@article{TLCR18442,
author = {Matthew P. Smeltzer and Fedoria E. Rugless and Bianca M. Jackson and Courtney L. Berryman and Nicholas R. Faris and Meredith A. Ray and Meghan Meadows and Anita A. Patel and Kristina S. Roark and Satish K. Kedia and Margaret M. DeBon and Fayre J. Crossley and Georgia Oliver and Laura M. McHugh and Willeen Hastings and Orion Osborne and Jackie Osborne and Toni Ill and Mark Ill and Wynett Jones and Hyo K. Lee and Raymond S. Signore and Roy C. Fox and Jingshan Li and Edward T. Robbins and Kenneth D. Ward and Lisa M. Klesges and Raymond U. Osarogiagbon},
title = {Pragmatic trial of a multidisciplinary lung cancer care model in a community healthcare setting: study design, implementation evaluation, and baseline clinical results},
journal = {Translational Lung Cancer Research},
volume = {7},
number = {1},
year = {2018},
keywords = {},
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.},
issn = {2226-4477}, url = {https://tlcr.amegroups.org/article/view/18442}
}