Radiotherapy (RT) is an essential and cost-effective component of curative and palliative cancer treatments, but is currently underutilised in Australia. Perceptions of RT-related inconvenience may influence consumers’ (patients and carers) treatment decisions and treating doctors’ referral practices. This study explored perceptions of consumers and health professionals (HPs) regarding RT and its practicalities.
Semi-structured focus groups (FGs) and interviews were conducted between December 2011 and March 2012 with consumers and HPs in metropolitan and regional/rural NSW. FG and interview transcripts were analysed thematically.
Interviews and FGs were conducted with 26 consumers and 30 HPs from metropolitan (6 consumers, 13 HPs) and regional NSW (20 consumers, 17 HPs). Multiple logistical, financial and psychosocial issues with accessing and utilising RT were identified. These appeared pronounced in non-metropolitan NSW. Final decisions regarding RT appeared to be driven primarily by perceived treatment benefits. Those who declined RT felt the potential benefit was not worth the inconvenience to them/ their family. The role of HPs in influencing RT decisions was apparent from consumer and HP perspectives. HPs felt the opportunity to consult with a radiation oncologist (RO) was crucial for consumers to be informed about the role, benefits and toxicities of RT. Referring doctors’ knowledge and perceptions of RT and RO services appeared to be important factors in treatment decisions and referral. For some referrers, bias towards their own treatment speciality was a potential barrier to discussing RT. Inadequate knowledge or difficulties with referral pathways were also perceived as possible referral barriers.
Perceived RT-related inconvenience was multifaceted. Many consumers were prepared to endure considerable RT-related inconvenience to gain a treatment benefit. Referrer recommendation was an important influence on a patient’s decision. Underutilisation of RT may be due to inadequate patient information provision as well as multiple barriers at the referral level.