title: Barriers to radiotherapy utilisation in New South Wales Australia: Health professionals' perceptions of impacting factors.
abstract: BACKGROUND
  Utilisation of radiation therapy (RT) in Australia is below recommended evidence-based benchmarks. Barriers to the referral of patients for RT and the uptake of RT by patients may be affecting RT utilisation. The current study aimed to examine health professionals' (HPs) perceptions of potential barriers to RT referral and uptake.
  
  
  METHODS
  A custom survey was developed to assess perceptions regarding the degree to which a range of issues affect decisions regarding RT. Hard copy surveys were disseminated to HPs involved in the care of cancer patients across New South Wales (NSW): medical, radiation and surgical oncologists, physicians (including palliative care), and general practitioners with an interest in oncology. Electronic versions of the survey were disseminated via oncology multidisciplinary teams and professional networks at participating hospitals.
  
  
  RESULTS
  Two hundred fifty-three HPs participated via hard copy (n = 208) or electronic (n = 45) surveys. Two-thirds of HPs perceived acute side effects of RT, their management and impact on daily commitments, as well as fear and anxiety about RT, to exert moderate to significant influence on RT decisions. Treatment-related travel, need for accommodation and relocation were also perceived by 64% of HPs to do the same. Over half of HPs rated concern regarding late effects of RT, disruption to family and work life, and the ability to organise family and work commitments around RT, as moderate to significant influences on RT uptake.
  
  
  CONCLUSIONS
  Perceptions of HPs in NSW reveal potential important influencers of RT decisions by patients and clinicians. An understanding of these additional issues and their actual impact on RT-related decisions may inform future interventions to improve RT access and utilisation.
authors.affiliation: Central Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Puma
authors.initials: P
authors.lastname: Sundaresan
authors.affiliation: Central Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.|Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Madeleine T
authors.initials: MT
authors.lastname: King
authors.affiliation: Central Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.|Clinical Trials Centre, National Health and Medical Research Centre, Sydney, New South Wales, Australia.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Stockler
authors.affiliation: Psycho-Oncology Cooperative Research Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Daniel Sj
authors.initials: DS
authors.lastname: Costa
authors.affiliation: Central Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.|Chris O'Brien Life House, Sydney, New South Wales, Australia.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Milross
mesh_terms: D000488:Allied Health Personnel / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D006801:Humans; D009517:New South Wales; D010820:Physicians / Q000706:statistics & numerical data*; D011832:Radiation Injuries / Q000523:psychology*; D011878:Radiotherapy / Q000706:statistics & numerical data*; D014600:Utilization Review; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data
keywords: access; radiation therapy; treatment decision; utilisation