Cargando…
Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings
PURPOSE: Cervical cancer is a major cause of mortality in low- and middle-income countries (LMICs) and the most common cancer diagnosed in women in Botswana. Most women present with locally advanced disease, requiring chemotherapy and radiation. Care co-ordination requires input from a multidiscipli...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Society of Clinical Oncology
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646885/ https://www.ncbi.nlm.nih.gov/pubmed/29094103 http://dx.doi.org/10.1200/JGO.2016.006353 |
_version_ | 1783272166273318912 |
---|---|
author | Grover, Surbhi Chiyapo, Sebathu Philip Puri, Priya Narasimhamurthy, Mohan Gaolebale, Babe Eunice Tapela, Neo Ramogola-Masire, Doreen Kayembe, Mukendi K.A. Moloi, Thabo Gaolebale, Ponatshego Andrew |
author_facet | Grover, Surbhi Chiyapo, Sebathu Philip Puri, Priya Narasimhamurthy, Mohan Gaolebale, Babe Eunice Tapela, Neo Ramogola-Masire, Doreen Kayembe, Mukendi K.A. Moloi, Thabo Gaolebale, Ponatshego Andrew |
author_sort | Grover, Surbhi |
collection | PubMed |
description | PURPOSE: Cervical cancer is a major cause of mortality in low- and middle-income countries (LMICs) and the most common cancer diagnosed in women in Botswana. Most women present with locally advanced disease, requiring chemotherapy and radiation. Care co-ordination requires input from a multidisciplinary team (MDT) to deliver appropriate, timely treatment. However, there are limited published examples of MDT implementation in LMICs. METHODS: In May 2015, a weekly MDT clinic for gynecologic cancer care was initiated at Botswana’s national referral facility. The MDT clinic served as a forum for discussion and coordination of patients with gynecologic cancer and consisted of a gynecologist, pathologist, medical oncologist, radiation oncologist, palliative care specialist, and nurse coordinator. RESULTS: Between May 2015 and December 2015, 135 patients were seen in the MDT clinic. The mean age of the patients was 49 years. Most (60%) of the patients were HIV positive. The most common diagnosis was cervical cancer (60%), followed by high-grade cervical intraepithelial neoplastic lesions (12%) and vulvar cancer (11%). Only data up to September 2015 were assessed for treatment delays. It was found that only 38% of patients needed more than one visit for care coordination before treatment initiation. Among patients with cervical cancer, the median delay from date of biopsy to start of radiation treatment was 39 days (interquartile range, 34 to 57 days) for patients treated after MDT initiation, compared with 108 days (interquartile range, 71 to 147 days) for patients treated before MDT initiation (P < .001). CONCLUSION: Implementation of MDT clinics in LMICs is feasible and can help reduce delays in treatment initiation, as demonstrated by a gynecologic MDT clinic in Botswana. Streamlining care through MDT clinics can enhance care coordination and improve clinical outcomes. This model can apply to cancer care in other LMICs. |
format | Online Article Text |
id | pubmed-5646885 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | American Society of Clinical Oncology |
record_format | MEDLINE/PubMed |
spelling | pubmed-56468852017-11-01 Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings Grover, Surbhi Chiyapo, Sebathu Philip Puri, Priya Narasimhamurthy, Mohan Gaolebale, Babe Eunice Tapela, Neo Ramogola-Masire, Doreen Kayembe, Mukendi K.A. Moloi, Thabo Gaolebale, Ponatshego Andrew J Glob Oncol Special Articles PURPOSE: Cervical cancer is a major cause of mortality in low- and middle-income countries (LMICs) and the most common cancer diagnosed in women in Botswana. Most women present with locally advanced disease, requiring chemotherapy and radiation. Care co-ordination requires input from a multidisciplinary team (MDT) to deliver appropriate, timely treatment. However, there are limited published examples of MDT implementation in LMICs. METHODS: In May 2015, a weekly MDT clinic for gynecologic cancer care was initiated at Botswana’s national referral facility. The MDT clinic served as a forum for discussion and coordination of patients with gynecologic cancer and consisted of a gynecologist, pathologist, medical oncologist, radiation oncologist, palliative care specialist, and nurse coordinator. RESULTS: Between May 2015 and December 2015, 135 patients were seen in the MDT clinic. The mean age of the patients was 49 years. Most (60%) of the patients were HIV positive. The most common diagnosis was cervical cancer (60%), followed by high-grade cervical intraepithelial neoplastic lesions (12%) and vulvar cancer (11%). Only data up to September 2015 were assessed for treatment delays. It was found that only 38% of patients needed more than one visit for care coordination before treatment initiation. Among patients with cervical cancer, the median delay from date of biopsy to start of radiation treatment was 39 days (interquartile range, 34 to 57 days) for patients treated after MDT initiation, compared with 108 days (interquartile range, 71 to 147 days) for patients treated before MDT initiation (P < .001). CONCLUSION: Implementation of MDT clinics in LMICs is feasible and can help reduce delays in treatment initiation, as demonstrated by a gynecologic MDT clinic in Botswana. Streamlining care through MDT clinics can enhance care coordination and improve clinical outcomes. This model can apply to cancer care in other LMICs. American Society of Clinical Oncology 2017-02-08 /pmc/articles/PMC5646885/ /pubmed/29094103 http://dx.doi.org/10.1200/JGO.2016.006353 Text en © 2017 by American Society of Clinical Oncology http://creativecommons.org/licenses/by-nc-nd/4.0/ Licensed under the Creative Commons Attribution 4.0 License: http://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Special Articles Grover, Surbhi Chiyapo, Sebathu Philip Puri, Priya Narasimhamurthy, Mohan Gaolebale, Babe Eunice Tapela, Neo Ramogola-Masire, Doreen Kayembe, Mukendi K.A. Moloi, Thabo Gaolebale, Ponatshego Andrew Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings |
title | Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings |
title_full | Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings |
title_fullStr | Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings |
title_full_unstemmed | Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings |
title_short | Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings |
title_sort | multidisciplinary gynecologic oncology clinic in botswana: a model for multidisciplinary oncology care in low- and middle-income settings |
topic | Special Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646885/ https://www.ncbi.nlm.nih.gov/pubmed/29094103 http://dx.doi.org/10.1200/JGO.2016.006353 |
work_keys_str_mv | AT groversurbhi multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT chiyaposebathuphilip multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT puripriya multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT narasimhamurthymohan multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT gaolebalebabeeunice multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT tapelaneo multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT ramogolamasiredoreen multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT kayembemukendika multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT moloithabo multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings AT gaolebaleponatshegoandrew multidisciplinarygynecologiconcologyclinicinbotswanaamodelformultidisciplinaryoncologycareinlowandmiddleincomesettings |