Impact of a Patient Navigator on Time to Diagnosis Among Pediatric Oncology Patients in Tanzania

Abstract

12 Background: Oncology patient navigation programs have been successfully implemented at hospitals throughout the United States and have enhanced the quality of care through financial guidance, treatment coordination, and psychosocial support. In low-resource settings, barriers to receiving cancer care are increased and a patient navigator in this setting has the potential to significantly impact outcomes; however, there is limited research on the efficacy of such programs in these settings. At Bugando Medical Centre in Mwanza, Tanzania, a patient navigation program was established to identify potential pediatric oncology patients, then assist these patients and their families throughout the diagnosis and treatment process with the goals of reducing time to oncology evaluation and diagnosis and, ultimately, improving survival outcomes. Methods: A retrospective analysis of hospital records was conducted of all pediatric oncology patients who were evaluated at Bugando Medical Centre from 2010 to 2016, separated by presentation date before or after establishment of the navigation program. Collected data include demographics, diagnosis, and time from presentation to oncology evaluation and diagnosis. Results: A total of 238 patient files were reviewed, with 169 patients pre- and 69 patients postprogram initiation. Patient groups did not differ by age or gender ( P = .329 and .744, respectively) or diagnosis distribution. After establishing a patient navigator program, average time to oncology evaluation decreased from 49.7 days to 16.6 days ( P = .015), and time to diagnosis decreased from 49.1 days to 23.6 days ( P = .07). Conclusion: In pediatric cancer, early diagnosis is critical for initiation of chemotherapy and improvement of outcomes. This study has shown that a patient navigation program has the potential to significantly impact patient outcomes through reductions in time to evaluation and diagnosis and should be included in comprehensive pediatric cancer care programs. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.

The Effect of a Patient Navigator on Treatment Abandonment and Follow-up for High Grade Osteosarcoma Patients in the Philippine General Hospital

“…Several studies support patient navigators being part of cancer care in resource limited settings. A retrospective study in one of the medical centers in Tanzania showed significant impact of patient navigators in patient outcomes of pediatric cancers through reduced time to evaluation and diagnosis from 49.7 days to 16.6 days (p = 0.02) as well as in decreased rate of abandonment 50% to 38% (p < 0.001) (Alvi et al, 2017). A local study involving breast cancer patients noted a decreased attrition rate 62% to 18% (p<0.0001) and improved quality of life of breast cancer patients after navigation program was employed (Patdu et al, 2015).…”