Aims

Utilisation of radiotherapy (RT) in Australia is below recommended evidence based benchmarks. Barriers to the referral of patients for RT and the uptake of RT by patients may be affecting RT utilisation. The current study aimed to examine health professionals’ (HPs) perceptions of potential barriers to RT referral and uptake.

Methods

A custom survey was developed to assess perceptions regarding the degree to which a range of issues affect decisions regarding RT. Hard copy surveys were disseminated to HPs involved in the care of cancer patients across New South Wales (NSW): medical, radiation and surgical oncologists, palliative care clinicians and other physicians (including general practitioners) with an interest in oncology. Electronic versions of the survey were disseminated via oncology multidisciplinary teams and professional networks at participating hospitals.

Results

254 HPs participated via hard copy (n=213) or electronic (n=31) surveys. Two thirds of HPs perceived acute side effects of RT, their management and impact on daily commitments, as well as fear and anxiety about RT, to exert moderate to significant influence on RT decisions.  Treatment related travel, need for accommodation and relocation were also perceived by 64% of HPs to do the same. Over half of HPs rated concern regarding late effects of RT, disruption to family and work life, and the ability to organise family and work commitments around RT, as moderate to significant influences on RT uptake.

Discussion

Perceptions of HPs in NSW reveal potential important influencers of RT decisions by patients and clinicians. Whilst some issues such as travel and relocation pertain to the availability of local RT services, issues unrelated to RT infrastructure, may also influence RT decisions. An understanding these additional issues and their actual impact on RT related decisions will inform future interventions aimed at improving RT utilization.