Effects of oncological care pathways in primary and secondary care on patient, professional, and health systems outcomes: protocol for a systematic review and meta-analysis

Hoeve, Jolanda C. van; Vernooij, Robin W.M.; Fiander, Michelle; Nieboer, Peter; Siesling, Sabine; Rotter, Thomas

doi:10.1186/s13643-018-0693-x

Cited by 9 publications

(5 citation statements)

References 30 publications

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“…A preliminary search for existing reviews was conducted in Cochrane Database, JBI Database of Systematic Reviews and Implementation Reports and PROSPERO. Care pathways have been the subject of few reviews, but these were limited to a single pathology such as cancer in general [ 33 ], blunt thoracic injury [ 34 ], cardiovascular disease [ 35 ], adolescent idiopathic scoliosis [ 36 ] or for particular pathway phases [ 37 ]. In the end, focusing on a single condition is not entirely consistent with a patient-centered approach to care insofar as patients often have comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review

Gartner

Kassim

Bergeron

et al. 2022

BMC Health Serv Res

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Background Confusion exists over the definition of the care pathway concept and existing conceptual frameworks contain various inadequacies which have led to implementation difficulties. In the current global context of rapidly changing health care systems, there is great need for a standardized definition and integrative framework that can guide implementation. This study aims to propose an accurate and up-to-date definition of care pathway and an integrative conceptual framework. Methods An innovative hybrid method combining systematic review, concept analysis and bibliometric analysis was undertaken to summarize qualitative, quantitative, and mixed-method studies. Databases searched were PubMed, Embase and ABI/Inform. Methodological quality of included studies was then assessed. Results Forty-four studies met the inclusion criteria. Using concept analysis, we developed a fine-grained understanding, an integrative conceptual framework, and an up-to-date definition of patient-centered care pathway by proposing 28 subcategories grouped into seven attributes. This conceptual framework considers both operational and social realities and supports the improvement and sustainable transformation of clinical, administrative, and organizational practices for the benefit of patients and caregivers, while considering professional experience, organizational constraints, and social dynamics. The proposed attributes of a fluid and effective pathway are (i) the centricity of patients and caregivers, (ii) the positioning of professional actors involved in the care pathway, (iii) the operation management through the care delivery process, (iv) the particularities of coordination structures, (v) the structural context of the system and organizations, (vi) the role of the information system and data management and (vii) the advent of the learning system. Antecedents are presented as key success factors of pathway implementation. By using the consequences and empirical referents, such as outcomes and evidence of care pathway interventions, we went beyond the single theoretical aim, proposing the application of the conceptual framework to healthcare management. Conclusions This study has developed an up-to-date definition of patient-centered care pathway and an integrative conceptual framework. Our framework encompasses 28 subcategories grouped into seven attributes that should be considered in complex care pathway intervention. The formulation of these attributes, antecedents as success factors and consequences as potential outcomes, allows the operationalization of this model for any pathway in any context.

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Section: Introductionmentioning

confidence: 99%

Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review

Gartner

Kassim

Bergeron

et al. 2022

BMC Health Serv Res

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“…A CP is concerned with a timeline of structured events to assist health care providers in coordinating and delivering care in the safest, most appropriate, effective, timely, efficient and equal manner [2][3][4]. It is also a valuable and cost-effective tool, especially in the field of oncology [5,6]. This characteristic is relevant in COVID-19 times, in which more professional and technical resources than ever need to be preserved.…”

Section: Introductionmentioning

confidence: 99%

Learning from Adaptations to the COVID-19 Pandemic: How Teleconsultation Supported Cancer Care Pathways at a Comprehensive Cancer Center in Northern Italy

Caviola

Daolio

Pellegri

et al. 2023

Cancers

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Multidisciplinary team (MDT) meetings are recognized as the gold standard for care management of cancer patients, and during the COVID-19 pandemic they were considered a priority to be maintained. Due to pandemic-related restrictions, MDT meetings were forcibly converted from in-person to telematic format. This retrospective study evaluated the annual performance of four MDT meeting indicators (MDT members’ attendance, number of discussed cases, frequency of MDT meetings, and duration) between 2019 and 2022 to report on the implementation of teleconsultation in MDT meetings related to 10 cancer care pathways (CCPs). Over the study period, MDT member participation and the number of discussed cases improved or did not change in 90% (9/10) and 80% (8/10) of the CCPs, respectively. We did not observe significant differences in any of the CCPs included in the study regarding the annual frequency and duration of MDT meeting. Considering the rapidity, extent, and intensity with which telematic tools were adopted due to the COVID-19 pandemic, the results of this study showed that MDT teleconsultation supported the CCPs, and consequently, the delivery of cancer care in COVID-19 times, helping to understand the effects of telematic tools on health care performance and the parties involved.

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“…Among the standard methods of analgesia, the need for general anesthesia (GA) declines with less-invasive oocyte retrieval techniques, and paracervical block (PCB) cannot meet a woman's anesthesia minimum needs. 1 Thus, conscious sedation and analgesia (CSA) are the most common and acceptable anesthesia methods with a high degree of satisfaction. 2 These pharmacological anesthetics provide immediate analgesia and are widely used in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Acupuncture for Pain Management in Women Undergoing Transvaginal Oocyte Retrieval

Liu¹,

Tian²,

Zhu³

et al. 2021

JPR

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Objective To obtain evidence-based conclusions about the effect of acupuncture on pain relief in women undergoing oocyte retrieval, the results of randomized controlled trials (RCTs) that met the criteria were assessed on the Pain Assessment Scale and pregnancy indicators. Search Methods References were retrieved in MEDLINE, EMBASE, CNKI database, CBM database, VIP database, and Wanfang database from inception to June 26, 2021. Unpublished ongoing trials were searched in the Clinical Trials Registries. This review included RCTs that investigated the acupuncture analgesic effects during oocyte retrieval in women undergoing in vitro fertilization. Results Fourteen RCTs (2503 women in total) with six types of comparisons were finally included. The quality of concluding evidence was generally low or very low. Performance bias and outcome assessment bias was the main risk of bias of the included studies. Acupuncture combined with conscious sedation and analgesia (CSA) was associated with less intraoperative (SMD=−1.03; 95% CI: −1.71 to −0.36) and postoperative (SMD = −1.11; 95% CI: −1.51 to −0.71) pain compared to receive CSA alone in oocyte retrieval. Acupuncture with non-steroidal anti-inflammatory drugs (NSAIDs) was more effective than using NSAIDs alone for postoperative analgesia (MD = −1.76; 95% CI: −2.08 to −1.44). Conclusion Acupuncture complex analgesic therapy is more effective than utilizing CSA or NSAIDs alone. Furthermore, there is no significant consensus on whether there is an analgesic effect of applying acupuncture alone during oocyte retrievals, which needs further research. The overall results should be interpreted with caution due to the high risk of bias/low-GRADE scores among these studies. Protocol and Registration PROSPERO registration number: CRD42020170095.

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Effects of oncological care pathways in primary and secondary care on patient, professional, and health systems outcomes: protocol for a systematic review and meta-analysis

Cited by 9 publications

References 30 publications

Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review

Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review

Learning from Adaptations to the COVID-19 Pandemic: How Teleconsultation Supported Cancer Care Pathways at a Comprehensive Cancer Center in Northern Italy

Systematic Review and Meta-Analysis of Acupuncture for Pain Management in Women Undergoing Transvaginal Oocyte Retrieval

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