Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Managing multimorbidity in cancer: Results of consultation with Australian consumers and healthcare professionals to inform a clinical pathway (145898)

Emma Kemp 1 , Monique Bareham 1 , Sharon Lawn 1 , Richard Reed 1 , Lisa Beatty 2 , Katia Ferrar 1 , Raechel Damarell 3 , Jackie Roseleur 1 , Bogda Koczwara 1 4
  1. Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
  2. Flinders Institute for Mental Health and Wellbeing, College of Human Sciences and Culture, Flinders University, Adelaide, South Australia, Australia
  3. College of Health and Enablement, Flinders University, Adelaide, South Australia, Australia
  4. Australian Research Centre for Cancer Survivorship, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia

Aims:

Multimorbidity (co-occurrence of two or more long-term conditions) impacts all stages of cancer care, increases prognosis uncertainty and care complexity, and is associated with adverse outcomes. This study aimed to understand Australian stakeholder experiences and recommendations for a model of care to manage multimorbidity in people with a history of cancer.

Methods:

Adult consumers with a history of cancer and multimorbidity or relevant caregiving experience, and healthcare professionals involved in cancer/multimorbidity care participated in qualitative semi-structured focus groups or interviews. Reflexive thematic analysis was used to identify key themes and inform a prototype clinical pathway.

Results:

Consumers (n=30) and healthcare professionals (n=26) reported challenges including fragmented care due to siloed systems, poor communication across settings, ineffective digital systems, consumer difficulty in self-management/navigation, inadequate psychological screening/treatment, inadequate resources/referral pathways for emerging chronic conditions. Follow-up care was difficult in tertiary centres and access to primary care was limited during and after cancer treatment.

Identified needs suggested a clinical pathway for multimorbidity in cancer requires ongoing navigation and referral support, coordinated by a designated healthcare professional/team with a whole-person approach from diagnosis through to post-treatment. To meet needs of survivors with multimorbidity, the pathway should address pre-existing and emerging conditions, including psychological morbidity, through comprehensive assessment, repeated screening, and sustained engagement with non-cancer specialists including primary care and allied health. Post-treatment/ongoing care should include guidance for consumers and healthcare professionals on late effects, including clear consumer advice on symptom management and who to contact if concerned.

Resources identified as necessary included improved capacity for specialist nursing coordination, expanded psycho-oncology services, improved access to primary care, fit-for-purpose digital health applications, and enhanced chronic disease management plans.

Conclusions:
Effective multimorbidity management in cancer requires comprehensive survivorship care with emphasis on interdisciplinary collaboration, navigation, and follow-up. Further implementation-focused research, policy reform, and resourcing are essential.