Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Which interventions improve adherence to optimal care pathways for lung cancer in australia? a systematic review and narrative synthesis.   (146309)

Keya Giri 1 , Ashfaq Chauhan 2 , Prince Peprah 2 , Ramya Walsan 2 , Kahren White 3 , Reema Harrison 2
  1. Macquarie University, Sydney, NSW, Australia
  2. Australian Institute of Health Innovation, Sydney, NSW, Australia
  3. Cancer Institute NSW, Sydney, NSW

Aims 

Many interventions have been developed Australia wide to improve adherence to lung cancer optimal care pathway (OCP) to provide evidence-based care. This systematic review was conducted to provide evidence synthesis for type of interventions and their effectiveness for improving adherence to lung cancer OCP to provide timely, person-centred, high-quality care.

Methods 
The review included peer-reviewed Australian quantitative, qualitative and mixed-methods studies published from 2014 which evaluated interventions targeting any component of the lung cancer OCP  (such as diagnostic and treatment timeliness). Five databases (MEDLINE, Embase, Web of Science, CINAHL and Scopus) were searched. Findings were narratively synthesised due to heterogeneity in study design, intervention types and outcomes. 

Results 
Nine studies were included following title, abstract and full text screening. Evaluated interventions comprised digital referral pathways, rapid-access clinics, service redesign initiatives, multi-disciplinary communication tools and general practitioner or community education. Six studies targeted diagnostic and treatment timeliness within Steps 2 and 3 of the OCP, while one assessed patient-reported outcome collection across the care continuum. Overall, the interventions demonstrated mixed effectiveness for improving adherence to OCP Among studies reporting percentage-based OCP indicators, post-intervention adherence ranged from 26.3% to 100%.1,2 Jeyakumar  et Al.’s rapid-access clinic increased adherence to the OCP treatment compliance from 33.3% to 77% and multidisciplinary meeting discussion rate from 58.3% to 100%.2 Other interventions produced mixed results: Samaranayake et Al’s referral pathway increased diagnostic pathway compliance from 17% to 69%3, while some referral and educational strategies improved selected intervals but not overall diagnostic timeliness.4,5 A multilingual digital care pathway achieved 90% baseline and 80% three-month patient-reported outcome completion.6

Conclusions 
Australian OCP-aligned interventions can improve selected timeliness, coordination and patient-engagement outcomes, particularly when integrated into clinical workflows. Evidence remains heterogeneous and concentrated in early pathway stages, highlighting the need for robust evaluations across survivorship, recurrence and end-of-life care. 

  1. Largey G, Briggs P, Davies H, et al. Victorian Lung Cancer Service Redesign Project: impacts of a quality improvement collaborative on timeliness and management in lung cancer. Intern Med J. 2021;51(12):2061-2068. doi:10.1111/imj.15043
  2. Jeyakumar HS, Wright A. Improving regional lung cancer optimal care pathway compliance through a rapid-access respiratory clinic. Intern Med J. 2020;50(7):805-810. doi:10.1111/imj.14465
  3. Samaranayake S, Hagerman G, Mupunga B, Dwyer P. Improving rural lung cancer referral pathways: an assessment of a general practitioner referral pathways programme for patients with lung cancer. Intern Med J. 2026;56(4):651-658. doi:10.1111/imj.70356
  4. Otty Z, Larkins S, Evans R, Brown A, Sabesan S. Improving the timeliness of care for regional lung cancer patients through the implementation of a web-based lung cancer referral pathway. Intern Med J. 2025;55(9):1474-1482. doi:10.1111/imj.70138
  5. Emery JD, Gray V, Walter FM, et al. The Improving Rural Cancer Outcomes Trial: a cluster-randomised controlled trial of a complex intervention to reduce time to diagnosis in rural cancer patients in Western Australia. Br J Cancer. 2017;117(10):1459-1469. doi:10.1038/bjc.2017.310
  6. Duckham RL, Webster T, See K. The development and implementation of the Northern Health lung cancer digital care pathway: a case study in service change. Aust Health Rev. 2024;48:148-153. doi:10.1071/AH23279