The impact of a patient-centered care pathway for patients treated with oral anticancer drugs: a multicenter pre-post-test study in Flanders

Abstract

Purpose In the Collaborative Network To Take Responsibility for Oral Anticancer Therapy (CONTACT) project, an evidence-based and patient-centered care pathway was implemented in 12 oncology departments in Flanders. The care pathway was developed in co-creation by an interdisciplinary project team, and tailored to the local hospital context. In this study, the impact of the care pathways on quality of patient-centered care (PCC) and other patient outcomes was investigated. Methods A pre-post-test study was performed in nine of the participating oncology departments. The primary outcome was quality of PCC. Furthermore, level of patient self-management, medication adherence, satisfaction with information about the OACD, and quality of life were measured as secondary outcomes. Linear mixed models were used to investigate differences in outcomes between the pre- and post-test group. Results Quality of PCC, as well as all secondary outcomes improved after implementation of the care pathway. However, the changes in pre- and post-test scores were not significant. The overall quality of PCC increased from 3.72 to 3.88, measured on a five-point Likert scale (p = 0.124). Conclusion This study showed small, however not significant, improvements in the quality of PCC and other patient outcomes. The lack of significant changes can be attributed to the complexity of the care pathway development, poor or unstable implementation of the care pathway, and limited changes in follow-up care. More insight in the actual implementation of the care pathway and potential contextual factors influencing its effect is needed to help understand the outcomes of this pre-post-test study.