Implementing community-directed patient-centred cancer care

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Published: 18 Dec 2014
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Dr Kimlin Ashing - Beckman Research Institute, Duarte, USA

Dr Ashing talks to ecancertv at the UICC World Cancer Congress 2014 about "implementation science," in which the community interacts with patients and advocates to improve access to cancer care and support.

Thus, cancer services and research should be built on the information gathered from community needs.

We’re speaking at the UICC meeting on implementation science, meaning that we want to focus on how to get patients’ care and quality of care improved through activating the community and involving community-based participatory research so that the work is from, by and informed by community and advocates. We really increase the capacity of advocates and join advocates with us. The theme of the conference is joining forces and that’s exactly what we do. So we reach the persons who are voices of the community, who are representatives of the community, to be included at the table so that whatever we do in terms of our service and our research is informed by the community themselves, so informing and engaging civil society in our work and engaging community advocates, survivors, from face-based organisations, grassroots organisations. So therefore we are building on the information that they are providing us to improve quality of care.

Our community advocates work with us to inform on their priority needs. So in terms of cancer survivorship they may be concerned about other aspects of their lives so there are multiple co-occurring chronic conditions. So that’s why we have to include in the survivorship care plan and the follow-up care what we call integrated care. So if diabetes is part of the issue, if hypertension is part of the issue, it must be included in the care that they receive as cancer patients and survivors.

Does it work?

Well engaging integrative care into practice is a challenge and we know that. It’s a challenge both from the provider and the oncology team, from the patients themselves to the primary care providers themselves, it is a challenge. So right now the science is behind the practice and the practice is informed by policy and advocates really have gotten the policy in place because it is patient-centred, it is the right thing to do. But we know that science is driven by hypotheses and so we’re testing the hypothesis does survivorship care planning make a difference in patients’ lives, both in terms of improving quality of care, improving surveillance and improving survival.

And the answer to that is? Have you got evidence that it does?

We have the evidence that we’re building. So in our specific study we are advocating peer navigators, we’re also advocating social workers and professionals to work with patients to improve their access as well as their accessibility to follow-up surveillance. So if they have a breast cancer diagnosis what is the regimen of mammography that they need to have? So improving these patients’ ability to know and understand what the treatment is, what are the side effects and what kind of surveillance they need in order to improve their quality of life and survival.