Article – Research

Mind the gap: is it time to invest in embedded researchers in regional, rural and remote health services to address health outcome discrepancies for those living in rural, remote and regional areas?

Research capacity building in healthcare works to generate and apply new knowledge to improve health outcomes; it creates new career pathways, improves staff satisfaction, retention and organisational performance. While there are examples of investment and research activity in rural Australia, overall, rural research remains under-reported, undervalued and under-represented in the evidence base. This is particularly so in primary care settings. This lack of contextual knowledge generation and translation perpetuates rural–metropolitan health outcome disparities. Through greater attention to and investment in building research capacity and capability in our regional, rural and remote health services, these issues may be partially addressed. It is proposed that it is time for Australia to systematically invest in rurally focussed, sustainable, embedded research capacity building.

Aust J Prim Health (2019) 25 (2): 104–107.
https://doi.org/10.1071/PY18201

Impacts of a Clinical Quality Registry on Lung Cancer Quality measures: A retrospective observational study of the Victorian Lung Cancer Registry

Highlights

• Clinical Quality Registries describe the appropriateness and effectiveness of delivered care

• We identified significant unwarranted clinical variation in Victorian lung cancer quality indicators

• We observed rapid translation of best evidence-based practice molecular investigation to clinical care

• The Victorian Lung Cancer Registry observed significant improvement in clinical documentation and MDM presentation

• Address to psycho-social distress screening remains a challenging objective

Real-world implementation of geriatric assessment in cancer care among older adults: the role of implementation science frameworks

Abstract

Purpose of review: The evidence supporting geriatric assessment (GA) in cancer care is well established, and GA is recommended by the American Society of Clinical Oncology, the International Society of Geriatric Oncology, and other oncology bodies. However, effective implementation of GA remains inadequate. Using selected papers indexed in Medline from the most recent 18 months to July 2024, including two outstanding interest papers, this review aimed to describe enablers and barriers to GA implementation in oncology and contrasts implementation with and without an implementation science framework. Finally, we make recommendations on applying an implementation science framework to facilitate integrating GA in oncology.

Recent findings: Implementation science frameworks have been widely employed in health services research, but their use in geriatric oncology, particularly to guide GA implementation and evaluation, is limited. Lack of time in busy practices coupled with workforce shortages adds to the challenges of GA implementation and adoption. A variety of screening and assessment tools such as the G8, electronic rapid fitness assessment, and Eastern Cooperative Oncology Group are often used in lieu of geriatrician review and to streamline GA. When effectively implemented in oncology, GA informs care and treatment decisions for improved outcomes.Summary: Despite the benefits for older adults, embedding GA into routine clinical practice is critical yet not common practice. The variety of available GA tools, logistics, and individual beliefs are some of the identified barriers to GA adoption in oncology. Enablers include organization readiness, adaptability, communication, and the use of multidisciplinary teams. Further research is needed to examine how implementation science frameworks could provide guidance and structure for successful GA implementation in oncology.

Palliative care clinical trials research in regional settings: Green fields of opportunity

ReViTALISE Palliative Care Research Fellow Dr Miriam Ferres’s publication was released in the Internal Medicine Journal recently. The publication, ‘Palliative care clinical trials research in regional settings: Green fields of opportunity’, highlights a baseline census conducted to establish the current research and clinical trial availability across eight participating regional palliative care services.

The project is funded through the Australian Medical Research Future Fund.