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Multidisciplinary Clinics for Colorectal Cancer Care Reduces Treatment Time
Abstract Introduction Management of locally advanced and metastatic colorectal cancer (CRC) requires expertise of multiple specialists. Multidisciplinary clinics (MDC) are a working model designed to facilitate delivery of coordinated care. This study evaluates the effects of MDC on time to treat. P...
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| Published in: | Clinical colorectal cancer 2017-12, Vol.16 (4), p.366-371 |
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| container_title | Clinical colorectal cancer |
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| creator | Kozak, Vanessa N., MD Khorana, Alok A., MD Amarnath, Sudha, MD Glass, Katherine E., M.P.H., M.S Kalady, Matthew F., MD |
| description | Abstract Introduction Management of locally advanced and metastatic colorectal cancer (CRC) requires expertise of multiple specialists. Multidisciplinary clinics (MDC) are a working model designed to facilitate delivery of coordinated care. This study evaluates the effects of MDC on time to treat. Patients and Methods Patients with CRC or locally advanced anal cancer who were evaluated at a single institution MDC between January 2014 and October 2015 were identified from an institutional registry. Clinical characteristics and timelines for various aspects of treatment were retrospectively reviewed and recorded. A control population of patients not evaluated at MDC was matched 1:2 by disease and the number of treating specialties. Primary endpoints were time to treatment from diagnosis and time to treat from first consultation. Results One-hundred-five patients were included: 35 evaluated at MDC and 70 controls. MDC patients experienced a 7.8 day shorter time to treatment from first consultation (21.5 vs. 29.3 days, p = 0.01). The difference was greater for patients visiting three departments (21.3 vs. 30.6 days, p |
| doi_str_mv | 10.1016/j.clcc.2017.03.020 |
| format | article |
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Multidisciplinary clinics (MDC) are a working model designed to facilitate delivery of coordinated care. This study evaluates the effects of MDC on time to treat. Patients and Methods Patients with CRC or locally advanced anal cancer who were evaluated at a single institution MDC between January 2014 and October 2015 were identified from an institutional registry. Clinical characteristics and timelines for various aspects of treatment were retrospectively reviewed and recorded. A control population of patients not evaluated at MDC was matched 1:2 by disease and the number of treating specialties. Primary endpoints were time to treatment from diagnosis and time to treat from first consultation. Results One-hundred-five patients were included: 35 evaluated at MDC and 70 controls. MDC patients experienced a 7.8 day shorter time to treatment from first consultation (21.5 vs. 29.3 days, p = 0.01). The difference was greater for patients visiting three departments (21.3 vs. 30.6 days, p<0.001). Patients requiring neoadjuvant chemoradiation accounted for the majority of the decreased interval compared to those requiring surgery alone as first treatment. The proportion of patients initiating treatment within 3 weeks from first consultation was higher for those seen in MDC (57.1% vs. 30% for controls, p = 0.01). Conclusion Implementation of a multidisciplinary CRC clinic yielded decreased intervals from first consultation to treatment in our institution. Focusing efforts to increase MDC utilization will improve treatment efficiency and improve patient access.</description><identifier>ISSN: 1533-0028</identifier><identifier>EISSN: 1938-0674</identifier><identifier>DOI: 10.1016/j.clcc.2017.03.020</identifier><identifier>PMID: 28527628</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Ambulatory Care Facilities - organization & administration ; Anus Neoplasms - therapy ; Cancer Care Facilities - organization & administration ; Colon cancer ; Colorectal Neoplasms - therapy ; Female ; Gastroenterology and Hepatology ; Health Services Accessibility ; Hematology, Oncology and Palliative Medicine ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy - methods ; Patient Care Team - organization & administration ; Process improvement ; Rectal cancer ; Registries ; Retrospective Studies ; Time to treatment ; Timely care</subject><ispartof>Clinical colorectal cancer, 2017-12, Vol.16 (4), p.366-371</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-ce9e6352bd76b4f6bb8391ccac0a2a8c8d6aea2ceced9364f32e535961ad02633</citedby><cites>FETCH-LOGICAL-c411t-ce9e6352bd76b4f6bb8391ccac0a2a8c8d6aea2ceced9364f32e535961ad02633</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28527628$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kozak, Vanessa N., MD</creatorcontrib><creatorcontrib>Khorana, Alok A., MD</creatorcontrib><creatorcontrib>Amarnath, Sudha, MD</creatorcontrib><creatorcontrib>Glass, Katherine E., M.P.H., M.S</creatorcontrib><creatorcontrib>Kalady, Matthew F., MD</creatorcontrib><title>Multidisciplinary Clinics for Colorectal Cancer Care Reduces Treatment Time</title><title>Clinical colorectal cancer</title><addtitle>Clin Colorectal Cancer</addtitle><description>Abstract Introduction Management of locally advanced and metastatic colorectal cancer (CRC) requires expertise of multiple specialists. Multidisciplinary clinics (MDC) are a working model designed to facilitate delivery of coordinated care. This study evaluates the effects of MDC on time to treat. Patients and Methods Patients with CRC or locally advanced anal cancer who were evaluated at a single institution MDC between January 2014 and October 2015 were identified from an institutional registry. Clinical characteristics and timelines for various aspects of treatment were retrospectively reviewed and recorded. A control population of patients not evaluated at MDC was matched 1:2 by disease and the number of treating specialties. Primary endpoints were time to treatment from diagnosis and time to treat from first consultation. Results One-hundred-five patients were included: 35 evaluated at MDC and 70 controls. MDC patients experienced a 7.8 day shorter time to treatment from first consultation (21.5 vs. 29.3 days, p = 0.01). The difference was greater for patients visiting three departments (21.3 vs. 30.6 days, p<0.001). Patients requiring neoadjuvant chemoradiation accounted for the majority of the decreased interval compared to those requiring surgery alone as first treatment. The proportion of patients initiating treatment within 3 weeks from first consultation was higher for those seen in MDC (57.1% vs. 30% for controls, p = 0.01). Conclusion Implementation of a multidisciplinary CRC clinic yielded decreased intervals from first consultation to treatment in our institution. Focusing efforts to increase MDC utilization will improve treatment efficiency and improve patient access.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ambulatory Care Facilities - organization & administration</subject><subject>Anus Neoplasms - therapy</subject><subject>Cancer Care Facilities - organization & administration</subject><subject>Colon cancer</subject><subject>Colorectal Neoplasms - therapy</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>Health Services Accessibility</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy - methods</subject><subject>Patient Care Team - organization & administration</subject><subject>Process improvement</subject><subject>Rectal cancer</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Time to treatment</subject><subject>Timely care</subject><issn>1533-0028</issn><issn>1938-0674</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9kUtr3DAUhUVJ6SRp_0AXwcts7Ohha2QogWDyoimBdroW8tU1aCLbU8kO5N9Hzky7yKKrexHnHHS-S8hXRgtGmbzYFuABCk7ZuqCioJx-IMesFiqncl0epb0SIqeUqxU5iXGbNikY-0RWXFV8Lbk6Jt9_zH5y1kVwO-8GE16yJk0HMevGkDWjHwPCZHzWmAEwvZiA2U-0M2DMNgHN1OMwZRvX42fysTM-4pfDPCW_b643zV3-8Hh731w95FAyNuWANUpR8dauZVt2sm2VqBmAAWq4UaCsNGg4IKCthSw7wbESVS2ZsUsDcUrO97m7MP6ZMU66T_9H782A4xw1qykTVKl6kfK9FMIYY8BO74LrU0vNqF4g6q1eIOoFoqZCJ4jJdHbIn9se7T_LX2pJ8G0vwNTy2WHQCR8mPNYtsLQd3f_zL9_Z4Q258U_4gnE7zmFI_DTTkWuqfy1nXK7IpEgpvBSvNMiX6g</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Kozak, Vanessa N., MD</creator><creator>Khorana, Alok A., MD</creator><creator>Amarnath, Sudha, MD</creator><creator>Glass, Katherine E., M.P.H., M.S</creator><creator>Kalady, Matthew F., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20171201</creationdate><title>Multidisciplinary Clinics for Colorectal Cancer Care Reduces Treatment Time</title><author>Kozak, Vanessa N., MD ; Khorana, Alok A., MD ; Amarnath, Sudha, MD ; Glass, Katherine E., M.P.H., M.S ; Kalady, Matthew F., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-ce9e6352bd76b4f6bb8391ccac0a2a8c8d6aea2ceced9364f32e535961ad02633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ambulatory Care Facilities - organization & administration</topic><topic>Anus Neoplasms - therapy</topic><topic>Cancer Care Facilities - organization & administration</topic><topic>Colon cancer</topic><topic>Colorectal Neoplasms - therapy</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Health Services Accessibility</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy - methods</topic><topic>Patient Care Team - organization & administration</topic><topic>Process improvement</topic><topic>Rectal cancer</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Time to treatment</topic><topic>Timely care</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kozak, Vanessa N., MD</creatorcontrib><creatorcontrib>Khorana, Alok A., MD</creatorcontrib><creatorcontrib>Amarnath, Sudha, MD</creatorcontrib><creatorcontrib>Glass, Katherine E., M.P.H., M.S</creatorcontrib><creatorcontrib>Kalady, Matthew F., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical colorectal cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kozak, Vanessa N., MD</au><au>Khorana, Alok A., MD</au><au>Amarnath, Sudha, MD</au><au>Glass, Katherine E., M.P.H., M.S</au><au>Kalady, Matthew F., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multidisciplinary Clinics for Colorectal Cancer Care Reduces Treatment Time</atitle><jtitle>Clinical colorectal cancer</jtitle><addtitle>Clin Colorectal Cancer</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>16</volume><issue>4</issue><spage>366</spage><epage>371</epage><pages>366-371</pages><issn>1533-0028</issn><eissn>1938-0674</eissn><abstract>Abstract Introduction Management of locally advanced and metastatic colorectal cancer (CRC) requires expertise of multiple specialists. Multidisciplinary clinics (MDC) are a working model designed to facilitate delivery of coordinated care. This study evaluates the effects of MDC on time to treat. Patients and Methods Patients with CRC or locally advanced anal cancer who were evaluated at a single institution MDC between January 2014 and October 2015 were identified from an institutional registry. Clinical characteristics and timelines for various aspects of treatment were retrospectively reviewed and recorded. A control population of patients not evaluated at MDC was matched 1:2 by disease and the number of treating specialties. Primary endpoints were time to treatment from diagnosis and time to treat from first consultation. Results One-hundred-five patients were included: 35 evaluated at MDC and 70 controls. MDC patients experienced a 7.8 day shorter time to treatment from first consultation (21.5 vs. 29.3 days, p = 0.01). The difference was greater for patients visiting three departments (21.3 vs. 30.6 days, p<0.001). Patients requiring neoadjuvant chemoradiation accounted for the majority of the decreased interval compared to those requiring surgery alone as first treatment. The proportion of patients initiating treatment within 3 weeks from first consultation was higher for those seen in MDC (57.1% vs. 30% for controls, p = 0.01). Conclusion Implementation of a multidisciplinary CRC clinic yielded decreased intervals from first consultation to treatment in our institution. Focusing efforts to increase MDC utilization will improve treatment efficiency and improve patient access.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28527628</pmid><doi>10.1016/j.clcc.2017.03.020</doi><tpages>6</tpages></addata></record> |
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| ispartof | Clinical colorectal cancer, 2017-12, Vol.16 (4), p.366-371 |
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| subjects | Adult Aged Aged, 80 and over Ambulatory Care Facilities - organization & administration Anus Neoplasms - therapy Cancer Care Facilities - organization & administration Colon cancer Colorectal Neoplasms - therapy Female Gastroenterology and Hepatology Health Services Accessibility Hematology, Oncology and Palliative Medicine Humans Male Middle Aged Neoadjuvant Therapy - methods Patient Care Team - organization & administration Process improvement Rectal cancer Registries Retrospective Studies Time to treatment Timely care |
| title | Multidisciplinary Clinics for Colorectal Cancer Care Reduces Treatment Time |
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