Dataset Information

Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results.

ABSTRACT:

Background

Responsible for 25% of all US cancer deaths, lung cancer presents complex care-delivery challenges. Adoption of the highly recommended multidisciplinary care model suffers from a dearth of good quality evidence. Leading up to a prospective comparative-effectiveness study of multidisciplinary vs. serial care, we studied the implementation of a rigorously benchmarked multidisciplinary lung cancer clinic.

Methods

We used a mixed-methods approach to conduct a patient-centered, combined implementation and effectiveness study of a multidisciplinary model of lung cancer care. We established a co-located multidisciplinary clinic to study the implementation of this care-delivery model. We identified and engaged key stakeholders from the onset, used their input to develop the program structure, processes, performance benchmarks, and study endpoints (outcome-related process measures, patient- and caregiver-reported outcomes, survival). In this report, we describe the study design, process of implementation, comparative populations, and how they contrast with patients within the local and regional healthcare system. Trial Registration: ClinicalTrials.gov Identifier: NCT02123797.

Results

Implementation: the multidisciplinary clinic obtained an overall treatment concordance rate of 90% (target >85%). Satisfaction scores were high, with >95% of patients and caregivers rating themselves as being "very satisfied" with all aspects of care from the multidisciplinary team (patient/caregiver response rate >90%). The Reach of the multidisciplinary clinic included a higher proportion of minority patients, more women, and younger patients than the regional population. Comparative effectiveness: The comparative effectiveness trial conducted in the last phase of the study met the planned enrollment per statistical design, with 178 patients in the multidisciplinary arm and 348 in the serial care arm. The multidisciplinary cohort had older age and a higher percentage of racial minorities, with a higher proportion of stage IV patients in the serial care arm.

Conclusions

This study demonstrates a comprehensive implementation of a multidisciplinary model of lung cancer care, which will advance the science behind implementing this much-advocated clinical care model.

SUBMITTER: Smeltzer MP

PROVIDER: S-EPMC5835591 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Publications

Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results.

Smeltzer Matthew P MP Rugless Fedoria E FE Jackson Bianca M BM Berryman Courtney L CL Faris Nicholas R NR Ray Meredith A MA Meadows Meghan M Patel Anita A AA Roark Kristina S KS Kedia Satish K SK DeBon Margaret M MM Crossley Fayre J FJ Oliver Georgia G McHugh Laura M LM Hastings Willeen W Osborne Orion O Osborne Jackie J Ill Toni T Ill Mark M Jones Wynett W Lee Hyo K HK Signore Raymond S RS Fox Roy C RC Li Jingshan J Robbins Edward T ET Ward Kenneth D KD Klesges Lisa M LM Osarogiagbon Raymond U RU

Translational lung cancer research 20180201 1

<h4>Background</h4>Responsible for 25% of all US cancer deaths, lung cancer presents complex care-delivery challenges. Adoption of the highly recommended multidisciplinary care model suffers from a dearth of good quality evidence. Leading up to a prospective comparative-effectiveness study of multidisciplinary <i>vs.</i> serial care, we studied the implementation of a rigorously benchmarked multidisciplinary lung cancer clinic.<h4>Methods</h4>We used a mixed-methods approach to conduct a patient ...[more]

PMID: 29535915

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Dataset Information

Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results.

Background

Methods

Results

Conclusions

Publications

Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results.

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