group (15 and 20 days, P = 0.03). Many of the Cancer Australia lung cancer optimal care pathway referral guidelines were not met. Only 40% of the pre-pathway group and 34% of the post-pathway group were seen in the specialist clinic within 2 weeks of GP referral. Significant proportions of patients in both groups did not have chest x-rays ordered by the GP, and the proportion of participants who were appropriately referred to the respiratory clinic did not improve after implementation of TLCRP (76% and 72%). Nearly 30% of participants in both groups were diagnosed after emergency presentation.</p><p><strong>Conclusions: </strong>TLCRP improved the time interval from initial GP consultation to specialist referral, thus meeting its primary objective. However, better strategies are required to improve other timelines and meet Cancer Australia's lung cancer optimal care pathway guidelines.</p>","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/imj.70138","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Lung cancer remains a significant public health problem and a leading cause of cancer-related mortality worldwide. The delays in the diagnosis of lung cancer are more pronounced for rural and regional Australians compared to their urban counterparts. Implementing an online HealthPathway is one way to reduce delays in the diagnosis of lung cancer.

Aim: The Townsville Lung Cancer Referral Pathway (TLCRP) was implemented to guide local general practitioners (GPs) in the referral process of people with suspected lung cancer. The aim of the study was to compare the time interval from initial GP consultation of the person with suspected lung cancer to the first specialist referral and from the first specialist referral to the initial specialist appointment, before and after implementation of TLCRP. Other lung cancer service outcomes were also compared between the pre- and post-implementation groups.

Methods: A retrospective cohort study of 316 participants was conducted, and descriptive statistical analysis of the data was used to discern any difference in timelines and other clinical outcomes in the pre-pathway implementation group compared to the post-pathway implementation group.

Results: The time interval from initial GP presentation to initial referral to specialist appointment was significantly reduced in the post-pathway group (15 days) compared to the pre-pathway group (8 days, P = 0.03). However, the time interval from GP referral to initial appointment with a specialist increased in the post-pathway group (15 and 20 days, P = 0.03). Many of the Cancer Australia lung cancer optimal care pathway referral guidelines were not met. Only 40% of the pre-pathway group and 34% of the post-pathway group were seen in the specialist clinic within 2 weeks of GP referral. Significant proportions of patients in both groups did not have chest x-rays ordered by the GP, and the proportion of participants who were appropriately referred to the respiratory clinic did not improve after implementation of TLCRP (76% and 72%). Nearly 30% of participants in both groups were diagnosed after emergency presentation.

Conclusions: TLCRP improved the time interval from initial GP consultation to specialist referral, thus meeting its primary objective. However, better strategies are required to improve other timelines and meet Cancer Australia's lung cancer optimal care pathway guidelines.

通过实施基于网络的肺癌转诊途径,提高对区域性肺癌患者护理的及时性。
背景:肺癌仍然是一个重要的公共卫生问题,也是世界范围内癌症相关死亡的主要原因。与城市相比,澳大利亚农村和边远地区的肺癌诊断延误更为明显。实施在线健康路径是减少肺癌诊断延误的一种方法。目的:实施汤斯维尔肺癌转诊路径(TLCRP),以指导当地全科医生(gp)在疑似肺癌患者的转诊过程中。该研究的目的是比较从疑似肺癌患者的首次全科医生咨询到首次专家转诊,以及从首次专家转诊到首次专家预约,在实施TLCRP之前和之后的时间间隔。其他肺癌服务结果也在实施前和实施后组之间进行了比较。方法:对316名参与者进行回顾性队列研究,并对数据进行描述性统计分析,以区分路径实施前组与路径实施后组在时间线和其他临床结果上的差异。结果:与路径组(8天,P = 0.03)相比,路径组从首次GP就诊到首次转诊到专家预约的时间间隔(15天)显着减少。然而,从全科医生转介到首次与专家预约的时间间隔在路径组中增加(15天和20天,P = 0.03)。许多癌症澳大利亚肺癌最佳护理途径转诊指南没有得到满足。只有40%的路径前组和34%的路径后组在全科医生转诊后2周内到专科诊所就诊。两组患者中有相当比例的患者没有接受全科医生的胸部x光检查,并且在实施TLCRP后,适当转到呼吸诊所的患者比例没有改善(76%和72%)。两组中近30%的参与者在急诊就诊后被确诊。结论:TLCRP缩短了从首次全科医生咨询到专家转诊的时间间隔,从而达到了其主要目的。然而,需要更好的策略来改善其他时间表,并满足澳大利亚癌症协会的肺癌最佳护理途径指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Internal Medicine Journal
Internal Medicine Journal 医学-医学:内科
CiteScore
3.50
自引率
4.80%
发文量
600
审稿时长
3-6 weeks
期刊介绍: The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信