Adherence to on-treatment visits (OTVs) among patients undergoing radiotherapy for lung cancer at a safety-net hospital was significantly improved by giving them a brightly colored placard as a physical reminder to return to the clinic. These findings from a retrospective study were published in JCO Oncology Practice.
OTVs represent a standard of care for patients undergoing radiotherapy. They provide an opportunity to evaluate the patient for signs of treatment toxicity, as well as cancer-related symptoms; the recommended schedule is at least once every 5 radiotherapy fractions/treatment sessions. Nevertheless, findings from previously conducted studies have shown that a high percentage of these patients miss attending scheduled OTVs.
The focus of the study was on patients with lung cancer undergoing treatment in the radiation oncology department of a safety-net hospital. Following receipt of radiation therapy, patients were given verbal instructions from the radiation therapist to return to the clinic for a scheduled OTV and, beginning on October 1, 2016, were also given a placard as a physical reminder of the OTV visit.
This analysis compared OTV attendance in the year prior to and the year following introduction of the OTV placard (October 1, 2015, to September 30, 2017), with the primary study outcome being the percent of missed OTVs.
Of the 98 patients included in the study, 50 patients received a placard and 48 did not. Median patient age was 68 years; 56.1% were male and 53.1% were Black. Approximately three-quarters of patients were classified as single, divorced, or widowed, and more than 90% spoke English. In addition, more than 80% of patients had stage I to III lung cancer, and approximately half were also receiving chemotherapy.
On multivariate analysis adjusted for dose of radiation, language, and cancer stage, the adjusted mean rates of missed OTVs were 7.1% and 1.4% in the groups receiving and not receiving a placard, respectively (P =.019).
Factors associated with missing an OTV included male sex and receipt of concurrent chemotherapy, whereas clinical stage I disease was associated with increased adherence to OTVs.
“Although the results of this study are speciﬁc to our safety-net population, we postulate that OTV placards would be helpful with many other patient populations,” the researchers noted.
They further commented that “this simple, inexpensive intervention that circumvents cultural, language, and medical literacy barriers may be easily implemented throughout radiation oncology practices to improve patient care.”
Moeller AR, Clancy PE, Quershi MM, et al. Placard in hand: a simple, inexpensive intervention to improve on-treatment visit compliance in a safety net radiation oncology patient population. JCO Oncol Pract. Published online September 16, 2020. doi:10.1200/OP.20.00343