Integrated, Multidisciplinary Management of Pulmonary Nodules Can Streamline Care and Improve Adherence to Recommendations.
Cancer screening
Low-dose CT
Lung cancer
Multidisciplinary care
Pulmonary nodules
Journal
The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
11
07
2019
accepted:
13
11
2019
pubmed:
27
12
2019
medline:
22
6
2021
entrez:
27
12
2019
Statut:
ppublish
Résumé
Every year millions of pulmonary nodules are discovered incidentally and through lung cancer screening programs. Management of these nodules is often suboptimal, with low follow-up rates and poor provider understanding of management approaches. There is an emerging body of literature about how to optimize management of pulmonary nodules. The Pulmonary Nodule and Lung Cancer Screening Clinic (PNLCSC) at Massachusetts General Hospital was founded in 2012 to manage pulmonary nodules via a multidisciplinary approach with optimized support staff. Recommendations from clinic providers and treatment details were recorded for all patients seen at the PNLCSC. Adherence to recommendations and outcomes were also tracked and reviewed. From October 2012 to September 2019, 1,136 patients were seen at the PNLCSC, each for a mean of 1.8 appointments (range, 1-10). A total of 356 procedures were recommended by the clinic and 271 patients were referred for surgery and/or radiation. The majority of interventions (74%) were recommended at the initial PNLCSC appointment. In total, 211 patients (19%) evaluated at the PNLCSC had pathologically confirmed pulmonary malignancies or were treated empirically with radiation. Among patients followed by the clinic, the adherence rate to clinic recommendations was 95%. This study shows how a multidisciplinary approach to pulmonary nodule management can streamline care and optimize follow-up. The PNLCSC provides a template that can be replicated in other health systems. It also provides an example of how multidisciplinary approaches can be applied to other complex conditions. IMPLICATIONS FOR PRACTICE: This work demonstrates how an integrated, multidisciplinary approach to management of pulmonary nodules can streamline patient care and improve adherence to provider recommendations. This approach has the potential to improve patient outcomes and reduce health care costs.
Identifiants
pubmed: 31876321
doi: 10.1634/theoncologist.2019-0519
pmc: PMC7216451
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
431-437Commentaires et corrections
Type : CommentIn
Informations de copyright
© AlphaMed Press 2019.
Références
N Engl J Med. 2011 Aug 4;365(5):395-409
pubmed: 21714641
J Thorac Dis. 2018 Apr;10(Suppl 7):S860-S866
pubmed: 29780632
Am J Prev Med. 2019 Jan;56(1):66-73
pubmed: 30467092
J Oncol Pract. 2016 Jun;12(6):e643-53
pubmed: 27143146
Transl Lung Cancer Res. 2019 Feb;8(1):5-14
pubmed: 30788230
J Thorac Oncol. 2011 Oct;6(10):1720-5
pubmed: 21760552
J Racial Ethn Health Disparities. 2019 Feb;6(1):22-26
pubmed: 29729002
JAMA Oncol. 2017 Sep 1;3(9):1278-1281
pubmed: 28152136
Value Health. 2011 Jan;14(1):41-52
pubmed: 21211485
Zhongguo Fei Ai Za Zhi. 2018 Nov 20;21(11):828-832
pubmed: 30454544
J Am Coll Radiol. 2013 Aug;10(8):586-92
pubmed: 23623708
J Clin Oncol. 2014 Jan 1;32(1):12-8
pubmed: 24276777
Lung Cancer. 2002 Jan;35(1):53-7
pubmed: 11750713
Thorax. 2004 Jan;59(1):45-9
pubmed: 14694247
Radiographics. 2015 Nov-Dec;35(7):1893-908
pubmed: 26495797
Chest. 2005 Oct;128(4):2282-8
pubmed: 16236885
Semin Roentgenol. 2017 Jul;52(3):161-165
pubmed: 28734398
J Thorac Imaging. 2013 Nov;28(6):388-91
pubmed: 24149862
Chest. 2015 Dec;148(6):1422-1429
pubmed: 25790082
Cancer Causes Control. 2019 Mar;30(3):235-240
pubmed: 30377905
Radiology. 2017 Jul;284(1):228-243
pubmed: 28240562
Clinicoecon Outcomes Res. 2017 May 12;9:261-269
pubmed: 28553128
J Gen Intern Med. 2012 Oct;27(10):1334-48
pubmed: 22183961
Mayo Clin Proc Innov Qual Outcomes. 2019 Feb 26;3(1):70-77
pubmed: 30899910
Clin Oncol (R Coll Radiol). 2000;12(3):141-4
pubmed: 10942328
Cancer. 2008 Jul 15;113(2):426-33
pubmed: 18470906
J Clin Oncol. 2014 Jan 1;32(1):3-4
pubmed: 24276778
J Natl Med Assoc. 2018 Oct;110(5):424-427
pubmed: 30129479
Am J Respir Crit Care Med. 2015 Nov 15;192(10):1208-14
pubmed: 26214244
J Natl Compr Canc Netw. 2018 Apr;16(4):412-441
pubmed: 29632061