The Effect of a Patient Navigator on Treatment Abandonment and Follow-up for High Grade Osteosarcoma Patients in the Philippine General Hospital

Treatment abandonment for osteosarcoma is a significant problem in developing countries with rates as high as 70%. This study aimed to determine the effect of a patient navigator on treatment abandonment and patient follow-up of osteosarcoma patients at a tertiary referral center. A retrospective re...

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Veröffentlicht in:Asian Pacific journal of cancer prevention : APJCP Jg. 22; H. 9; S. 2873 - 2877
Hauptverfasser: Gaston, Czar Louie, Taleon, Kathleen, Barsales, Ken, Dimayuga, Cesar, Estanislao, Jochrys, Fajardo, Pamela, Quintos, Albert, Rubio, Donnel, Wang, Edward, Alcasabas, Ana Patricia
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Thailand West Asia Organization for Cancer Prevention 01.09.2021
Schlagworte:
Adolescent
Female
Hospitals, General
Humans
Male
Neoplasm Grading
Osteosarcoma - pathology
Osteosarcoma - therapy
Patient Dropouts - statistics & numerical data
Patient Navigation - statistics & numerical data
Philippines
Retrospective Studies
Tertiary Care Centers
Philippines
LMIC (Low to middle income country)
navigator
abandonment
osteosarcoma
ISSN:2476-762X, 1513-7368, 2476-762X
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Abstract Treatment abandonment for osteosarcoma is a significant problem in developing countries with rates as high as 70%. This study aimed to determine the effect of a patient navigator on treatment abandonment and patient follow-up of osteosarcoma patients at a tertiary referral center. A retrospective review of osteosarcoma patients was performed investigating 2 cohorts based on the start of the patient navigator. Group 1 (Pre-Patient Navigator, n=46) were treated from January 2016 to December 2017 while Group 2 (Post-Patient Navigator, n=29) were treated from January 2018 to June 2019. The primary outcome investigated was treatment abandonment defined as missing 4 or more consecutive weeks of treatment. Semi-structured interviews were conducted to investigate the effect of the patient navigator on the cohorts. Treatment abandonment rates for the Pre-Patient Navigator group was significantly higher compared to those with a patient navigator (50% vs 6%, p=0.0001). Abandonment for the pre-navigator group occurred at a mean of 2.9 months (0 - 9 months, median 3 months). Fourteen of 23 patients who abandoned from Group 1 did not proceed to neoadjuvant chemotherapy while 3 patients abandoned after completing 1 cycle of neoadjuvant chemotherapy. In the patient navigator group, no patients abandoned prior to completing 3 cycles of chemotherapy. One patient abandoned after refusing a below knee amputation after 3 cycles of neoadjuvant chemotherapy and 1 patient did not complete further chemotherapy after having a hip disarticulation. Patient feedback on the patient navigator experience was favorable. Having a patient navigator from diagnosis throughout treatment reduced treatment abandonment rates in osteosarcoma patients and may serve as a model for other low to middle income countries.
AbstractList Treatment abandonment for osteosarcoma is a significant problem in developing countries with rates as high as 70%. This study aimed to determine the effect of a patient navigator on treatment abandonment and patient follow-up of osteosarcoma patients at a tertiary referral center. A retrospective review of osteosarcoma patients was performed investigating 2 cohorts based on the start of the patient navigator. Group 1 (Pre-Patient Navigator, n=46) were treated from January 2016 to December 2017 while Group 2 (Post-Patient Navigator, n=29) were treated from January 2018 to June 2019. The primary outcome investigated was treatment abandonment defined as missing 4 or more consecutive weeks of treatment. Semi-structured interviews were conducted to investigate the effect of the patient navigator on the cohorts. Treatment abandonment rates for the Pre-Patient Navigator group was significantly higher compared to those with a patient navigator (50% vs 6%, p=0.0001). Abandonment for the pre-navigator group occurred at a mean of 2.9 months (0 - 9 months, median 3 months). Fourteen of 23 patients who abandoned from Group 1 did not proceed to neoadjuvant chemotherapy while 3 patients abandoned after completing 1 cycle of neoadjuvant chemotherapy. In the patient navigator group, no patients abandoned prior to completing 3 cycles of chemotherapy. One patient abandoned after refusing a below knee amputation after 3 cycles of neoadjuvant chemotherapy and 1 patient did not complete further chemotherapy after having a hip disarticulation. Patient feedback on the patient navigator experience was favorable. Having a patient navigator from diagnosis throughout treatment reduced treatment abandonment rates in osteosarcoma patients and may serve as a model for other low to middle income countries.
Treatment abandonment for osteosarcoma is a significant problem in developing countries with rates as high as 70%. This study aimed to determine the effect of a patient navigator on treatment abandonment and patient follow-up of osteosarcoma patients at a tertiary referral center.INTRODUCTIONTreatment abandonment for osteosarcoma is a significant problem in developing countries with rates as high as 70%. This study aimed to determine the effect of a patient navigator on treatment abandonment and patient follow-up of osteosarcoma patients at a tertiary referral center.A retrospective review of osteosarcoma patients was performed investigating 2 cohorts based on the start of the patient navigator. Group 1 (Pre-Patient Navigator, n=46) were treated from January 2016 to December 2017 while Group 2 (Post-Patient Navigator, n=29) were treated from January 2018 to June 2019. The primary outcome investigated was treatment abandonment defined as missing 4 or more consecutive weeks of treatment. Semi-structured interviews were conducted to investigate the effect of the patient navigator on the cohorts.MATERIALS AND METHODSA retrospective review of osteosarcoma patients was performed investigating 2 cohorts based on the start of the patient navigator. Group 1 (Pre-Patient Navigator, n=46) were treated from January 2016 to December 2017 while Group 2 (Post-Patient Navigator, n=29) were treated from January 2018 to June 2019. The primary outcome investigated was treatment abandonment defined as missing 4 or more consecutive weeks of treatment. Semi-structured interviews were conducted to investigate the effect of the patient navigator on the cohorts.Treatment abandonment rates for the Pre-Patient Navigator group was significantly higher compared to those with a patient navigator (50% vs 6%, p=0.0001). Abandonment for the pre-navigator group occurred at a mean of 2.9 months (0 - 9 months, median 3 months). Fourteen of 23 patients who abandoned from Group 1 did not proceed to neoadjuvant chemotherapy while 3 patients abandoned after completing 1 cycle of neoadjuvant chemotherapy. In the patient navigator group, no patients abandoned prior to completing 3 cycles of chemotherapy. One patient abandoned after refusing a below knee amputation after 3 cycles of neoadjuvant chemotherapy and 1 patient did not complete further chemotherapy after having a hip disarticulation. Patient feedback on the patient navigator experience was favorable.RESULTSTreatment abandonment rates for the Pre-Patient Navigator group was significantly higher compared to those with a patient navigator (50% vs 6%, p=0.0001). Abandonment for the pre-navigator group occurred at a mean of 2.9 months (0 - 9 months, median 3 months). Fourteen of 23 patients who abandoned from Group 1 did not proceed to neoadjuvant chemotherapy while 3 patients abandoned after completing 1 cycle of neoadjuvant chemotherapy. In the patient navigator group, no patients abandoned prior to completing 3 cycles of chemotherapy. One patient abandoned after refusing a below knee amputation after 3 cycles of neoadjuvant chemotherapy and 1 patient did not complete further chemotherapy after having a hip disarticulation. Patient feedback on the patient navigator experience was favorable.Having a patient navigator from diagnosis throughout treatment reduced treatment abandonment rates in osteosarcoma patients and may serve as a model for other low to middle income countries.CONCLUSIONSHaving a patient navigator from diagnosis throughout treatment reduced treatment abandonment rates in osteosarcoma patients and may serve as a model for other low to middle income countries.
Author Alcasabas, Ana Patricia
Estanislao, Jochrys
Wang, Edward
Gaston, Czar Louie
Dimayuga, Cesar
Fajardo, Pamela
Quintos, Albert
Taleon, Kathleen
Rubio, Donnel
Barsales, Ken
AuthorAffiliation 2 Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila
1 Department of Orthopedics, College of Medicine and Philippine General Hospital, University of the Philippines Manila
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Keywords LMIC (Low to middle income country)
navigator
abandonment
osteosarcoma
Language English
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Snippet Treatment abandonment for osteosarcoma is a significant problem in developing countries with rates as high as 70%. This study aimed to determine the effect of...
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SubjectTerms Adolescent
Female
Hospitals, General
Humans
Male
Neoplasm Grading
Osteosarcoma - pathology
Osteosarcoma - therapy
Patient Dropouts - statistics & numerical data
Patient Navigation - statistics & numerical data
Philippines
Retrospective Studies
Tertiary Care Centers
Title The Effect of a Patient Navigator on Treatment Abandonment and Follow-up for High Grade Osteosarcoma Patients in the Philippine General Hospital
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