Abstract
e17533 Background: Implementation of multi-disciplinary clinics (MDC) has the potential to improve the care of cancer patients. Little data presently exists on the impact of MDC based care on cancer patient populations. Methods: A multi-disciplinary lung cancer clinic was implemented at a large, rural, multispecialty medical center in 2009. A retrospective analysis of the impact of MDC implementation on patient care was accomplished from 2009-2010 and was compared to care of patients from a reference period consisting of all patients treated in 2007. Patient survival, time to first appointment, time to treatment, use of clinical trials, and selection of palliative therapy only were analyzed using descriptive statistics. Two sided students t-test was performed to compare results from each cohort. Results: A new diagnosis of lung cancer was identified in 290 patients from 2009-2010. A total of 175 patients received care within the MDC and 115 patients were treated outside of the MDC. One hundred and forty-two patients were analyzed from the pre-MDC period of 2007. Seventy-seven percent of patients had NSCLC in 2007 and 81% of patients had NSCLC in 2009-2010. The time from referral to first appointment, and diagnosis to treatment are shown in the Table. There was a significant improvement in the mean time to initiation of cancer therapy with the introduction of the MDC clinic with patients starting therapy at a mean of 22 days instead of 28 days, however, the median time to treatment increased to 17 days from 5 days. MDC was associated with improvement in clinical trial accrual to 15% from 10%. Conclusions: The implementation of MDC was associated with greater homogeneity in timeliness of care, with fewer patients being outliers with long delays in time to care, hence improvements in mean time to care, with a detriment in median time to care owning to the increased complexity of scheduling. MDC also resulted in improvements in clinical trial accrual. [Table: see text]
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