Multidisciplinary Care Coordination for Patients With NSCLC
Posted: Thursday, July 9, 2020
A multidisciplinary care team should be employed to address barriers to and improve the care of patients with non–small cell lung cancer (NSCLC). David R. Spigel, MD, of Sarah Cannon Research Institute, Nashville, and colleagues shared findings from a national survey conducted by the Association of Community Cancer Centers (ACCC) during the ASCO20 Virtual Scientific Program (Abstract e19195). In addition, also during ASCO20, Mark A. Socinski, MD, of AdventHealth Cancer Institute, Orlando, Florida, and colleagues published recommendations complied by an ACCC expert steering committee (Abstract e19181).
“Uniting the people who care for patients with lung cancer along with their different areas of expertise is the beauty of this initiative and what we are all ultimately trying to accomplish,” said Dr. Spigel in an ACCC press release. “The work we are doing right now is the bridge to greater care with greater outcomes.”
Dr. Spigel’s team compiled the results of 639 surveys from 160 unique cancer programs representing 44 U.S. states. Of the respondents, 41% reported their cancer program did not have a thoracic multidisciplinary clinic. There was also a significant negative correlation between how frequently tumor board meetings occurred and the time to complete disease staging. Nurse navigators and radiation oncologists seemed to be more likely to utilize shared decision-making than members of other disciplines. The most challenging barriers to delivering quality care for patients with NSCLC included a lack of community awareness, patient interest, and transportation to screening; limited access to diagnostic procedures, patient refusal, and poor handling of biopsy samples; lack of communication, misinterpretation of biomarker results, and lack of patient adherence to schedules.
The team led by Dr. Socinski offered several key recommendations on caring for patients with NSCLC, including multidisciplinary evaluation of suspicious findings and coordination for efficient biopsy collection. In addition, they recommended utilizing invasive staging procedures to increase sensitivity and specificity; using biomarker test results to inform treatment-related discussions; giving patients access to a multidisciplinary care navigator; inviting patients to participate in shared decision-making; and providing further education for patients on their diagnosis, management, and treatment.
Disclosure: For authors’ disclosures, visit coi.asco.org and coi.asco.org.
