Multidisciplinary virtual management of pulmonary nodules

Introduction and objectives: Multidisciplinary nodule clinics provide high-quality care and favor adherence to guidelines. Virtual care has shown savings benefits along with patient satisfaction. Our aim is to describe the first year of operation of a multidisciplinary virtual lung nodule clinic, th...

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Autores: Polanco Alonso, Dinora, González, Jessica, Gracia-Lavedan, Esther, Pinilla, Lucía, Plana, R., Molina, M., Pardina Solano, Marina Asunción, Barbé Illa, Ferran
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Recursos:Universitat de Lleida (UdL)
Repositorio:Repositori Obert UdL
OAI Identifier:oai:repositori.udl.cat:10459.1/83253
Acesso em linha:https://doi.org/10.1016/j.pulmoe.2021.12.003
http://hdl.handle.net/10459.1/83253
Access Level:acceso abierto
Palavra-chave:Lung cancer
Lung nodule
Multidisciplinary care
Pulmonary nodules
Remote care
Virtual care
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spelling Multidisciplinary virtual management of pulmonary nodulesPolanco Alonso, DinoraGonzález, JessicaGracia-Lavedan, EstherPinilla, LucíaPlana, R.Molina, M.Pardina Solano, Marina AsunciónBarbé Illa, FerranLung cancerLung noduleMultidisciplinary carePulmonary nodulesRemote careVirtual careIntroduction and objectives: Multidisciplinary nodule clinics provide high-quality care and favor adherence to guidelines. Virtual care has shown savings benefits along with patient satisfaction. Our aim is to describe the first year of operation of a multidisciplinary virtual lung nodule clinic, the population evaluated and issued decisions. Secondarily, among discharged patients, we aimed to analyze their follow-up prior to the existence of our consultation, evaluating its adherence to guidelines. Materials and methods: Observational study including all patients evaluated at the Virtual Lung Nodule Clinic (VLNC) (March 2018- March 2019). Clinical and radiological data were recorded. Recommendations, based on 2017 Fleischner Society guidelines, were categorized into follow-up, discharge or referral to lung cancer consultation. Discharged patients were classified according to adherence to guidelines of their previous management, into adequate, prolonged and non-indicated follow-up. Results: A total of 365 patients (58.9% men; median age 64.0 years) were included. Sixty-four percent had smoking history and 23% had chronic obstructive pulmonary disease (COPD). Most nodules were solid (87.4%) and multiple (57.5%). The median diameter was 6.00 mm. 43.8% of patients were discharged following first VLNC evaluation. Among them, 27.5% had received appropriate follow-up, but 66.9% had received poor management. Patients with prolonged follow-up (33.1%) were older (67.0 vs 60.5 years) and had larger nodules (6.00 mm vs 5.00). Non-indicated follow-up patients (33.8%) were more non-smokers (77.8% vs 31.8%) and presented smaller nodules (4.00 vs 5.00 mm). Conclusions: During its first year of operation, the VLNC has evaluated a population with a relevant risk profile for lung cancer development, management of which should be cautious and adhere to guidelines. After the first VLNC assessment, approximately one-half of this population was discharged. It was noticeable that previous follow-up of discharged patients was found poorly adherent to guidelines, with a marked tendency to overmanagement.ElsevierSociedade Portuguesa de Pneumologia2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://doi.org/10.1016/j.pulmoe.2021.12.003http://hdl.handle.net/10459.1/83253reponame:Repositori Obert UdL instname:Universitat de Lleida (UdL)InglésReproducció del document publicat a: https://doi.org/10.1016/j.pulmoe.2021.12.003Pulmonology, 2024, vol. 30, num 3, p. 239-246cc-by-nc-nd (c) Sociedade Portuguesa de Pneumologia, 2022info:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by-nc-nd/4.0/oai:repositori.udl.cat:10459.1/832532026-06-24T12:42:17Z
dc.title.none.fl_str_mv Multidisciplinary virtual management of pulmonary nodules
title Multidisciplinary virtual management of pulmonary nodules
spellingShingle Multidisciplinary virtual management of pulmonary nodules
Polanco Alonso, Dinora
Lung cancer
Lung nodule
Multidisciplinary care
Pulmonary nodules
Remote care
Virtual care
title_short Multidisciplinary virtual management of pulmonary nodules
title_full Multidisciplinary virtual management of pulmonary nodules
title_fullStr Multidisciplinary virtual management of pulmonary nodules
title_full_unstemmed Multidisciplinary virtual management of pulmonary nodules
title_sort Multidisciplinary virtual management of pulmonary nodules
dc.creator.none.fl_str_mv Polanco Alonso, Dinora
González, Jessica
Gracia-Lavedan, Esther
Pinilla, Lucía
Plana, R.
Molina, M.
Pardina Solano, Marina Asunción
Barbé Illa, Ferran
author Polanco Alonso, Dinora
author_facet Polanco Alonso, Dinora
González, Jessica
Gracia-Lavedan, Esther
Pinilla, Lucía
Plana, R.
Molina, M.
Pardina Solano, Marina Asunción
Barbé Illa, Ferran
author_role author
author2 González, Jessica
Gracia-Lavedan, Esther
Pinilla, Lucía
Plana, R.
Molina, M.
Pardina Solano, Marina Asunción
Barbé Illa, Ferran
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Lung cancer
Lung nodule
Multidisciplinary care
Pulmonary nodules
Remote care
Virtual care
topic Lung cancer
Lung nodule
Multidisciplinary care
Pulmonary nodules
Remote care
Virtual care
description Introduction and objectives: Multidisciplinary nodule clinics provide high-quality care and favor adherence to guidelines. Virtual care has shown savings benefits along with patient satisfaction. Our aim is to describe the first year of operation of a multidisciplinary virtual lung nodule clinic, the population evaluated and issued decisions. Secondarily, among discharged patients, we aimed to analyze their follow-up prior to the existence of our consultation, evaluating its adherence to guidelines. Materials and methods: Observational study including all patients evaluated at the Virtual Lung Nodule Clinic (VLNC) (March 2018- March 2019). Clinical and radiological data were recorded. Recommendations, based on 2017 Fleischner Society guidelines, were categorized into follow-up, discharge or referral to lung cancer consultation. Discharged patients were classified according to adherence to guidelines of their previous management, into adequate, prolonged and non-indicated follow-up. Results: A total of 365 patients (58.9% men; median age 64.0 years) were included. Sixty-four percent had smoking history and 23% had chronic obstructive pulmonary disease (COPD). Most nodules were solid (87.4%) and multiple (57.5%). The median diameter was 6.00 mm. 43.8% of patients were discharged following first VLNC evaluation. Among them, 27.5% had received appropriate follow-up, but 66.9% had received poor management. Patients with prolonged follow-up (33.1%) were older (67.0 vs 60.5 years) and had larger nodules (6.00 mm vs 5.00). Non-indicated follow-up patients (33.8%) were more non-smokers (77.8% vs 31.8%) and presented smaller nodules (4.00 vs 5.00 mm). Conclusions: During its first year of operation, the VLNC has evaluated a population with a relevant risk profile for lung cancer development, management of which should be cautious and adhere to guidelines. After the first VLNC assessment, approximately one-half of this population was discharged. It was noticeable that previous follow-up of discharged patients was found poorly adherent to guidelines, with a marked tendency to overmanagement.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://doi.org/10.1016/j.pulmoe.2021.12.003
http://hdl.handle.net/10459.1/83253
url https://doi.org/10.1016/j.pulmoe.2021.12.003
http://hdl.handle.net/10459.1/83253
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.pulmoe.2021.12.003
Pulmonology, 2024, vol. 30, num 3, p. 239-246
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Sociedade Portuguesa de Pneumologia, 2022
info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by-nc-nd/4.0/
rights_invalid_str_mv cc-by-nc-nd (c) Sociedade Portuguesa de Pneumologia, 2022
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
Sociedade Portuguesa de Pneumologia
publisher.none.fl_str_mv Elsevier
Sociedade Portuguesa de Pneumologia
dc.source.none.fl_str_mv reponame:Repositori Obert UdL
instname:Universitat de Lleida (UdL)
instname_str Universitat de Lleida (UdL)
reponame_str Repositori Obert UdL
collection Repositori Obert UdL
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812429

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