The European initiative for quality management in lung cancer care

Abstract

Lung cancer is the commonest cause of cancer-related death worldwide and poses a significant respiratory disease burden. Little is known about the provision of lung cancer care across Europe. The overall aim of the Task Force was to investigate current practice in lung cancer care across Europe.The Task Force undertook four projects: 1) a narrative literature search on quality management of lung cancer; 2) a survey of national and local infrastructure for lung cancer care in Europe; 3) a benchmarking project on the quality of (inter)national lung cancer guidelines in Europe; and 4) a feasibility study of prospective data collection in a pan-European setting.There is little peer-reviewed literature on quality management in lung cancer care. The survey revealed important differences in the infrastructure of lung cancer care in Europe. The European guidelines that were assessed displayed wide variation in content and scope, as well as methodological quality but at the same time there was relevant duplication. The feasibility study demonstrated that it is, in principle, feasible to collect prospective demographic and clinical data on patients with lung cancer. Legal obligations vary among countries.The European Initiative for Quality Management in Lung Cancer Care has provided the first comprehensive snapshot of lung cancer care in Europe. Executive summaryThis European Respiratory Society (ERS) Task Force report describes the first phase of an ambitious initiative with the ultimate aim to improve the quality of care for people with lung cancer across Europe. The Task Force undertook four projects. 1) An extensive review of the literature on quality management revealed evidence that was mainly limited to individual aspects of quality improvement. 2) A baseline survey of national and local infrastructure of healthcare showed marked differences in resources and access to care among 37 countries. 3) A benchmarking project on the quality of guidelines showed that well-resourced guidelines were better. 4) A feasibility study showed that contemporary clinical data collection was possible through a clinical network representing 28 European countries. The Task Force has created a platform for future research and development of initiatives that may lead to improved care for people with lung cancer in Europe.

Analysis of advanced lung cancer patients diagnosed following emergency admission

“…Another possible explanation may be a difference in the accessibility of respiratory specialists; the route to specialists in the UK is generally through a general practitioner, while patients in Japan may see specialists directly, leading to shorter diagnostic delays and less cancer progression during the interval. From these points, quality management in lung cancer care might be very important to reduce the number of DFEA patients, as reported previously in European countries [12].…”

The lung cancer patient, the pneumologist and palliative care: a developing alliance

“…guidance for and provision of palliative care in lung cancer) [131]. Thus, the crucial question for the understanding and planning of present and future integrated care is why the highly appealing, holistic concept of palliative care, which has the inherent potential to improve quality of life as well as the process of coping with disease, is not yet available to the majority of lung cancer patients.…”

Treatment of limited disease small cell lung cancer: the multidisciplinary team

“…Core team members communicate closely and involve a multitude of other agents, e.g. general practitioners, social workers, physiotherapists, administrators, clinical trial specialists and nurses, to achieve the best possible results for the patient [1,5,6].…”

“…Tumour boards are established in most hospitals across Europe; however, wide variations of implementation and organisational details exist [6]. These variations, or lack of implementation, are even larger across the world [22].…”