Table 2.

Summary of key recommendations for radium-223 service provision

Category	Recommendation
Centre organization and preparation: structured coordination	Designate a key staff member to be the main radium-223 service coordinator to interact with everyone involved and oversee the complete treatment process Ensure close alignment of the nuclear medicine, oncology and urology services
Centre organization and preparation: staff training	Nuclear medicine physicians should be familiar with the management of patients with radium-223 and alternative treatment options; additional focused education may be required Provide practical training for new and existing staff members (nurses/technologists/scientific staff) with respect to preparing and administering radium-223 injections
Patient referral	Before the introduction of a radium-223 therapy service, provide background information about radium-223 for referring physicians, including a checklist to identify patients who are suitable for treatment
Radium-223 treatment delivery/administration: blood tests	Patients should have the option of either two short visits at the centre (one for blood test, one for injection) or one longer visit (blood test and injection on the same day) Alternatively, blood tests may be performed at the local GP surgery or local hospital. Provision of results by telephone can be used as an opportunity to discuss the patient’s health status
Radium-223 treatment delivery/administration: administration of radium-223	The nuclear medicine physician should undertake a consultation with the patient at each injection to help build a trusting relationship and ensure continuity of care
Patient experience: patient comfort and satisfaction	Patients should have one key worker throughout the treatment period
Patient experience: patient information	Discrepancies between information derived from different sources should be avoided wherever possible (e.g., provide a national unified radium-223 flyer)

GP, general practitioner