An evaluation of an advanced practice role in palliative radiation therapy

Abstract

Introduction The purpose of the study was to evaluate the palliative advanced practice radiation therapy (APRT) role with respect to the impact on waiting times for patients from referral to radiation treatment delivery, the ability of the APRT to define palliative radiation therapy fields and patient satisfaction. The evaluation of the impact of the APRT role and referral pathway on patient waiting times has been previously published. Methods Patients were allocated to two different pathways; APRT and standard. Patients in the APRT pathway had their radiotherapy treatment managed by the APRT including defining their palliative fields blinded to the radiation oncologist (RO). Results Of the 150 palliative patients, 94 had their radiation therapy managed by the APRT and 56 were managed through the standard pathway. 82/92 APRT defined fields were accepted by the RO. Conclusions Inter‐observer variability between the APRT and the RO in defining palliative radiation therapy fields is similar to that reported in the literature between clinicians. With previously published reduced wait times from referral to treatment for palliative patients, the establishment of the APRT role is justified.

Does a radiographer-led palliative radiotherapy pathway provide an efficient service for patients with symptoms of advanced cancer? The Northampton experience

“…From this, it may be suggested that radiographer-led roles have the potential to improve access to palliative radiotherapy through reduced waiting times. 26,27 Statistical analyses in both studies show a high correlation between radiographer's and clinical oncologist's plans, supporting the authors' claim of equivalence in work quality. Their conclusion that radiographer-led pathways can reduce waiting times is, however, a supposition.…”

Rapid Access Palliative Radiotherapy Programmes

“…In Brisbane, Australia, a 2014e2015 study of 150 patients showed that an advanced practice radiation therapist reduced the mean time from referral for palliation to consultation from 3.2 to 1.4 days, the mean time from referral to treatment from 8.1 to 3.5 days and increased the rate of patients assessed and treated on the same day from 9% to 33% [45]. Another report from the same group showed that 82/92 (89%) of field borders independently created by the therapist for a variety of palliative indications were deemed clinically acceptable by the patient's radiation oncologist [46]. Fields were considered acceptable if the clinical outcome to the patient would not have been meaningfully different compared with the outcome expected from the radiation oncologist's fields.…”

Advancing Roles of Healthcare Professionals in Palliative Radiotherapy

“…The APRT role at ROPART has been formally evaluated, with the results showing a reduction in wait times for palliative patients from referral to delivery of radiotherapy treatment and reduced hospital visits. Additionally, the ability of the APRT to define palliative radiotherapy treatment volumes when compared with a radiation oncologist has been successfully evaluated, and the impact of the role when reviewing overall patient satisfaction is positive [5,6].…”