Will the presence of the patient at multidisciplinary meetings influence the decision in head and neck oncology management?

Massoubre, J.; Lapeyre, M.; Pastourel, R.; Dupuch, V.; Biau, J.; Dillies, Anne-Françoise; Mom, T.; Pereira, Bruno; Gilain, L.; Saroul, N.

doi:10.1080/00016489.2017.1384059

Cited by 8 publications

(10 citation statements)

References 12 publications

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“…In general, healthcare providers fear attendance would increase anxiety, undermine the doctor-patient relationship (through complex discussions in jargon with different viewpoints put forward by the attending professionals) and have a negative impact on the dynamics of the meeting [ 22 ]. The effect of the presence of the patient during the MDTM, including physical examination, did not change the therapeutic decision in a prospective study among 119 head and neck cancer patients [ 60 ]. From a patient’s point of view, increased anxiety or depression due to MDTM participation was not noted in most studies, while being better informed and able to present their own preferences were named as advantages [ 20 , 23 , 24 , 27 , 60 ].…”

Section: Resultsmentioning

confidence: 99%

“…The effect of the presence of the patient during the MDTM, including physical examination, did not change the therapeutic decision in a prospective study among 119 head and neck cancer patients [ 60 ]. From a patient’s point of view, increased anxiety or depression due to MDTM participation was not noted in most studies, while being better informed and able to present their own preferences were named as advantages [ 20 , 23 , 24 , 27 , 60 ].…”

Section: Resultsmentioning

confidence: 99%

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Factors influencing the quality and functioning of oncological multidisciplinary team meetings: results of a systematic review

Walraven

Hel

Hoeven³

et al. 2022

BMC Health Serv Res

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Background Discussing patients with cancer in a multidisciplinary team meeting (MDTM) is customary in cancer care worldwide and requires a significant investment in terms of funding and time. Efficient collaboration and communication between healthcare providers in all the specialisms involved is therefore crucial. However, evidence-based criteria that can guarantee high-quality functioning on the part of MDTMs are lacking. In this systematic review, we examine the factors influencing the MDTMs’ efficiency, functioning and quality, and offer recommendations for improvement. Methods Relevant studies were identified by searching Medline, EMBASE, and PsycINFO databases (01–01-1990 to 09–11-2021), using different descriptions of ‘MDTM’ and ‘neoplasm’ as search terms. Inclusion criteria were: quality of MDTM, functioning of MDTM, framework and execution of MDTM, decision-making process, education, patient advocacy, patient involvement and evaluation tools. Full text assessment was performed by two individual authors and checked by a third author. Results Seventy-four articles met the inclusion criteria and five themes were identified: 1) MDTM characteristics and logistics, 2) team culture, 3) decision making, 4) education, and 5) evaluation and data collection. The quality of MDTMs improves when the meeting is scheduled, structured, prepared and attended by all core members, guided by a qualified chairperson and supported by an administrator. An appropriate amount of time per case needs to be established and streamlining of cases (i.e. discussing a predefined selection of cases rather than discussing every case) might be a way to achieve this. Patient centeredness contributes to correct diagnosis and decision making. While physicians are cautious about patients participating in their own MDTM, the majority of patients report feeling better informed without experiencing increased anxiety. Attendance at MDTMs results in closer working relationships between physicians and provides some medico-legal protection. To ensure well-functioning MDTMs in the future, junior physicians should play a prominent role in the decision-making process. Several evaluation tools have been developed to assess the functioning of MDTMs. Conclusions MDTMs would benefit from a more structured meeting, attendance of core members and especially the attending physician, streamlining of cases and structured evaluation. Patient centeredness, personal competences of MDTM participants and education are not given sufficient attention.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Factors influencing the quality and functioning of oncological multidisciplinary team meetings: results of a systematic review

Walraven

Hel

Hoeven³

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…For future research, we strongly recommend defining and differentiating the unit of analysis by breaking it down into the recommendation or decision. This might explain divergent results concerning the need for MTCpp: While Massoubre et al 36 found that 97% of MTC recommendations without patient participation were followed and concluded that MTCpp is not essential, Hollunder et al found a great lack of MTC decision adherence caused by missing patient information and failure to consider their preferences 23 which might increase the need for MTCpp, even in the case of limited clinical evidence 53 or limited multidisciplinary discussion. 54,55 For future research, this should firstly mean that patient outcomes have to be analyzed as they are an important part of general MTC outcome quality.…”

Section: Discussionmentioning

confidence: 99%

“…Our results confirm previous findings from international research concerning providers' views on MTCpp. [34][35][36][37]51 Butow et al 2007 reported providers mentioning potential patient anxiety during and after the MTC as well as a conflict between medical and lay language. 35 We can expand Butow's findings concerning the management of patient involvement by describing variations of MTCpp: Patients may enter the MTC after the medical discussion, a smaller MTC setting may be implemented, and patients may be supported by a breast care nurse before, during and after the meeting.…”

Section: Feasibility Of Mtc Patient Participationmentioning

confidence: 99%

“…Few studies have explored the attitudes of providers toward MTCpp as well as its potential benefits and risks. [34][35][36][37][38] Still, the question if and how MTCpp is feasible in routine cancer care remains unanswered. Analyzing the providers' perspective is important since their expectations or experiences might influence the possibility for patients to participate in an MTC in a cancer center.…”

Section: Introductionmentioning

confidence: 99%

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<p>Patient Participation in Multidisciplinary Tumor Conferences from the Providers’ Perspective: Is It Feasible in Routine Cancer Care?</p>

Heuser

Diekmann

Schellenberger

et al. 2020

JMDH

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Objective: Recent studies from Germany show that a small amount of breast and gynecological cancer patients participate in multidisciplinary tumor conferences (MTCs) at some cancer centers. One reason for the variation by center might be the providers' attitudes about and experiences with MTC patient participation (MTCpp), which has not been analyzed before. Therefore, it is the aim of this study to analyze the providers' expected or experienced feasibility concerning MTCpp at breast and gynecological cancer centers in Germany. Methods: This paper presents cross-sectional qualitative interview data from the PINTU study. From April to December 2018, n=30 health-care providers from n=6 breast and gynecological cancer centers in North-Rhine-Westphalia, Germany, were interviewed. Onehalf of the providers had no experience and the other half had experience with MTCpp. Inductive and deductive coding was performed in order to capture the feasibility aspects of participation. Results: MTCpp seems not to be feasible in routine cancer care following providers' expected barriers and negative experiences. However, MTCpp seems to be feasible for selected cancer patients following providers' expected opportunities and positive experiences. Our results show that both provider groups report positive and negative experiences or expectations. Conclusion: The mixed findings regarding expected or experienced feasibility of MTCpp provide first insights into differences concerning MTCpp between organizations. Our results suggest that the providers' perceptions (expectations and experiences) influence the possibility for patients to participate in an MTC in a cancer center.

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Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations

et al. 2020

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Background Multidisciplinary team (MDT) meetings or tumor boards (TBs) are fundamental components of cancer treatment. Although their primary function is improved outcomes, this aspect is often underreported. The main objective of this study was to analyze the outcomes of patients with head and neck squamous cell carcinoma (HNSCC) discussed at TBs, and to compare the effect of adherence and nonadherence to recommended treatment plans on outcomes. Methods Retrospective data analysis was conducted of HNSCC patients those who were adherent and nonadherent to TB therapy recommendations during 2008‐2009 at a comprehensive cancer center. Fisher's exact test and t test were used for group‐wise comparison, and Kaplan‐Meier and logistic regression models, for survival analysis and determination of the contributing factors to nonadherence. Results Comprehensive Treatment plans were recommended by TBs in 293 HNSCC patients with curative intent. Seventy‐two patients were excluded based on the selection criteria. Among the remaining 221 patients, 172 (77.9%) were adherent to TB recommendations, while 49 (22.1%) failed to comply. Patient (n = 36; 73.5%), clinician (n = 2; 4.1%), and disease‐related (n = 11; 22.4%) factors were significant contributors to nonadherence. Mean (±standard deviation (SD)) survival time was 55.6 ± 2.32 and 29.1 ± 4 months in the adherent and nonadherent groups, ( P < .0001, respectively). Multivariate analyses showed that gender, ethnicity, higher T‐stage, and multimodal treatment were associated with nonadherence. Conclusion Adherence to TB recommendations improved overall survival, reflecting the importance of interdisciplinary expertise in contemporary cancer treatment. Early identification and intervention is crucial in “at risk” patients to prevent subsequent drop‐out from optimal cancer care.

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Will the presence of the patient at multidisciplinary meetings influence the decision in head and neck oncology management?

Abstract: The presence of the patient during MTMs is not essential if the files are thoroughly presented and discussed.

Cited by 8 publications

References 12 publications

Factors influencing the quality and functioning of oncological multidisciplinary team meetings: results of a systematic review

Factors influencing the quality and functioning of oncological multidisciplinary team meetings: results of a systematic review

<p>Patient Participation in Multidisciplinary Tumor Conferences from the Providers’ Perspective: Is It Feasible in Routine Cancer Care?</p>

Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations

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