Aims:
Optimal Care Pathways (OCPs) define the expected standard of evidence-based, person-centred cancer care across the continuum. Despite national implementation efforts, there is currently no standardised approach to measuring adherence to OCPs. This research program aims to co-design and evaluate a tool that can be used to measure adherence to the OCPs in a research setting.
Methods:
The tool development comprises four phases: (1) a narrative review examining Australia’s cancer policy history (2025); (2) systematic review synthesising methods used to measure adherence to health clinical guidelines internationally (2025-2026); (3) a Participatory Action Research (PAR) study to develop an adherence measurement tool with clinicians, consumers, researchers, policymakers, and key stakeholders (2026-2027); (4) piloting and evaluating the tool within 11 cancer services across Australia (2027-2029). The PAR approach will use consensus-building and cross-sector stakeholder engagement to ensure the tool is clinically meaningful, feasible, and applicable across diverse health service settings.
Results:
Findings across both the narrative and systematic reviews revealed that despite substantial advances in cancer policy and the widespread adoption of Optimal Care Pathways, there remains no consistent approach to measuring whether recommended care is delivered in practice. There are ongoing challenges including fragmented data systems, variable monitoring approaches, and gaps in translating policy commitments into measurable improvements. In addition, existing adherence measures are fragmented, predominantly process-focused and lack conceptual and methodological consistency, limiting their ability to support meaningful evaluation across health services.
Conclusions:
This research will establish a system-relevant approach to measuring adherence to Australia’s OCPs, addressing critical gaps in monitoring quality, equity, and implementation of evidence-based cancer care. Clinicians, health service leaders, researchers, and consumers are invited to participate in the PAR co-design process to ensure the tool reflects real-world practice and supports meaningful improvements in cancer care delivery.