Outpatient specialized care (ASV) is intended to improve interdisciplinary, transsectoral care for patients with rare or complex diseases, especially cancer. Up to now, only very few such specialized care teams have been established. The aim of our study was to evaluate the current state of information and participation as well as reasons for the reluctance of office-based hematologists and oncologists. We conducted a web-based survey amongst office-based hematologists and oncologists in Germany and received responses from 145 institutions comprising more then 350 doctors working there. The questions comprised 22 items concerning the state of information, implementation as well as obstacles to participation and evaluation of the ASV. The majority of the interviewed doctors was well informed about ASV. Only a minority was in principle against this concept. 6% of them had already treated patients within ASV, 8% had completed the preparation, 16% were in the preparation process, 26% were indecisive and 45% had decided not to participate. The main reasons for non-participation or barriers were high expenditure and a lack of benefit for patients, strategic positioning as well as reimbursement. Although implemented more than 5 years ago, ASV plays no relevant role in patient care. The reluctance seems not to be due to information deficits, but rather to obstacles in the participation procedure. Relevant advantages for patient care, interdisciplinary communication or reimbursement are not anticipated. As long as the current low acceptance to participate in ASV is not improved, it cannot unfold its potential.
<b><i>Background:</i></b> Oral antiproliferative therapies have become increasingly important in the treatment of tumors. To ensure patient safety, medical care is focused on adherence and side effects. <b><i>Objectives:</i></b> To meet increased personnel and time requirements, delegation of tasks to nonmedical specialists (NMS) may be a solution; however, presently, little is known about the options in Germany. <b><i>Method:</i></b> At least 3,300 members of the German Society for Hematology and Medical Oncology (DGHO), 580 members of the Professional Association of Office-Based Hematologists and Oncologists in Germany (BNHO), and 1,500 members of the Conference on Oncology Nursing and Pediatric Nursing (KOK) were contacted via a web-based survey. The survey focused on the feasibility of oncology nurse consultation as an additional consulting service for patients undergoing oral tumor therapy. <b><i>Results:</i></b> In total, 255 (physicians) and 206 (NMS) questionnaires were evaluable; 90.9% of the physicians were hematologists/oncologists, 87.8% advocated oncology nurse consultation, 34.1% had previously implemented/scheduled such consultations, 58.3% of the NMS were nursing staff, 46.1% had advanced training in oral tumor therapy, 94.2% were interested in further qualifications, 37.8% worked at facilities with established/planned nurse consultations, and 62.1% personally conducted/preferred conducting consultations. <b><i>Conclusions:</i></b> Throughout Germany, there seems to exist a group of qualified NMS who are motivated to provide care to patients undergoing oral tumor therapy. Particular physicians actively support these nurse consultations. Extensive implementation of delegation concepts in standard care of patients undergoing oral tumor therapy is not yet underway.
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