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Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia

Timely care is essential to increase breast cancer survival. However, patients in Ethiopia still face multilevel barriers on their pathway to timely treatment initiation. This cross-sectional study at Tikur Anbessa Specialized Hospital Oncology Unit in Addis Ababa assessed systemic treatment initiat...

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Autores principales: Teshome, Bethel, Trabitzsch, Josephin, Afework, Tsion, Addissie, Adamu, Kaba, Mirgissa, Kantelhardt, Eva Johanna, Getachew, Sefonias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437283/
https://www.ncbi.nlm.nih.gov/pubmed/34516552
http://dx.doi.org/10.1371/journal.pone.0257163
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author Teshome, Bethel
Trabitzsch, Josephin
Afework, Tsion
Addissie, Adamu
Kaba, Mirgissa
Kantelhardt, Eva Johanna
Getachew, Sefonias
author_facet Teshome, Bethel
Trabitzsch, Josephin
Afework, Tsion
Addissie, Adamu
Kaba, Mirgissa
Kantelhardt, Eva Johanna
Getachew, Sefonias
author_sort Teshome, Bethel
collection PubMed
description Timely care is essential to increase breast cancer survival. However, patients in Ethiopia still face multilevel barriers on their pathway to timely treatment initiation. This cross-sectional study at Tikur Anbessa Specialized Hospital Oncology Unit in Addis Ababa assessed systemic treatment initiation intervals of breast cancer patients and quantified the impact of socio-demographic and clinical factors, perceived barriers, and the patients´ perceived social support status on timely systemic treatment initiation (chemotherapy or hormonal therapy). A structured questionnaire was designed based on Pechansky´s “Concept of Access”. Applying simple and multivariate logistic regression we analysed the influence of patients´ characteristics as well as their perceived barriers on timely treatment initiation. We measured social support with the Multidimensional Score of Perceived Social Support (MSPSS) and used the Wilcoxon Rank-Sum Test to assess its relationship with timely treatment initiation. Of 196 patients included into the study, 53% received systemic treatment within 90 days of their pathological diagnosis–the median treatment initiation interval was 85 days (IQR 123.5). Older women and patients diagnosed at late stages had higher odds of timely treatment initiation. Not being able to pay for services and lack of transport were most often perceived as barriers towards timely care. However, none of the perceived barriers showed a substantial influence on timely treatment initiation in the multivariate regression model. The patients´ perceived social support was found to be high, with an average MSPSS score of 73 out of 84 (SD 13,63). No impact of the perceived social support status on timely treatment initiation was found. The percentage of breast cancer patients waiting longer than 90 days from pathological diagnosis to systemic treatment initiation in Ethiopia remains unacceptably high. While women generally feel well supported by their social environment, costs and accessibility of treatment are perceived to be major barriers towards timely treatment initiation.
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spelling pubmed-84372832021-09-14 Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia Teshome, Bethel Trabitzsch, Josephin Afework, Tsion Addissie, Adamu Kaba, Mirgissa Kantelhardt, Eva Johanna Getachew, Sefonias PLoS One Research Article Timely care is essential to increase breast cancer survival. However, patients in Ethiopia still face multilevel barriers on their pathway to timely treatment initiation. This cross-sectional study at Tikur Anbessa Specialized Hospital Oncology Unit in Addis Ababa assessed systemic treatment initiation intervals of breast cancer patients and quantified the impact of socio-demographic and clinical factors, perceived barriers, and the patients´ perceived social support status on timely systemic treatment initiation (chemotherapy or hormonal therapy). A structured questionnaire was designed based on Pechansky´s “Concept of Access”. Applying simple and multivariate logistic regression we analysed the influence of patients´ characteristics as well as their perceived barriers on timely treatment initiation. We measured social support with the Multidimensional Score of Perceived Social Support (MSPSS) and used the Wilcoxon Rank-Sum Test to assess its relationship with timely treatment initiation. Of 196 patients included into the study, 53% received systemic treatment within 90 days of their pathological diagnosis–the median treatment initiation interval was 85 days (IQR 123.5). Older women and patients diagnosed at late stages had higher odds of timely treatment initiation. Not being able to pay for services and lack of transport were most often perceived as barriers towards timely care. However, none of the perceived barriers showed a substantial influence on timely treatment initiation in the multivariate regression model. The patients´ perceived social support was found to be high, with an average MSPSS score of 73 out of 84 (SD 13,63). No impact of the perceived social support status on timely treatment initiation was found. The percentage of breast cancer patients waiting longer than 90 days from pathological diagnosis to systemic treatment initiation in Ethiopia remains unacceptably high. While women generally feel well supported by their social environment, costs and accessibility of treatment are perceived to be major barriers towards timely treatment initiation. Public Library of Science 2021-09-13 /pmc/articles/PMC8437283/ /pubmed/34516552 http://dx.doi.org/10.1371/journal.pone.0257163 Text en © 2021 Teshome et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Teshome, Bethel
Trabitzsch, Josephin
Afework, Tsion
Addissie, Adamu
Kaba, Mirgissa
Kantelhardt, Eva Johanna
Getachew, Sefonias
Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia
title Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia
title_full Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia
title_fullStr Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia
title_full_unstemmed Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia
title_short Perceived barriers to timely treatment initiation and social support status among women with breast cancer in Ethiopia
title_sort perceived barriers to timely treatment initiation and social support status among women with breast cancer in ethiopia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437283/
https://www.ncbi.nlm.nih.gov/pubmed/34516552
http://dx.doi.org/10.1371/journal.pone.0257163
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