Feasibility, delivery, and acceptance of a multidisciplinary survivorship care model based in an Asian national ambulatory cancer center: A six-month review.

Authors

null

Yu Ke

National University of Singapore, Singapore, Singapore

Yu Ke, Patricia Soek Hui Neo, Kiley Loh, Grace Meijuan Yang, Shirlynn Ho, Yee Pin Tan, Mothi Babu Ramalingam, Daniel Quah, Lita Chew, Phebe Si, Yung Ying Tan, Beng Choo Tay, Suzanne Poh Geok Koh, Alexandre Chan

Organizations

National University of Singapore, Singapore, Singapore, National Cancer Centre Singapore, Singapore, Singapore, Singapore General Hospital, Singapore, Singapore, University of California, Irvine, CA

Research Funding

Other
Temasek Foundation Cares (Singapore).

Background: Accessible Cancer Care to Enable Support for Cancer Survivors (ACCESS) is a multidisciplinary survivorship care model launched at the National Cancer Centre Singapore, the largest ambulatory cancer centre serving 70% of adult cancer patients in the public sector. ACCESS employs routine distress screening to triage patients with varying care needs and complexities. This study aims to examine the feasibility, delivery, and acceptance of ACCESS in providing appropriate service referrals to cancer patients in clinical settings. Methods: As part of an ongoing evaluation, we evaluated ACCESS for a 6-month implementation period between September 2019 and February 2020. Feasibility was assessed by proportions of (1) eligible breast and gynecological cancer patients who completed the locally adapted Distress Thermometer (DT) screening tool, (2) highly distressed patients, and (3) highly distressed patients requiring multidisciplinary meetings (MDM). Delivery was characterized by the mode and number of supportive care team (SCT) reviews required. Acceptance rates of SCT reviews by distressed patients and the uptake rate of service referrals recommended by the SCT were tabulated. Results: ACCESS screened 1074/1471 (73.0%) of all eligible patients within the 6-month period and identified 239/1074 (22.3%) as highly distressed for follow-up with the SCT. Eventually, 84.5% agreed to SCT review, with approximately one-fourth (26.7%) requiring MDM reviews. The majority (62.4%) of all distressed patients were identified at their first DT completion, whereas 19.8% and 7.4% were identified at their second and third completions respectively. The most common modes of follow-up were phone reviews (49.9%) and face-to-face in clinic waiting areas (48.6%). The SCT recommended 80 referrals to distressed patients for the following services: psychosocial (27.2%), cancer rehabilitation (5.9%), and home hospice (5.0%). The acceptance rates of the referrals for psychosocial, rehabilitation, and hospice services were 43.6%, 75.0%, and 80.0% respectively. Conclusions: ACCESS is a feasible model for triaging Asian cancer patients based on distress levels, and identifying complex patients requiring care personalization through MDM. The poorer acceptance rate of psychosocial services highlights patients’ preference for interventions targeting physical than psychosocial issues. Future studies should explore whether the uptake of psychosocial services is higher in the post-COVID era.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2020 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

On-Demand Poster Session: Cost, Value, and Policy

Track

Cost, Value, and Policy

Sub Track

Value-Based Models of Care

Citation

J Clin Oncol 38, 2020 (suppl 29; abstr 34)

DOI

10.1200/JCO.2020.38.29_suppl.34

Abstract #

34

Poster Bd #

Online Only

Abstract Disclosures

Similar Abstracts

Abstract

2022 ASCO Annual Meeting

Patient experience with breast cancer care delivered in a multidisciplinary clinic.

First Author: Stephanie L. Graff

First Author: George Therapondos

First Author: Dhaval Patel