New Approach for Collecting Cancer Patients' Views and Preferences Through Medical Staff

Clinical Utility of Integrated Multidisciplinary Patient-Centered Information in Breast Cancer Care: A Mixed Methods Study

Purpose

The purpose of this study was to evaluate and assess the clinical utility of the integrated multidisciplinary patient-centered information (PCI) written by various healthcare professionals for promoting patient-centered care in the treatment and care of breast cancer patients.

Methods

This study employed a convergent mixed methods interventional design in which Control and Intervention were compared by integrating both quantitative and qualitative results obtained from questionnaires and verbatim transcripts. In three breast cancer cases, a multidisciplinary team meeting (MDTM) using a conventional electronic health record (EHR) viewer was designated Control, and a MDTM using a conventional EHR viewer plus the integrated multidisciplinary PCI was designated Intervention. Questionnaires, which consisted of questions about efficiency and patient-centeredness employing a 5-point Likert scale, were analyzed statistically using Wilcoxon rank test and summary statistics. Verbatim transcripts were analyzed using a thematic analysis hybrid approach.

Results

Three surgical oncologists and three nurses (ward, outpatient chemotherapy, and palliative care) participated in the MDTMs for both Control and Intervention. The quantitative data suggested that there were statistically significant differences between Control and Intervention (p<0.05), with Intervention superior to Control from the viewpoints of efficiency and patient-centeredness. The qualitative data suggested that the MDTM for Intervention involved more PCI and promoted shared understanding from early in the meeting. Synthesis of both the quantitative and qualitative results suggested that use of the integrated multidisciplinary PCI in MDTMs may facilitate the utilization of PCI and lead to more efficient and patient-centered discussions and decision-making to promote patient-centered care.

Conclusion

Integrating the PCI obtained from medical records of various healthcare specialists already documented in the hospital information system could prove to be helpful for supporting MDTMs and routine clinical practice without placing an additional burden on busy healthcare professionals while also promoting the digital transformation of healthcare.

Healthcare professionals roles in pancreatic cancer care: patient and family views and preferences

OBJECTIVES

This study explored the information needs and requirements of patients with pancreatic cancer (PPCs) and their families through patients' and families' views and preferences (PVPs) collected by healthcare professionals (HCPs) and to identify differences in PVPs by profession.

METHODS

We conducted an anonymous web-based survey of HCPs in cancer care hospitals in Japan, posing specific questions from patients or families regarding pancreatic cancer within the past year. We qualitatively analysed the data and classified them into several categories according to their content. We also compared the percentage of PVPs in each category in the medical profession.

RESULTS

We collected 893 PVPs from 353 HCPs and classified them into 15 topics within 5 categories: (1) treatment and care, (2) characteristics of the disease, (3) daily life, (4) feelings of patients or families and (5) communication with HCPs/peer support information. Physicians, nurses and pharmacists received mainly PVPs in categories 1 and 2. Characteristically, cancer counsellors received PVPs in all categories, with higher frequencies for categories 3-5.

CONCLUSIONS

PPCs and families have diverse PVPs, and appear to select different HCPs for consultation based on their specific concerns. Each HCP should recognise that their individual experience may be insufficient in understanding the full spectrum of PVPs; however, cancer counsellors tend to have a broader awareness of them. To support PPCs and families, HCPs should appropriately collaborate with each other, considering that HCPs like cancer counsellors who do not provide direct treatment still play an important role in providing holistic support.

Integrated Electronic Health Record of Multidisciplinary Professionals Throughout the Cancer Care Pathway: A Pilot Study Exploring Patient-Centered Information in Breast Cancer Patients

Purpose

The aim of this pilot study was to first aggregate and then integrate the medical records of various healthcare professionals involved with breast cancer patients to reveal if and how patient-centered information is documented in multidisciplinary cancer care.

Patients and Methods

We aggregated 20 types of medical records from various healthcare professionals such as physicians, nurses and allied healthcare professionals (AHPs) throughout three breast cancer patients' care pathways in a department of breast surgery at a university hospital. Purposeful sampling was used, and three cases were examined. The number of integrated type of records was 14, 14, 17 in case 1, 2 and 3, respectively. We manually annotated and analyzed them exploratively using a thematic analysis. The tags were produced using both a deductive template approach and a data-driven inductive approach. All records were then given tags. We defined patient-centered information related tags and biomedical information related tags and then analyzed for if and how patient-centered information was documented.

Results

The number of patient-centered information related tags accounted for 30%, 30% and 20% of the total in case 1, 2 and 3, respectively. In all cases, patient-centered information was distributed across various medical records. The Progress Note written by doctors provided much of the patient-centered information, while other records contained information not described elsewhere in the Progress Notes. The records of nurses and AHPs included more patient-centered information than the doctors' notes. Each piece of patient-centered information was documented in fragments providing from each of the healthcare professionals' viewpoints.

Conclusion

The documented information throughout the breast cancer care pathway in the cases examined was dominated by biomedical information. However, our findings suggest that integrating fragmented patient-centered information from various healthcare professionals' medical records produces holistic patient-centered information from multiple perspectives and thus may facilitate an enhanced multidisciplinary patient-centered care.

Analysis of the status and content of consultations with a Cancer Consultation and Support Centre during the COVID-19 pandemic

PURPOSE

Cancer Consultation and Support Centres (CCSCs) in Japan have been established at designated cancer hospitals nationwide and these centres provide information and consultation support for cancer care. The purpose of this study is to analyse the status and content of consultations during the COVID-19 pandemic using consultation record data from the Cancer Consultation Support Centre (CCSC) database from January 2020 to March 2021.

METHODS

First, we examined the number and percentage of cases involving and not involving COVID-19 and compared the items of the entry forms between the groups. The comparison between the two groups suggests that the traditional consultation items used before the COVID-19 pandemic did not adequately cover the consultation content during the COVID-19 pandemic. Therefore, we categorised the content of consultation records related to COVID-19.

RESULTS

As a result, the content was consolidated into 16 categories, which were appropriately captured from five different aspects.

CONCLUSION

Using the resulting categories, we were able to create a complementary consultation entry form that could be operational during the COVID epidemic and consult consultants for the support they needed.

TRIAL REGISTRATION

Not applicable.

Creation and provision of a question and answer resource for esophageal cancer based on medical professionals' reports of patients' and families' views and preferences

BACKGROUND

In the rapidly-progressing healthcare environment, it is essential to improve treatment quality through continuous clarification of the needs and concerns of esophageal cancer patients and their families. Effective collaboration between information providers and academic associations could help make such clarified information available.

METHODS

We analyzed esophageal cancer patients' views and preferences (PVPs) using data that were previously obtained from medical staff in Japan. Based on these PVPs, we created a question and answer (Q&A) resource through collaboration with the Cancer Information Service in Japan (CISJ) and the Japan Esophageal Society (JES).

RESULTS

Regarding esophageal cancer, "diet and eating behavior" was the most frequent PVP mentioned by patients and their families, followed by "treatment-related symptoms and adverse effects" and "daily life, recuperation, and survivorship." These PVPs were noted by a wide variety of medical specialties. By analyzing the PVPs, the CISJ developed 11 proposed questions and sent them to the JES, which then created answers based on evidence and clinical-practice-associated consensus. The resultant Q&A resource was uploaded to the CISJ website with mutual linkage to the JES website.

CONCLUSIONS

This study showed the usefulness of collecting esophageal-cancer-related PVPs from medical staff and fostering successful collaboration between a cancer-information provider and an academic association. This arrangement may represent a model case for developing a sustainable system that can satisfactorily respond to PVPs regarding other cancers and/or issues.