Barriers and facilitators to provide multidisciplinary care for breast cancer patients in five Latin American countries: A descriptive-interpretative qualitative study

Barrios, Carlos H.; Sánchez-Vanegas, Guillermo; Villarreal‐Garza, Cynthia; Gomez, Carlos Andres Ossa; Lombana, Milton; Monterrosa-Blanco, Angélica; Ferrigno, Ana S.; Castro, Carlos A.

doi:10.1016/j.lana.2022.100254

Cited by 11 publications

(15 citation statements)

References 30 publications

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“…Patients, therefore, require frequent access to these services, and health services planning requires considering the integration of services, including chemotherapy that might be given in combination with chemotherapy. [37][38][39]73,85 Future research could optimise the distribution of treatments with an integral perspective to minimise travel and service fragmentation and to provide continuity with established integral cancer treatment teams. 73 Radiotherapy services are a sophisticated, expensive technology delivered by highly trained teams, with specialised radiotherapy modalities (e.g., 3D Conformal Radiotherapy, Intensity-Modulated Radiation Therapy, Image Guided Radiation Therapy, Stereotactic Body Radiation Therapy, Proton Therapy) beyond conventional radiotherapy (i.e., 2D Conformal Radiotherapy) There is an opportunity to look at the accessibility issues seeking to ensure a sound distribution of treatment modalities for existing service clusters and new centres to offer most common treatment options within reasonable travel times from where most of the population resides.…”

Section: Key Resultsmentioning

confidence: 99%

“…Since radiotherapy is an integral part of a comprehensive treatment, service providers should avoid fragmenting healthcare services to maximise accessibility and quality of care. 36,37,73 Recognising that many individuals may face challenges accessing the service providers with the shortest journeys, our study ndings are intended to encourage and inform societal agreements to improve accessibility to such radiotherapy services. This challenge will likely extend to other cities in Colombia and beyond, amplifying inequities.…”

Section: Discussionmentioning

confidence: 99%

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Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020

Cuervo,

Villamizar,

Cuervo

et al. 2024

Preprint

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In this study, we employed a methodology to evaluate and forecast the cumulative opportunities for residents to access radiotherapy services in Cali, Colombia, while accounting for traffic congestion from an equity perspective. Furthermore, we identified 1-2 optimal locations where new services would maximise accessibility. We utilised open data and publicly available big data. Methodology: Using a people-centred approach, we tested a web-based digital platform developed through design thinking. The platform integrates open data, including the location of radiotherapy services, the disaggregated sociodemographic microdata for the population and places of residence, and big data for travel times from Google Distance Matrix API. We used genetic algorithms to search heuristics to identify optimal locations for new services. We predicted accessibility cumulative opportunities (ACO) for traffic ranging from peak congestion to free-flow conditions at hourly assessments for 6–12 July 2020 and 23–29 November 2020. The interactive digital platform is openly available. Primary and Secondary Outcomes: We present descriptive statistics and population distribution heatmaps based on 20-minute Accessible Catchment Area (ACO) isochrones for car journeys. These isochrones connect the population-weighed centroid of the traffic analysis zone at the place of residence to the corresponding zone of the radiotherapy service with the shortest travel time under varying traffic conditions, ranging from free-flow to peak-traffic congestion levels. Additionally, we conducted a time-series bivariate analysis to assess geographical accessibility based on economic stratum. We identify 1–2 optimal locations where new services would maximise the 20-minute ACO during peak-traffic congestion. Results: Traffic congestion significantly diminished accessibility to radiotherapy services, particularly affecting vulnerable populations. For instance, urban 20-minute ACO by car dropped from 91% during free-flow traffic to 31% during peak traffic for the week of 6–12 July 2020. Specific ethnic groups, individuals with lower educational attainment, and residents in the outskirts of Cali experienced disproportionate effects, with accessibility decreasing to 11% during peak traffic compared to 81% during free-flow traffic for low-income households. We predict that strategically adding sufficient services in 1–2 locations in eastern Cali would notably enhance accessibility and reduce inequities. The recommended locations for new services remained consistent in both of our measurements. These findings underscore the significance of prioritising equity and comprehensive care in healthcare accessibility. They also offer a practical approach to optimising service locations to mitigate disparities. Expanding this approach to encompass other transportation modes, services, and cities, or updating measurements, is feasible and affordable. The new approach and data are particularly relevant for planning authorities and urban development actors.

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Section: Key Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020

Cuervo,

Villamizar,

Cuervo

et al. 2024

Preprint

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“…The clinical management of patients by MDT has now entered clinical practice and is recommended by several oncologic guidelines, 26,27 although the implementation is heterogenous worldwide, 28 especially in developing countries. 29 It is well established that the accuracy of diagnosis is improved, with the indication to perform examinations to guarantee a more complete staging [14][15][16][17]30 and cancer care can be improved using newly developed electronic health record and cloudbased software. 11,12,31 Consequently, treatment is also modified and integrated among all the specialists taking part in the discussion, thus increasing the adherence to the guidelines.…”

Section: Discussionmentioning

confidence: 99%

From “Cure” to “Care”: The Role of the MultiDisciplinary Team on Colorectal Cancer Patients’ Satisfaction and Oncological Outcomes

Lucarini¹,

Garbarino²,

Orlandi³

et al. 2022

JMDH

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Background: MultiDisciplinary Team (MDT) are held to undertake decisions regarding the whole aspect of oncological diseases. Over the years, they acquired a collaborative approach where clinical decisions are shared by all members. Different guidelines recommend the implementation of MDT, in order to improve the outcomes of these patients. Our aim is to evaluate how the implementation of MDT affects the patients' satisfaction and adherence to treatment. Methods: A survey was submitted to every patient affected by colorectal cancer treated by the MDT of Sant'Andrea Hospital (Rome, IT). The investigation period was January 2017-March 2020. Data from patients inside the MDT were compared with patients outside the MDT to evaluate a reduction in waiting times. Results: A total of 591 patients were collected. A total of 355 patients with colorectal neoplasia were included in our analysis. Cumulative overall survival was 79%. The average waiting time for computed tomography or colonoscopy was 14.9 days for patients in the MDT versus 24.5. A total of 201 patients were eligible for our satisfaction survey. An 89.5% of patients felt followed in their treatment. A 93.5% of patients expressed a high grade of satisfaction for the MDT design. Conclusion: Our study confirms the importance of a well-structured MDT. Dedicated slots shorten the waiting time, leading to better satisfaction and faster diagnosis. Patients' satisfaction should be considered as an index of good practice when it comes to oncological patients' treatment.

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“…For example, in cancer treatment, considerable high-level evidence for the effectiveness of MAs has been accumulated, and the concept has been fully endorsed by cancer organizations. [1][2][3] However, evidence for the effectiveness of MAs in the care of patients with spinal disabilities is not well established. 4 Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord impairment worldwide; the prevalence is estimated at a minimum of 605 per million in North America.…”

mentioning

confidence: 99%

“…A multidisciplinary approach (MA) enhances the collaboration and coordination of health services to improve patient care through smooth communication among different disciplines involved in patient management. For example, in cancer treatment, considerable high-level evidence for the effectiveness of MAs has been accumulated, and the concept has been fully endorsed by cancer organizations 1–3 . However, evidence for the effectiveness of MAs in the care of patients with spinal disabilities is not well established 4 …”

mentioning

confidence: 99%

The Impact of Multidisciplinary Approaches to Social Functioning on Surgical Outcomes Following Surgery for Cervical Myelopathy

Tamai

Terai

Watanabe

et al. 2023

Spine

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Study Design. Prospective cohort study Objective. To identify the effects of multidisciplinary approaches (MAs) to improve social functioning (SF) on 1-year surgical outcomes in patients with cervical myelopathy Summary of Background Data. Despite significant improvement in cervical myelopathy, a patient’s quality of life (QOL) sometimes does not improve postoperatively. A previous study revealed that SF, rather than myelopathy severity, correlated with QOL improvement after decompression surgery for cervical myelopathy. Methods. This study compared two prospective cohorts in Japan. Patients who underwent cervical laminoplasty for cervical myelopathy from 2018 to 2020 were enrolled in the control cohort. Patients who underwent the same surgery with the same indications between 2020 and 2021 were enrolled in the MA cohort. Patients in the control cohort were treated with a standard care protocol and those in the MA cohort were treated with a multidisciplinary protocol that focused on SF improvement. The changes in the total JOA score and in the domains of the JOA scores (upper limb function, lower limb function, upper limb sensory, and lower limb sensory) from preoperatively to 1 year postoperatively were compared between the control and MA cohorts using a mixed-effect model. Results. The control and MA cohorts comprised 140 and 31 patients, respectively. The improvement in the Japanese Orthopaedic Association (JOA) score was significantly better in the MA cohort than in the control cohort (P=0.040). In analyses of each JOA score domain, the improvement of upper limb function was significantly better in the MA cohort than in the control cohort (P=0.033). Similarly, the MA cohort demonstrated significantly higher patient-reported outcome for upper extremity function than the control cohort (P<0.001). Additionally, the self-care domain of QOL score at 1 year postoperatively was significantly higher in the MA cohort than in the control cohort (P=0.047). Conclusion. MAs to improve/rebuild a patient’s SF were effective in improving cervical myelopathy and self-care domain of QOL. This study is the first to demonstrate the effectiveness of a postoperative MAs in patients with cervical myelopathy. Level of Evidence. III

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Barriers and facilitators to provide multidisciplinary care for breast cancer patients in five Latin American countries: A descriptive-interpretative qualitative study

Cited by 11 publications

References 30 publications

Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020

Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020

From “Cure” to “Care”: The Role of the MultiDisciplinary Team on Colorectal Cancer Patients’ Satisfaction and Oncological Outcomes

The Impact of Multidisciplinary Approaches to Social Functioning on Surgical Outcomes Following Surgery for Cervical Myelopathy

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