Clinical pathways have shown considerable success in bringing about change in patient management, however the context and implementation strategies utilised are critical. The Clinical Pathway for the Identification and Management of Anxiety and Depression in Adult Cancer Patients (Clinical Pathway) advocates routine screening across the cancer journey, promoting early identification and prompt access to evidence-based care as well as educational support of cancer care staff to guide appropriate and successful implementation.
Methods & Results:
Our barrier analysis identified lack of resources, education and training and support from leaders; poor uptake by patients; and lack of integration within the community, as key. The Anxiety and Depression Pathway (ADAPT) research program in Australia has developed a suite of resources addressing these barriers and facilitators. These include: (i) the ADAPT Portal, a flexible web-based system to operationalise the stepped care model incorporated into the Clinical Pathway for individual cancer services, recommendations for validated screening tools and evidence-based interventions for identifying and managing anxiety and depression; (ii) an online health professional training program focusing on skills related to screening and discussion about referral with patients; (iii) a purpose-built online CBT-based therapy program for managing anxiety/depression in the cancer context, iCanADAPT; and (iv) patient resources to inform, normalise and de-stigmatise routine screening and managing the impact of cancer on emotional wellbeing.
Lessons learned from pilot testing of these resources, ahead of the planned cluster RCT of implementation strategies in 12 cancer services in NSW, will be presented and discussed.
Funding: Cancer Institute NSW