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BMC Health Services Research
Published in: BMC Health Services Research 1/2015

Open Access 01-12-2015 | Research article

Everybody wants it done but nobody wants to do it: an exploration of the barrier and enablers of critical components towards creating a clinical pathway for anxiety and depression in cancer

Authors: Nicole M Rankin, Phyllis N Butow, Thida Thein, Tracy Robinson, Joanne M Shaw, Melanie A Price, Kerrie Clover, Tim Shaw, Peter Grimison

Published in: BMC Health Services Research | Issue 1/2015

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Abstract

Background

This study aimed to explore barriers to and enablers for future implementation of a draft clinical pathway for anxiety and depression in cancer patients in the Australian context.

Methods

Health professionals reviewed a draft clinical pathway and participated in qualitative interviews about the delivery of psychosocial care in their setting, individual components of the draft pathway, and barriers and enablers for its future implementation.

Results

Five interrelated themes were identified: ownership; resources and responsibility; education and training; patient reluctance; and integration with health services beyond oncology.

Conclusions

The five themes were perceived as both barriers and enablers and provide a basis for an implementation plan that includes strategies to overcome barriers. The next steps are to design and deliver the clinical pathway with specific implementation strategies that address team ownership, endorsement by leaders, education and training modules designed for health professionals and patients and identify ways to integrate the pathway into existing cancer services.
Literature
1.
National Breast Cancer Centre, National Cancer Control Initiative. Clinical practice guidelines for the psychosocial care of adults with cancer. Camperdown, NSW.: National Breast Cancer Centre; 2003.
2.
Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10(1):19–28.CrossRefPubMed
3.
Moorey S, Greer S, Bliss J, Law M. A comparison of adjuvant psychological therapy and supportive counselling in patients with cancer. Psychooncology. 1998;7(3):218–28.CrossRefPubMed
4.
Turner J, Zapart S, Pedersen K, Rankin N, Luxford K, Fletcher J, et al. Clinical practice guidelines for the psychosocial care of adults with cancer. Psychooncology. 2005;14(3):159–73.CrossRefPubMed
5.
Bultz B, Groff S, Fitch M, Blais MC, Howes J, Levy K, et al. Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice. Psychooncology. 2011;20:463–9.CrossRefPubMed
6.
Holland JC, Breitbart W, Dudley MM, Fulcher C, Greiner, CB, Hoofring L. Distress Management. Clinical practice guidelines in oncology. J Natl Compr Canc Netw 2010; 8:448–50
7.
Hollingworth W, Metcalfe C, Mancero S, Campbell R, Biddle L, McKell-Redwood D, et al. Are needs assessments cost effective in reducing distress among patients with cancer? A randomized controlled trial using the distress thermometer and problem list. J Clin Oncol. 2013;31(29):3631–8.CrossRefPubMed
8.
Mitchell AJ. Screening for cancer-related distress: when is implementation successful and when is it unsuccessful? Acta Oncol. 2013;52(2):216–24.CrossRefPubMed
9.
Meijer A, Roseman M, Delisle VC, Milette K, Levis B, Syamchandra A, et al. Effects of screening for psychological distress on patient outcomes in cancer: a systematic review. J Psychosom Res. 2013;75(1):1–17.CrossRefPubMed
10.
Carlson LE, Waller A, Mitchell AJ. Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol. 2012;30(11):1160–77.CrossRefPubMed
11.
Jacobsen PB, Ransom S. Implementation of NCCN distress management guidelines by member institutions. J Natl Compr Canc Netw. 2007;5:99–103.PubMed
12.
Allen D, Gillen E, Rixson L. Systematic review of the effectiveness of integrated care pathways: what works, for whom, in which circumstances? Int J Evid Base Healthc. 2009;7:61–74.CrossRef
13.
Rotter T, Kinsman L, James EL, Machotta A, Gothe H, Willis J, Snow P, Kugler J. Clinical pathways: effects on professional practice, patient outcomes, length of stay and hospital costs. Cochrane Database of Systematic Reviews; 2010 Issue 3, Art.No.:CD006632. doi:10.1002/14651858.CD006632.pub2..
14.
15.
Andersen B, DeRubeis RJ, Berman BS, Gruman J, Champion VL, Massie MJ, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol. 2014;32(15):1605–19.CrossRefPubMedPubMedCentral
16.
Lovell M, Luckett T, Phillips J, Boyle F, Davidson P, Stubbs J, et al. Cancer pain: closing the evidence-practice gap. In Clinical Oncology Society of Australia Annual Scientific Meeting. Volume 10 Suppl 8. Melbourne: Asia-Pacific Journal of Clinical Oncology; 2014;101.
17.
Johnson MJ, Currow DC, Booth S. Prevalence and assessment of breathlessness in the clinical setting. Expert Rev Respir Med. 2014;8(2):151–61.CrossRefPubMed
18.
Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, et al. Lost in knowledge translation: time for a Map? Journal of Continuing Education in the Health Professions. 2006;26:13–24.CrossRefPubMed
19.
Grol R, Wensing M, Eccles M, Davis D, editors. Improving patient care: The implementation of change in health care. Chichester: Wiley Blackwell; 2013.
20.
Evans-Lacko S, Jarrett M, McCrone P, Thornicroft G. Facilitators and barriers to implementing clinical care pathways. BMC Health Serv Res. 2010;10:182.CrossRefPubMedPubMedCentral
21.
Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, et al. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282(15):1458.CrossRefPubMed
22.
Grimshaw JM, Shirran L, Thomas R, Mowatt G, Fraser C, Bero L, et al. Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001;39(8 Suppl 2):II2–45.PubMed
23.
Luckett T, Davidson P, Green A, Boyle F, Stubbs J, Lovell M. Assessment and management of adult cancer pain: a systematic review and synthesis of recent qualitative studies aimed at developing insights for managing barriers and optimizing facilitators within a comprehensive framework of patient care. J Pain Symptom Manage. 2013;46(2):229–53.CrossRefPubMed
24.
Baker R, Camosso-Stefinovic J, Gillies C, Shaw EJ, Cheater F, Flottorp S, Robertson N. Tailored interventions to overcome identified barriers to change: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews; 2010. Issue 3.Art No.: CD005470. doi:10.1002/14651858.CD005470.pub2.
25.
Shaw J, Price M, Butow P, Clayton J, Grimison P, Shaw T, et al. Evaluating an evidence-based care pathway for the management of anxiety and depression in cancer care: a Delphi consensus study. Asia Pac J Clin Oncol 2014, 10 Suppl 8:152.
26.
Loscalzo M, Clark KL, Holland J. Successful strategies for implementing biopsychosocial screening. Psychooncology. 2011;20(5):455–62.CrossRefPubMed
27.
Mitchell AJ, Lord K, Slattery J, Grainger L, Symonds P. How feasible is implementation of distress screening by cancer clinicians in routine clinical care? Cancer. 2012;118(24):6260–9.CrossRefPubMed
28.
Wensing M, Bosch M, Grol R. Determinants of change. In: Grol R, Wensing M, Eccles M, Davis D, editors. Improving Patient Care: The Implementation of change in health care. Oxford: Wiley Blackwell; 2013.
29.
Parry C, Padgett L, Zebrack B. Now what? toward an integrated research and practice agenda in distress screening. J Psychosoc Oncol. 2012;30:715–27.CrossRefPubMed
30.
McKillop A, Crisp J, Walsh K. Barriers and enablers to implementation of a New Zealand-wide guideline for assessment and management of cardiovascular risk in primary health care: a template analysis. Worldviews Evid Based Nurs. 2012;9(3):159–71.CrossRefPubMed
31.
McCluskey A, Vratsistas-Curto A, Schurr K. Barriers and enablers to implementing multiple stroke guideline recommendations: a qualitative study. BMC Health Serv Res. 2013;13:323.CrossRefPubMedPubMedCentral
32.
Checkland K, Harrison S, Marshall M. Is the metaphor of ‘barriers to change’ useful in understanding implementation? Evidence from general medical practice. J Health Serv Res Pol. 2007;12(2):95–100.CrossRef
33.
Mitchell AJ, Kaar S, Coggan C, Herdman J. Acceptability of common screening methods used to detect distress and related mood disorders: preferences of cancer specialists and non-specialists. Psychooncology. 2008;17(3):226–36.CrossRefPubMed
34.
Rankin NM, Barron JA, Lane LG, Mason CA, Sinclair S, Bishop JF. Psychosocial oncology services in New South Wales. Aust Health Rev. 2011;35:156–63.CrossRefPubMed
35.
van Scheppingen C, Schroevers MJ, Smink A, van der Linden YM, Veronique EM, Langendijk JA, et al. Does screening for distress efficiently uncover meetable unmet needs in cancer patients? Psychooncology. 2011;20:655–63.CrossRefPubMed
36.
Dilworth S, Higgins I, Parker V, Kelly B, Turner J. Patient and health professional’s perceived barriers to the delivery of psychosocial care to adults with cancer: a systematic review. Psychooncology. 2014;23(6):601–12.CrossRefPubMed
37.
Clover K, Kelly P, Rogers K, Britton B, Carter G. Predictors of desire for help in oncology outpatients reporting pain or distress. Psychooncology. 2013;22:1611–7.CrossRefPubMed
Metadata
Title
Everybody wants it done but nobody wants to do it: an exploration of the barrier and enablers of critical components towards creating a clinical pathway for anxiety and depression in cancer
Authors
Nicole M Rankin
Phyllis N Butow
Thida Thein
Tracy Robinson
Joanne M Shaw
Melanie A Price
Kerrie Clover
Tim Shaw
Peter Grimison
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-0691-9

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