COSA Fellowships

Project: Documentation of hypersensitivity reactions to systemic anticancer therapy (SACT)

A COSA Position Statement will be developed for endorsement by the CPG Executive and COSA Council, on the Documentation of hypersensitivity reactions to systemic anticancer therapy (SACT) to support safe, consistent, and high-quality practice across Australian cancer services.

Project: Developing a value-based framework for exercise oncology programs

The aim of the project is to calculate the costs and benefits of implementing the COSA exercise guidelines and the expected losses from suboptimal implementation. This work will make an important contribution to the exercise oncology literature as we move towards the implementation phase.

Project: Evidence Synthesis and development of an implementation plan for the COSA Model of Survivorship Care

The project is aimed at helping the Survivorship Policy and Implementation Working Group to review and update the COSA Model of Survivorship Care and to co-develop a national implementation plan to support its translation into routine practice.

Project: Mapping Survivorship in Australian State and Territory Cancer Plans: A National Update

The project aim is to conduct a national review of survivorship content in current Australian State and Territory cancer plans, and to compare findings with the Australian Cancer Plan (ACP) to help the Survivorship Policy and Implementation Working Group identify opportunities for alignment, enhancement, and national consistency. 

Project: Assessing the current provision of nutrition and dietetic services to people with cancer within acute health services providing cancer treatment across Australia

The project is aimed at identifying where targeted service improvement and advocacy are most needed.

Project: Implementation of World Health Organization (WHO) Rehabilitation and Psychological Intervention Packages for people with cancer in the Solomon Islands: Perspectives of Health Professionals

Alanah will be working on the Exercise and Rehabilitation Implementation component of the project.

The project is ultimately aimed at producing practical useable outputs in the form of co-designed health professional and consumer materials, as well as resource-adapted guidelines and models of care that would be suitable for the Solomon Islands and potentially be adaptable to other Pacific Islands.

Project: Research into solutions that aim to reduce financial toxicity

The project is aimed at advancing activity under COSA’s Financial Toxicity Roadmap to Reducing Financial Toxicity Experienced by People Affected by Cancer.

Project: Implementation of World Health Organization (WHO) Rehabilitation and Psychological Intervention Packages for people with cancer in the Solomon Islands: Perspectives of Health Professionals

Gowri will be working on the Policy and Implementation component of the project.

The project is ultimately aimed at producing practical useable outputs in the form of co-designed health professional and consumer materials, as well as resource-adapted guidelines and models of care that would be suitable for the Solomon Islands and potentially be adaptable to other Pacific Islands for implementation.

Project: An options analysis to identify and determine feasible and beneficial options to enhance job and income security and mitigate the risk of financial toxicity

The project is aimed at advancing activity under COSA’s Financial Toxicity Roadmap to Reducing Financial Toxicity Experienced by People Affected by Cancer.

Project: Defining research and infrastructure priorities for cancer survivorship in Australia: a modified Delphi study
The aim of this study was to establish research and infrastructure priorities for cancer survivorship in Australia. In line with similar initiatives internationally, a two-round modified-Delphi study was conducted with key stakeholders to develop a list of important priorities for cancer survivorship research.

Following an international literature search, 77 priority items were generated and mapped across four research categories: physiological outcomes; psychosocial outcomes; population groups; and health services, and one category concerning research infrastructure. In round one,panellists ranked the importance of the items and in round two, panellists ranked their top five priorities within each category and specified the type of research needed.

Upon completion, the highest priorities included cancer progression or recurrence, fear of recurrence, rare cancer types or cancer types under-represented in research, and quality of care research. Research priorities reflect cancer survivors’ unmet needs, and there was a strong preference for intervention development and implementation research designs in most areas. The availability of patient data; multi-disciplinary, collaborative research; and funding opportunities were the most important infrastructure priorities.

This study has defined priorities that can be used to support coordinated action between researchers, funding bodies, and other key stakeholders.

Published research:
Research and infrastructure priorities for cancer survivorship in Australia: a modified Delphi study

Project: Quality cancer survivorship care: a modified Delphi study to define nurse capabilities

The aim of this project was to establish capabilities required by nurses to deliver quality cancer survivorship care in Australia. A two-round online modified Delphi was conducted with Australian cancer nurses; 63 capabilities across eight cancer survivorship care domains were identified and allocated to different nursing groupings.

This study provides important foundational work by identifying the capabilities of cancer nurses to deliver quality cancer survivorship care in Australia. The identification of clearly defined capabilities may improve the quality of cancer survivorship care through the enrichment and standardisation of educational curricula and continuing professional education, and through improved workforce planning.

Published research:
Quality cancer survivorship care: a modified Delphi study to define nurse capabilities

Project: Priority recommendations for the implementation of patient-reported outcomes in clinical cancer care: A Delphi study

The aim of this study was to develop priority recommendations for the service level implementation of patient reported outcomes (PROs) into clinical cancer care.

Development of draft guidance statements was informed by a literature review, the Knowledge to Action (KTA) implementation framework, and discussion with PRO experts and cancer survivors. A two-round modified Delphi survey with key stakeholders including cancer survivors, clinical and research experts, and IT specialists was undertaken. Round 1 rated the importance of the statements and Round 2 ranked statements in order of priority.

Items ranked as the highest priorities included assessment of current staff capabilities and service requirements, mapping of workflows and processes to enable collection, and using collected PROs to guide improved health outcomes.

This stakeholder consultation process has identified key priorities in PRO implementation into clinical cancer care that include: clinical relevance, stakeholder engagement, communication, and integration within the existing processes and capabilities.

Publications:
Priority recommendations for the implementation of patient-reported outcomes in clinical cancer care: a Delphi study
PRO Active Workshop November 2023 - Summary Report published July 2024

Project: Current landscape of cancer survivorship research in Australia

The study aimed to address gaps, minimise research duplication, and provide vital information to direct investment.

Research gaps were identified in rare cancer populations, late survivorship, gender- and culturally-diverse Australians, and people with a disability. Addressing these gaps is essential to diversifying national survivorship research and responding to the needs of survivors in these populations.

Barriers impeding survivorship research activity included funding, networking and collaboration, mentoring, and time.

Published research:
Current landscape of cancer survivorship research in Australia

Project: Utilisation of Medicare Chronic Disease Management item numbers for people with cancer in Queensland, Australia

Chronic disease is common in people with cancer. However, the utilisation of Medicare chronic disease management (CDM) items for cancer patients in Australia remains unexplored. This study investigated Medicare CDM item numbers relating to people with cancer, including general practitioner (GP) and allied health CDM item numbers, and any associated sociodemographic factors.

Data from 86,571 people with cancer registered in the Queensland Cancer Registry between July 2011 and June 2015 and the CDM items codes from Medical Benefits Scheme records until 2018 were analysed. This includes utilisation of General Practitioner Management Plans (GPMP) and Team Care Arrangements (TCAs), reviews of GPMPs and TCAs, and engagement with allied health services until June 2018 following a cancer diagnosis.

The findings underscore the need to examine uptake and implementation patterns of CDM items, especially in relation to clinical, social, and service provider-level factors and related potential barriers. Further exploration is warranted to understand whether people with cancer’s care needs are being met and ways to optimise the supportive care of these people.

Published research:
Utilisation of Medicare chronic disease management item numbers for people with cancer in Queensland, Australia

Project: Patterns of Care and Health Service Costs for Adolescent and Young Adult Cancer Survivors in Queensland

This Fellowship project aimed to quantify health service use and out-of-pocket costs for adolescents and young adults with cancer in Queensland over time, and focused on:

• Diversity across First Nations and Non-First Nations people
• Diversity in different geographical and sociodemographic settings
• Differences in cancer diagnosis and age

Published research:
Quantifying Cancer Healthcare Costs for Adolescents and Young Adults in Queensland, Australia

Project: Priorities for multimorbidity management and research in cancer: a Delphi study of Australian cancer survivors, clinicians, and researchers

Multimorbidity is common in people with cancer and associated with increased complexity of care, symptoms, mortality, and costs. This study aimed to identify priorities for care and research for cancer survivors with multimorbidity.

A Delphi consensus process was conducted. Elements of care and research were based on Australia’s National Strategic Framework for Chronic Conditions, a literature review, and expert input. For care delivery, principles of ‘survivorship’ and ‘self-management’ were ranked highest, and ‘peer support’ and ‘technology’ were the most important enablers. For research, ‘survivorship’ and ‘coordinated care’ were the highest-ranked principles, with ‘peer support’ and ‘education’ the most important enablers.

Most elements apply to the general population and cancer survivors; however, additional elements relevant to survivorship need consideration when managing multimorbidity in cancer survivors. Chronic disease frameworks should be more inclusive of issues prioritised by people with, managing, or researching cancer through interdisciplinary approaches including acute and primary care.

Published research:
Priorities for multimorbidity management and research in cancer: a Delphi study of Australian cancer survivors, clinicians, and researchers.