Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Translation of Lung Multidisciplinary Team Meeting Recommendations into Clinical Practice (#259)

Kirsten J Duggan 1 2 , Jesmin Shafiq 1 3 4 , Sandra Avery 5 , Nasreen Kaadan 1 2 , Shalini K Vinod 4 6
  1. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  2. SWSLHD Clinical Cancer Registry, Liverpool, NSW, Australia
  3. Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Liverpool Hospital, Liverpool, NSW, Australia
  4. South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
  5. SWSLHD Cancer Services, Liverpool, NSW, Australia
  6. Liverpool Cancer Therapy Centre, SWSLHD, Liverpool, NSW, Australia

Background:

Multidisciplinary team meetings (MDM) are well established in modern oncology management, as the benefits include reduced time to treatment, improved adherence to guidelines, and increased treatment utilisation. We aimed to measure the proportion of Lung Cancer MDM recommendations translated into clinical practice, identify reasons for discordance, and factors associated with discordant care.

Method:

A retrospective audit of patients discussed at the weekly Lung MDM at Liverpool and Macarthur Cancer Therapy Centres between 01/02/2017-31/07/2017 was conducted. All MDM documentation was sourced from the Oncology Information System (MOSAIQ®) and reviewed for quality and completeness. Multivariable logistic regression analyses were used to identify any factors associated with translation of recommendations into clinical practice.

Results:

There were 181 discussions recorded for 144 patients presented at the Lung Cancer MDM during the study period, with 33 (22.9%) discussed more than once. 121 (83.3%) patients had a diagnosis of lung cancer, 90 (62.5%) were male, 60 (41.7%) were from culturally and linguistically diverse backgrounds, and 99 (68.8%) resided in suburbs in the two highest quintiles of socioeconomic disadvantage in NSW. Discussions were for new diagnoses of cancer (n=128, 70.7%), recurrent disease (n=27, 14.9%), or treatment related issues (n=26,14.4%). 112(61.9%) presentations recommended active treatment, with the others recommending further discussion (n=34,18.8%), clinical follow-up (n=18, 9.9%) or no treatment (n=17, 9.4%). 105 (72.9%) patients had management fully concordant with MDM. 14 (9.7%) recommendations were partially concordant and 25 (17.4%) were discordant. Reasons for discordance were most often undocumented (30.8%), patient decision (20.5%), clinician decision (17.9%).

Conclusion:

Our concordance rate for clinical translation of Lung MDM recommendations is similar to other Australian data (72%) and within the range of international data (63% to 98%).We identified no significant factors associated with discordant care.