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The following is a summary of “Interventions To Improve Adherence To Clinical Guidelines For The Management And Follow-Up Of Pulmonary Nodules: A Systematic Review,” published in the March 2025 issue of the CHEST by Aunger et al. 

Lung cancer is the leading cause of cancer-related mortality worldwide and the third most commonly diagnosed cancer in the United Kingdom. The early detection and appropriate management of pulmonary nodules are critical for improving patient outcomes, as these nodules can be indicative of early-stage lung cancer. However, adherence to established guidelines for pulmonary nodule surveillance and management remains inconsistent, and the most effective strategies for improving adherence have not been clearly identified. This systematic review aimed to evaluate existing interventions designed to enhance adherence to pulmonary nodule management guidelines and assess their impact on follow-up completion, guideline adherence, and early cancer detection.

Studies assessing interventions designed to improve follow-up completion, adherence to guideline-recommended management, or early diagnosis of lung cancer were included regardless of study design. The risk of bias was evaluated using three established quality assessment tools based on study type. A total of 3,664 titles and abstracts were screened, and 31 studies met the inclusion criteria. Six distinct categories of interventions were identified: tracking systems, clinical decision support tools, patient navigation programs, provider education initiatives, multidisciplinary team approaches, and automated reminders. All reported interventions demonstrated some level of effectiveness, with tracking systems and clinical decision support tools showing the most significant improvements in adherence to guidelines, follow-up completion, and early lung cancer detection. However, follow-up rates varied substantially across studies, suggesting heterogeneity in intervention implementation, healthcare settings, and patient populations. 

While tracking systems exhibited the highest potential for improving patient follow-up, further research is needed to assess long-term effectiveness and generalizability across diverse healthcare settings. Given the critical role of early nodule detection in reducing lung cancer mortality, implementing robust, evidence-based interventions to optimize pulmonary nodule management is essential. Future studies should focus on integrating tracking systems with electronic health records, assessing cost-effectiveness, and standardizing outcome measures to ensure sustainable improvements in patient adherence and clinical outcomes.

Source: sciencedirect.com/science/article/pii/S0012369225002818