1
|
Delaney GP, Barton MB. Great expectations or waiting for Godot? Time for development of a near real-time national reporting system of radiotherapy utilisation. J Med Imaging Radiat Oncol 2022; 66:826-829. [PMID: 35610753 DOI: 10.1111/1754-9485.13437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/05/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Geoff P Delaney
- South Western Sydney Local Health District, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,South Western Sydney Clinical School, University of NSW, Sydney, NSW, Australia
| | - Michael B Barton
- South Western Sydney Local Health District, Sydney, NSW, Australia.,Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.,South Western Sydney Clinical School, University of NSW, Sydney, NSW, Australia
| |
Collapse
|
2
|
Nicholls L, Bravery B, Chelvarajah R, Shi K, Tieu MT, Turner S, Windsor A. The status of radiation oncology teaching in Australian and New Zealand medical schools. J Med Imaging Radiat Oncol 2018; 62:828-834. [PMID: 30074292 DOI: 10.1111/1754-9485.12788] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/11/2018] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Radiation therapy is a core component of curative and palliative cancer treatment; however, its indications and benefits remain poorly understood across the medical profession. METHODS An electronic survey focussing on curriculum content, teaching and assessment in radiation oncology and plans for curriculum change was developed. The Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiology (RANZCR) distributed the survey to all 24 Australian and New Zealand medical schools. The survey was conducted from November 2017 to January 2018 following ethics approval. RESULTS Sixteen of the 24 (67%) medical Faculties in Australia and New Zealand responded. Ninety-four percent of Faculties had no formal radiation oncology curriculum. Most Faculties (87%) dedicated <15% of the total medical course to oncology, of which the majority (63%) dedicated <10% to radiation oncology. At least 50% of Faculties did not offer formal radiation oncology teaching to all students. When offered, students' exposure to radiation oncology was often <5 days over the entire course (44%). The majority of medical schools (73%) are planning curriculum changes in the next 5 years; however, most have no intention of changing radiation oncology teaching. CONCLUSION Radiation oncology continues to be underrepresented in medical curricula throughout Australia and New Zealand with no plans for improvement by Faculties. This study supports the need for formal advocacy for improving radiation oncology education in medical schools and will form the basis of new national recommendations for radiation oncology curriculum development.
Collapse
Affiliation(s)
- Luke Nicholls
- Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Ben Bravery
- School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia
| | | | - Kate Shi
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Minh Thi Tieu
- University of Newcastle, Callaghan, New South Wales, Australia.,Radiation Oncology Department, Calvary Mater Hospital, Newcastle, New South Wales, Australia
| | - Sandra Turner
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia
| | - Apsara Windsor
- University of Newcastle, Callaghan, New South Wales, Australia.,Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia.,Central Coast Cancer Centre, Gosford, New South Wales, Australia
| |
Collapse
|
3
|
Sundaresan P, King M, Stockler M, Costa D, Milross C. Barriers to radiotherapy utilization: Consumer perceptions of issues influencing radiotherapy-related decisions. Asia Pac J Clin Oncol 2016; 13:e489-e496. [PMID: 27573509 DOI: 10.1111/ajco.12579] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 05/30/2016] [Accepted: 06/05/2016] [Indexed: 12/14/2022]
Abstract
AIMS Radiation therapy (RT) is an essential and cost-effective cancer treatment, but it is underutilized in Australia. We aimed to quantify consumers' perceptions of factors that influence RT decisions. METHODS A cross-sectional, survey-based study was conducted in March-August 2012. Potential participants were invited to complete an electronic survey disseminated through multiple patient support and advocacy groups throughout New South Wales (NSW), Australia. Study invitations were also placed in local newspapers across NSW with hard copy surveys mailed to respondents. Current or past cancer patients (and carers) who had been offered RT were eligible to participate regardless of their RT decision. RESULTS Of the 1191 participants (electronic, n = 1153; hard copy, n = 38), 91% were female, most (88%) were current or past patients, and 78% had accepted RT. Issues commonly perceived to be moderate to strong influencers of RT decisions were: concern about acute and long-term side effects; management of side effects; fear and anxiety regarding RT; lack of awareness of RT; lack of local availability of RT; and lack of RT information resources. Those who declined RT were significantly more likely to highlight practical difficulties with receiving RT. CONCLUSIONS Although availability of RT is well recognized, other issues such as fear and anxiety about RT and perceived side effects appear to feature prominently in consumers' decisions. Perceived practical difficulties with receiving RT may have influenced those who declined RT. There may be a need for information resources, support services and interventions to increase awareness of RT.
Collapse
Affiliation(s)
- Puma Sundaresan
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Madeleine King
- Sydney Medical School, The University of Sydney, Sydney, Australia.,Psycho-Oncology Cooperative Research Group (POCOG), The University of Sydney, Sydney, Australia
| | - Martin Stockler
- Sydney Medical School, The University of Sydney, Sydney, Australia.,Chris O'Brien Lifehouse, Sydney, Australia
| | - Daniel Costa
- Psycho-Oncology Cooperative Research Group (POCOG), The University of Sydney, Sydney, Australia
| | - Christopher Milross
- Sydney Medical School, The University of Sydney, Sydney, Australia.,Chris O'Brien Lifehouse, Sydney, Australia
| |
Collapse
|
4
|
Shukla N, Wickramasuriya R, Miller A, Perez P. An approach to plan and evaluate the location of radiotherapy services and its application in the New South Wales, Australia. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2015; 122:245-256. [PMID: 26310502 DOI: 10.1016/j.cmpb.2015.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/17/2015] [Accepted: 08/03/2015] [Indexed: 06/04/2023]
Abstract
This paper proposes an integrated modelling approach for location planning of radiotherapy treatment services based on cancer incidence and road network-based accessibility. Previous research efforts have established travel distance/time barriers as a key factor affecting access to cancer treatment services, as well as epidemiological studies have shown that cancer incidence rates vary with population demography. Our study is built on the evidence that the travel distances to treatment centres and demographic profiles of the accessible regions greatly influence the uptake of cancer radiotherapy (RT) services. An integrated service planning approach that combines spatially-explicit cancer incidence projections, and the placement of new RT services based on road network based accessibility measures have never been attempted. This research presents a novel approach for the location planning of RT services, and demonstrates its viability by modelling cancer incidence rates for different age-sex groups in New South Wales, Australia based on observed cancer incidence trends; and estimations of the road network-based access to current NSW treatment centres. Using three indices (General Efficiency, Service Availability and Equity), we show how the best location for a new RT centre may be chosen when there are multiple competing locations.
Collapse
Affiliation(s)
- Nagesh Shukla
- SMART Infrastructure Facility, Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Rohan Wickramasuriya
- SMART Infrastructure Facility, Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Andrew Miller
- SMART Infrastructure Facility, Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; Illawarra Cancer Care Centre, Wollongong Hospital, Wollongong, NSW 2500, Australia
| | - Pascal Perez
- SMART Infrastructure Facility, Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia
| |
Collapse
|
5
|
Sundaresan P, Milross CG, Smith A, Evans A, Stockler MR, King MT. Factors influencing the use of RT in NSW: a qualitative study exploring consumer and health professional perspectives. J Med Imaging Radiat Oncol 2014; 58:625-32. [PMID: 24945988 DOI: 10.1111/1754-9485.12198] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/24/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Radiotherapy (RT) is an essential and cost-effective cancer treatment. It is underutilised in Australia. Bridging the gap between actual and optimal RT utilisation requires not only provision of adequate RT infrastructure but also an understanding of the factors that influence the extent to which this opportunity for RT is utilised. This study explored factors perceived to affect RT-related decision making by consumers and health professionals (HPs). METHODS Six semi-structured focus groups (FGs) and 13 interviews were conducted at three geographical locations in NSW, Australia (n = 26 consumers and 30 HPs). Audio recordings of FGs and interviews were transcribed verbatim and analysed thematically. RESULTS An exhaustive list of issues perceived to affect consumer and HP RT decisions was identified. There were common themes across participant groups and locations. Perceptions of RT and its benefits, as well as accurate communication of the expected benefits and risks of RT, were highlighted as important to decision making. Perceived factors relating to 'inconvenience' of RT were multifaceted and included travel, relocation, accommodation, time away from work and financial challenges. Perceived potential barriers to RT referral included knowledge of RT and RT services, availability of a local or visiting RT service, referrer bias, and the low profile of RT. CONCLUSIONS Important drivers during RT decisions appear to include the perceived benefit, risks and inconvenience of RT. Underutilisation of RT may also result from multiple barriers at the referrer level. Further research into whether these factors influence actual RT decisions is needed.
Collapse
Affiliation(s)
- Puma Sundaresan
- The Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Central Coast Cancer Centre, Gosford Hospital, Sydney, New South Wales, Australia
| | | | | | | | | | | |
Collapse
|
6
|
Bydder SA, Spry NA. Distance to the closest radiotherapy facility and survival after a diagnosis of rectal cancer in Queensland. Med J Aust 2011; 195:662; author reply 662. [DOI: 10.5694/mja11.11271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|