College of Health, Medicine and Wellbeing - The University of Newcastle, University Drive Callaghan, New South Wales 2308, Australia; Global Centre for Research and Training in Radiation Oncology - The University of Newcastle, University Drive Callaghan, New South Wales 2308, Australia.
College of Health, Medicine and Wellbeing - The University of Newcastle, University Drive Callaghan, New South Wales 2308, Australia; Hunter Medical Research Institute (HMRI), The University of Newcastle, University Drive Callaghan, New South Wales 2308, Australia.
Radiother Oncol. 2024 Oct;199:110423. doi: 10.1016/j.radonc.2024.110423. Epub 2024 Jul 15.
The underutilisation of radiation therapy (RT) is contributing to the significant global burden of cancer with studies identifying actual utilisation rates are significantly lower than evidence-based optimal utilisation rates. Attributing factors vary considerably, ranging from patient preference, referrer bias, to geographic variations. The aim of this scoping review is to map and synthesise the current literature reporting on barriers and facilitators influencing utilisation of RT globally. Four online databases; Medline, Embase, Scopus and CINAHL identified articles dated between 1993 and 2023. Study eligibility included reporting on RT services, specifically barriers and influences on utilisation of RT. Title and abstract screening, followed by full text review was performed as per PRISMA guidelines. Variables were extracted and categorised into patient, health professional (HP) and department level influences. In total, 340 studies were included in the scoping review. HP influences (included in this specific review) were reported in 225 (66 %) papers with the most prevalent HP influence being referral (n = 187; 83 %). Of the HP papers, 114 (51 %) identified knowledge and education as an influence on RT utilisation. Subsequently, role interpretation, describing the assumed role adopted by the General Practitioner as the patients advocate, educator, manager or carer was identified in 89 (40 %) studies. This scoping review demonstrates the range of factors impacting RT utilisation. The results suggest referrer knowledge and understanding gaps impact RT utilisation internationally. Future research and intervention into referrer RT education is required to limit the impact of such influences.
放疗（RT）的利用不足是导致癌症全球负担巨大的原因之一，研究表明，实际利用率明显低于基于证据的最佳利用率。归因因素差异很大，包括患者偏好、推荐者偏见以及地理差异等。本范围综述的目的是绘制和综合目前全球报告的影响 RT 利用的障碍和促进因素的文献。通过 Medline、Embase、Scopus 和 CINAHL 这四个在线数据库，检索了 1993 年至 2023 年期间发表的文章。研究纳入标准包括报告 RT 服务，特别是 RT 利用的障碍和影响。按照 PRISMA 指南进行了标题和摘要筛选，然后进行全文审查。提取变量并分类为患者、卫生专业人员（HP）和部门层面的影响。总共纳入了 340 项研究。在 225 篇（66%）论文中报告了 HP 影响（包括在本次具体综述中），最常见的 HP 影响是转诊（n=187；83%）。在 HP 论文中，有 114 篇（51%）认为知识和教育是影响 RT 利用的因素。随后，在 89 项研究（40%）中确定了角色解释，即描述全科医生作为患者的倡导者、教育者、管理者或照顾者的角色。本范围综述表明了影响 RT 利用的各种因素。结果表明，国际上推荐者对 RT 的知识和理解差距会影响 RT 的利用。需要对推荐者 RT 教育进行未来的研究和干预，以限制这些影响。
