Author(s): Davie P.; Mackay E.A.; Brindas P.; Tippett V.M.; Aziz Al Rahim A.

Source: Thorax; Dec 2017; vol. 72

Publication Date: Dec 2017

Publication Type(s): Conference Abstract

Available  at Thorax –  from BMJ Journals – NHS

Abstract:Background and Objectives in 2014 the workload relating to surveillance of indeterminate lung nodules was increasing with associated growing need for clinical and administrative resource. A ‘virtual’ nodule clinic (VNC) was established with clinicians reviewing scan Results and using an electronic proforma to generate a letter to both GP and patient outlining the results and any follow up plans. With each letter the patients are given details of how to arrange a clinic appointment for face-to-face discussion should they wish, as well as an information leaflet about lung nodules. When details of this novel service were presented at the BTS Winter Conference 2015 colleagues questioned the acceptability of this system to patients. Methods as many patients will never be seen in clinic face-toface it was not possible to ask their preference directly. As a surrogate we analysed patient records from each VNC between July 2014 and August 2016 to ascertain which patients had been seen in clinic following a VNC review, and whether that appointment was arranged at the patient’s request or by a clinician (for example due to nodule growth). If this was at a patient’s request we reviewed outpatient letters to ascertain, where possible, the reason for the review. Results 1591 patient episodes were reviewed. Of these 11 patients requested a face-to-face review. Reasons given included concerns about symptoms, malignancy and stopping follow up too soon. 89 VNC appointments resulted in the clinician requesting an appointment for face-to-face review. Conclusion The VNC is acceptable to patients with less than 1% of patient episodes resulting in a request for a face-to-face review. This compares with 5.6% of patient episodes where the clinician requests an appointment. Reasons given by patients for requesting a review should inform future revision of the patient information leaflet sent with each VNC letter.

Database: EMBASE

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