Implementation Science for Global Oncology: The Imperative to Evaluate the Safety and Efficacy of Cancer Care Delivery

Tapela, Neo; Mpunga, Tharcisse; Karema, Nadine; Nzayisenga, Ignace; Fadelu, Temidayo; Uwizeye, Frank Regis; Hirschhorn, Lisa R.; Muhimpundu, Marie Aimée; Balinda, Jean Paul; Amoroso, Cheryl; Wagner, Claire; Binagwaho, Agnès; Shulman, Lawrence N.

doi:10.1200/jco.2015.61.7738

Cited by 19 publications

(12 citation statements)

References 78 publications

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“…The limited study window and restriction to newly diagnosed cases at only one site left us with a small sample size for many of our reported conditions. Additionally, we do not report extensive disease-specific outcomes, but this information has been published elsewhere for several of the disease groups in combination with the cohort from Butaro Cancer Center of Excellence [22,[25][26][27][28][29][30][31]. An additional limitation of our study is that transfer data was not available in the EMR, so transferred patients may have been recorded as LTFU.…”

Section: Discussionmentioning

confidence: 99%

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda

Rutayisire

Mutabazi

Bayingana

et al. 2020

Annals of Global Health

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Background: In rural sub-Saharan Africa, access to care for severe non-communicable diseases (NCDs) is limited due to myriad delivery challenges. We describe the implementation, patient characteristics, and retention rate of an integrated NCD clinic inclusive of cancer services at a district hospital in rural Rwanda. Methods: In 2006, the Rwandan Ministry of Health at Rwinkwavu District Hospital (RDH) and Partners In Health established an integrated NCD clinic focused on nurse-led care of severe NCDs, within a single delivery platform. Implementation modifications were made in 2011 to include cancer services. For this descriptive study, we abstracted medical record data for 15 months after first clinic visit for all patients who enrolled in the NCD clinic between 1 July 2012 and 30 June 2014. We report descriptive statistics of patient characteristics and retention. Results: Three hundred forty-seven patients enrolled during the study period: oncology-71.8%, hypertension-10.4%, heart failure-11.0%, diabetes-5.5%, and chronic respiratory disease (CRD)-1.4%. Twelve-month retention rates were: oncology-81.6%, CRD-60.0%, hypertension-75.0%, diabetes-73.7%, and heart failure-47.4%. Conclusions: The integrated NCD clinic filled a gap in accessible care for severe NCDs, including cancer, at rural district hospitals. This novel approach has illustrated good retention rates.

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Section: Discussionmentioning

confidence: 99%

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda

Rutayisire

Mutabazi

Bayingana

et al. 2020

Annals of Global Health

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“…The HVO program, for example, creates an infrastructure on site that improves safety, and gives estimates for each site of the risk involved for the volunteer and her family. Time spent away from one's home institution can interfere with teaching and research responsibilities; as noted above, metrics are needed to document the success of any intervention, and collaborations to study outcomes and implementations can lead to meaningful and significant research products [15]. Conscientious involvement of residents and fellows from one's home institution in outreach work can be invaluable for all concerned, and one could imagine that some institutions might recognize teaching at LMIC partner institutions as a portion of a faculty member's teaching obligation.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 98%

Cancer and the world's poor: What's a gynecologic cancer specialist to do?

Randall¹,

Goodman²,

Schmeler³

et al. 2016

Gynecologic Oncology

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“…A vital investment has been the development and refinement of an electronic medical records system to track patient outcomes, which allows for real-time monitoring, quality control, and prospective research. 65 A number of scientific articles have been published as a result, which document the patient outcomes at BCCOE—implementation science research is a priority of the MOH/DFCI/PIH partnership. 66 , 67 Although there are still no oncologists based at BCCOE, their partnerships have allowed for capacity-building and task-shifting.…”

Section: Rwanda: Partnering For Cancer Controlmentioning

confidence: 99%

Establishing Cancer Treatment Programs in Resource-Limited Settings: Lessons Learned From Guatemala, Rwanda, and Vietnam

Wagner

Antillón

Uwinkindi

et al. 2018

JGO

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PurposeThe global burden of cancer is slated to reach 21.4 million new cases in 2030 alone, and the majority of those cases occur in under-resourced settings. Formidable changes to health care delivery systems must occur to meet this demand. Although significant policy advances have been made and documented at the international level, less is known about the efforts to create national systems to combat cancer in such settings.MethodsWith case reports and data from authors who are clinicians and policymakers in three financially constrained countries in different regions of the world—Guatemala, Rwanda, and Vietnam, we examined cancer care programs to identify principles that lead to robust care delivery platforms as well as challenges faced in each setting.ResultsThe findings demonstrate that successful programs derive from equitably constructed and durable interventions focused on advancement of local clinical capacity and the prioritization of geographic and financial accessibility. In addition, a committed local response to the increasing cancer burden facilitates engagement of partners who become vital catalysts for launching treatment cascades. Also, clinical education in each setting was buttressed by international expertise, which aided both professional development and retention of staff.ConclusionAll three countries demonstrate that excellent cancer care can and should be provided to all, including those who are impoverished or marginalized, without acceptance of a double standard. In this article, we call on governments and program leaders to report on successes and challenges in their own settings to allow for informed progression toward the 2025 global policy goals.

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Implementation Science for Global Oncology: The Imperative to Evaluate the Safety and Efficacy of Cancer Care Delivery

Cited by 19 publications

References 78 publications

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda

Cancer and the world's poor: What's a gynecologic cancer specialist to do?

Establishing Cancer Treatment Programs in Resource-Limited Settings: Lessons Learned From Guatemala, Rwanda, and Vietnam

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