HSR23-103: Pancreatic Cancer: The Impact of Early Connectivity and Coordination of Care on Retention and Time to Treat

Background: Delays in pancreatic cancer (PC) diagnosis and lack of coordinated care can often lead to increased anxiety. We hypothesized that early connection with patients would result in more efficient, comprehensive, and timely treatment. A pre-consultation phone call, First Connect (FC), was initiated by a nurse or physician assistant within 24 hours of the referral. Methods: PC patients with confirmed exocrine adenocarcinoma, presenting for initial consultation at our institution during January-December 2021, were included in the study (n=466). Data was collected on accuracy of scheduling, timeliness of appointment, coordination of care (defined as additional multidisciplinary consultations and/or supportive services (imaging, dietitian, genetics, social work)), and time to treatment initiation (TTI). Descriptive variables were used to report outcomes. Results: During 2021, 94% (440/466) of the patients were enrolled into the program. The completion rate was 100%. 21% of the appointments were rescheduled earlier by a median of 10 days based on medical need, availability, and appropriateness of provider. A change in multidisciplinary provider was required in 11% based on patient interview and disease stage, most commonly reflecting a change from surgery to medical oncology for metastatic disease. Median time from referral to scheduled appointment was 11 days. In 2021, 275 patients (59%) were seeking strictly medical oncology consultation for metastatic disease (n=242) or adjuvant therapy (n=33). Of those that were resectable, borderline resectable, or locally advanced (n=191), 76% (145/191) had coordinated care secondary to their FC call; 68% of patients saw multiple interdisciplinary providers, with 25% occurring on the initial visit, and 25% received supportive services. Coordinated care resulted in a retention rate of 88% (patient received multimodality therapy at our institution). As a result of FC calls and care coordination, median TTI was 21 days. Data pre-FC, pre-Covid demonstrates longer wait time for initial consultation (median=21 days), with fewer than 56% of patients receiving coordinated care, resulting in increased TTI. Conclusions: FC calls allowed for early connection and interview of patients with PC resulting in a high rate of coordinated care. This led to improved efficiency, retention, and TTI. FC calls appear to have a significant positive impact on patient care. Hence this may be an effective improvement for all disease sites.