P355\u2005Design and implementation of the first one-stop multidisciplinary clinic for Lynch syndrome in the UK

Abstract

Introduction The clinical benefit of a multidisciplinary clinic (MDC) model has been well documented for a variety of medical conditions. We designed and implemented a novel MDC for Lynch syndrome (LS) patients, which aims to improve treatment outcomes, participation in research trials, and patient satisfaction. Methods From January 2019, LS patients in our region were invited to attend a bimonthly MDC offering gene-specific evidence-based cancer risk management. Patients could choose to see the gastroenterology, colorectal, gynaecology, medical oncology, research, and clinical psychology teams. Clinical outcomes and patient satisfaction were evaluated over 12 months. Results Thirty-eight LS patients were seen (8 MLH1, 18 MSH2, 8 MSH6, 4 PMS2); mean age was 46y (range: 20–69y); 15 patients had colorectal cancer (39.5%). Twenty-six (68.4%) patients were female; 6 (23.1%) had undergone prior risk-reducing gynaecological surgery, 7 (27%) underwent surgery at our institution (n= 4) or locally (n=3), and 13 (50%) were too young for surgery. Eight patients (30.8%) transferred their colonoscopic surveillance to our care due to concerns about local provision. Nineteen patients (73.1%) accessed psychological support and 10 patients (38.5%) were recruited to research studies. Twenty-six patients (68.4%) completed a post-clinic satisfaction questionnaire; 96.2% (n=25) rated their experience as excellent or very good. Conclusions We have designed and implemented an effective multidisciplinary model of care for LS, which addresses unmet needs in this patient group. Other institutions are encouraged to adopt a coordinated MDC service for LS. We will continue to evaluate the MDC’s impact on disease-specific outcomes in future reports.