Patient Preferences for Timing and Access to Radiation Therapy

Abstract

Purpose Patient preferences for radiation therapy (rt) access were investigated. MethodsPatients completing a course of rt at 6 centres received a 17-item survey that rated preferences for time of day; day of week; actual, ideal, and reasonable travel times for rt; and actual, ideal, and reasonable times between referral and first oncologic consultation. Patients receiving single-fraction rt or brachytherapy alone were excluded. ResultsOf the respondents who returned surveys (n = 1053), 54% were women, and 74% had received more than 15 rt fractions. With respect to appointment times, 88% agreed or strongly agreed that rt between 08h00 and 16h30 was preferred; 14%-15% preferred 07h30-08h00 or 16h30-17h00; 10% preferred 17h00-18h00; and 6% or fewer preferred times before 07h30 or after 18h00. A preference not to receive rt before 07h30 or after 18h00 was expressed by 30% or more of the respondents. When days of the week were considered, 18% and 11% would have preferred to receive rt on a Saturday or Sunday respectively; 52% and 55% would have preferred not to receive rt on those days. A travel time of 1 hour or less for rt was reported by 82%, but 61% felt that a travel time of 1 hour or more was reasonable. A first consultation within 2 weeks of referral was felt to be ideal or reasonable by 88% and 73% of patients respectively.Conclusions An rt service designed to meet patient preferences would make most capacity available between 08h00 and 16h30 on weekdays and provide 10%-20% of rt capacity on weekends and during 07h30-08h00 and 16h30-18h00 on weekdays. Approximately 80%, but not all, of the responding patients preferred a 2-week or shorter interval between referral and first oncologic consultation.

Radiotherapy treatment scheduling: Implementing operations research into clinical practice

“…Results of a survey amongst six RT centers showed that patients have different preferences regarding the time of their treatment appointments, with 80% of the patients agreeing that having RT between 08h00 and 16h30 was preferred, while 14%-15% preferred the 07h30-08h00 or the 16h30-17h00 time windows. A further 6% or fewer patients preferred times before 07h30 or after 18h00 [ 6 ]. From a patient’s perspective, research shows that the professional staffing standards and low waiting times for both diagnosis and treatment are the most important factors [ 7 ].…”

Radiotherapy treatment scheduling considering time window preferences

“…The growing number of treatment sessions to be booked amongst the available machines makes the scheduling process especially complex for RT centers aiming at delivering timely and patient-friendly treatments. Not only has it been shown that delays in the start of treatment may induce greater psychological distress in patients subject to longer waiting times [ 5 ], but also that 80% of the patients prefer a short interval (2 weeks or less) between referral and first oncology consultation [ 6 ]. The problem of scheduling RT treatment sessions for large varieties of treatment care pathways and technical constraints has been tackled by several studies in the current literature [ 7 ].…”

“…They showed that the quality of care, from a patients’ perspective, increased when patients feel involved into the scheduling process and experience the provider trying to satisfy their personal preferences for the (several) number of visits they must pay to the hospital. Moreover, literature shows that patients have different preferences regarding the time of their appointments, emphasizing the importance of fulfilling those for increased patient-centeredness [ 6 ]. The goal of these RT centers is to schedule irradiation sessions such that all patients start treatment in due time, medical and technological constraints are satisfied, and the fulfilment of patient preferences regarding the starting time of their sessions is maximized.…”

Logistical optimization of radiotherapy treatments

“…literature shows that patients have different preferences regarding the time of their appointments, emphasizing the importance of fulfilling those for increased patient-centeredness [70]. The goal of these RT centers is to schedule irradiation sessions such that all patients start treatment in due time, medical and technological constraints are satisfied, and the fulfilment of patient preferences regarding the starting time of their sessions is maximized.…”

“…The growing number of treatment sessions to be booked amongst the available machines makes the scheduling process especially complex for RT centers aiming at delivering timely and patient-friendly treatments. Not only has it been shown that delays in the start of treatment may induce greater psychological distress in patients subject to longer waiting times [63], but also that 80% of the patients prefer a short interval (two weeks or less) between referral and first oncology consultation [70]. The problem of scheduling RT treatment sessions for large varieties of treatment care pathways and technical constraints has been tackled by several studies in the current literature [107].…”