PURPOSE: The Vancouver Rapid Access (VARA) clinic aimed to deliver urgent palliative radiotherapy (RT) and holistic care to patients with newly diagnosed incurable lung cancer. The purpose of this paper is to describe the 9-month pilot phase of the clinic and to compare its efficacy to standard practice. METHODS: A multidisciplinary team performed the initial consult, and if appropriate, the patient received RT the same day and was connected with supportive services as required. Patient and treatment details were prospectively collected. A retrospective chart review of similar patients in standard practice 1 year prior to VARA was performed. Variables compared between VARA and standard practice included RT wait times and supportive service referrals. RESULTS: During the pilot phase, 58 patients were assessed. Forty percent were inpatients, and 62% had an ECOG 2 or higher. Fifty-four patients received RT; the majority (72%) received RT on the same day as their consultation, compared to 41% in standard practice (p < 0.001). The most common sites treated were the bone (42%), lung (34%), and brain (14%). More than half of VARA patients (54%) were referred to an additional health service such as home care nursing compared to 31% of standard practice patients (p = 0.01). The VARA clinic decreased the proportion of patients double-booked into an oncologists schedule from 23 to 13% (p < 0.001). CONCLUSIONS: The VARA clinic has improved wait times for palliative RT, increased patient access to supportive services, and improved the workload for lung radiation oncologists. This clinic could serve as a model for other patients with incurable cancer.
PURPOSE: The Vancouver Rapid Access (VARA) clinic aimed to deliver urgent palliative radiotherapy (RT) and holistic care to patients with newly diagnosed incurable lung cancer. The purpose of this paper is to describe the 9-month pilot phase of the clinic and to compare its efficacy to standard practice. METHODS: A multidisciplinary team performed the initial consult, and if appropriate, the patient received RT the same day and was connected with supportive services as required. Patient and treatment details were prospectively collected. A retrospective chart review of similar patients in standard practice 1 year prior to VARA was performed. Variables compared between VARA and standard practice included RT wait times and supportive service referrals. RESULTS: During the pilot phase, 58 patients were assessed. Forty percent were inpatients, and 62% had an ECOG 2 or higher. Fifty-four patients received RT; the majority (72%) received RT on the same day as their consultation, compared to 41% in standard practice (p < 0.001). The most common sites treated were the bone (42%), lung (34%), and brain (14%). More than half of VARA patients (54%) were referred to an additional health service such as home care nursing compared to 31% of standard practice patients (p = 0.01). The VARA clinic decreased the proportion of patients double-booked into an oncologists schedule from 23 to 13% (p < 0.001). CONCLUSIONS: The VARA clinic has improved wait times for palliative RT, increased patient access to supportive services, and improved the workload for lung radiation oncologists. This clinic could serve as a model for other patients with incurable cancer.
Authors: Jennifer S Temel; Joseph A Greer; Alona Muzikansky; Emily R Gallagher; Sonal Admane; Vicki A Jackson; Constance M Dahlin; Craig D Blinderman; Juliet Jacobsen; William F Pirl; J Andrew Billings; Thomas J Lynch Journal: N Engl J Med Date: 2010-08-19 Impact factor: 91.245
Authors: C Danjoux; E Chow; A Drossos; L Holden; C Hayter; M Tsao; T Barnes; E Sinclair; M Farhadian Journal: Support Care Cancer Date: 2005-04-23 Impact factor: 3.603
Authors: A Fairchild; E Pituskin; B Rose; S Ghosh; J Dutka; A Driga; P Tachynski; J Borschneck; L Gagnon; S Macdonnell; J Middleton; K Thavone; S Carstairs; D Brent; D Severin Journal: Support Care Cancer Date: 2008-06-20 Impact factor: 3.603
Authors: R Sean Morrison; Joan D Penrod; J Brian Cassel; Melissa Caust-Ellenbogen; Ann Litke; Lynn Spragens; Diane E Meier Journal: Arch Intern Med Date: 2008-09-08
Authors: Jackson S Y Wu; Marc Kerba; Rebecca K S Wong; Erin Mckimmon; Bernhard Eigl; Neil A Hagen Journal: Int J Radiat Oncol Biol Phys Date: 2009-11-10 Impact factor: 7.038
Authors: Thomas J Smith; Sarah Temin; Erin R Alesi; Amy P Abernethy; Tracy A Balboni; Ethan M Basch; Betty R Ferrell; Matt Loscalzo; Diane E Meier; Judith A Paice; Jeffrey M Peppercorn; Mark Somerfield; Ellen Stovall; Jamie H Von Roenn Journal: J Clin Oncol Date: 2012-02-06 Impact factor: 44.544
Authors: Francesco Cellini; Rossella Di Franco; Stefania Manfrida; Valentina Borzillo; Ernesto Maranzano; Stefano Pergolizzi; Alessio Giuseppe Morganti; Vincenzo Fusco; Francesco Deodato; Mario Santarelli; Fabio Arcidiacono; Romina Rossi; Sara Reina; Anna Merlotti; Barbara Alicja Jereczek-Fossa; Angelo Tozzi; Giambattista Siepe; Alberto Cacciola; Elvio Russi; Maria Antonietta Gambacorta; Marta Scorsetti; Umberto Ricardi; Renzo Corvò; Vittorio Donato; Paolo Muto; Vincenzo Valentini Journal: Radiol Med Date: 2021-09-27 Impact factor: 3.469