Observational Study of the Multisciplinaryteam role (MDT) on Healthcare Management of Cancer Patients: Benefits and Barriers, AbuDhabi 2017
DOI:
https://doi.org/10.32007/jfacmedbaghdad890Keywords:
MDT, Multidisciplinary team meetings MDM, MDC ,cancer careAbstract
Background: Multidisciplinary team meetings (MDTs) are designed to optimize patient outcomes. It appears intuitive that MDTs are essential to clinical decision - making and patient management; however, it is unclear whether that belief is supported by evidence. With regard to cancer patients, studies demonstrated that treatment plans made by interacting health care professionals are more effective than those made by individual practitioners. Objectives: To assess the impact of multidisciplinary teams (MDTs) on clinical decision - making and patient outcomes. Methods: We follow a descriptive questionnaire survey study design and created a (10) sections surveymonkey that was distributed via email to (150) experts in surgical oncology, general surgery, oncology, radiation oncology, pathologists, and administrative staff. Fourty (40) completed responses were collected to ensure a statistical basis on which to draw sound conclusions. The remaining 110 staff have submitted incomplete answers. Answers were discussed in a separate MDT meeting with most of the participants.The survey was followed by an interpretation of the respondents’ results and comparison with literatures. Results: 75% of the participants chose” Agree and strongly agree”, supporting the hypothesis that MDT meetings ensure an effective and up-to- date management guidelines. This means that the risk of not discussing a cancer patient cannot be neglected any longer. So the hypothesis statement (H0) is rejected and the alternative statement (Ha) is accepted. Conclusions: The majority of participants saw the value in the MDT process and expressed support for its implementation locally and nationally; however, feedback about the most appropriate format is yet to be established. The clinicians identified the need for agreed standards in MDT performanceDownloads
References
Albreht T, Audisio R, "Policy statement on multidisciplinary cancer care" , European J of cancer, 2014, vol 50, (3): 475-480.
https://doi.org/10.1016/j.ejca.2013.11.012 DOI: https://doi.org/10.1016/j.ejca.2013.11.012
2. Bain C, Gitesh KR, . "Multi-disciplinary team meetings for cancer care: Results of an Australian Survey" J Cancer Research and Treatment, 2013 Vol. 1,( No. 1, 12-23).
3. Vishakha S, Stranieri A. "Group decision making in health care: A case study of multidisciplinary meetings" , J Decision Systems, 2016, 25:sup1,( 476-485). https://doi.org/10.1080/12460125.2016.1187388 DOI: https://doi.org/10.1080/12460125.2016.1187388
4. Croke J, El-Sayed S. "Multidisciplinary management of cancer patients: Chasing a shadow or real value? An overview of the literature" . Current Oncology, August 2012;Volume 19, Number 4.
https://doi.org/10.3747/co.19.944 DOI: https://doi.org/10.3747/co.19.944
5. Chang JH. "The impact of a multidisciplinary breast cancer center on recommendations for patient management" : The University of Pennsylvania Experience. J Cancer 2001; 91: (1231-1237).
https://doi.org/10.1002/1097-0142(20010401)91:7<1231::AID-CNCR1123>3.0.CO;2-K DOI: https://doi.org/10.1002/1097-0142(20010401)91:7<1231::AID-CNCR1123>3.0.CO;2-K
6. Shulman T, Bain C., "Obstacles to sustaining cancer care multidisciplinary team meetings: An australian survey" . J Research in cancer and tumor, 2013; 2 (1): 10-21.
7. Slavova N, Azmanova S, Johnson CE. "Peer review of cancer multidisciplinary teams: Is it acceptable in Australia?" J. MJA February 2015; 202 (3) p144.
https://doi.org/10.5694/mja14.00768 DOI: https://doi.org/10.5694/mja14.00768
8. Lamb BW, Rozh TJ." Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: A survey study", J. BMC Health Services Research, 2014; 14:377.
https://doi.org/10.1186/1472-6963-14-377 DOI: https://doi.org/10.1186/1472-6963-14-377
9. Prades J, Remue E, Van Hoof E et al., "Is it worth recognizing cancer services on the basis of multidisciplinary (MDTs)? A systematic review of the objectives and organization of MDTs and their impact on patient outcomes" . Health policy, 2015,vol.119 (4), 464-474.
https://doi.org/10.1016/j.healthpol.2014.09.006 DOI: https://doi.org/10.1016/j.healthpol.2014.09.006
10. Vinod SK, Sighom MA, Delaney GP. "Do multidisciplinary meetings follow guideline-based care?" J Oncol Practice 2010; 6 (6): 276-281.
https://doi.org/10.1200/JOP.2010.000019 DOI: https://doi.org/10.1200/JOP.2010.000019
11. Pillay B, Wootten A C, Crowe H. et al., "The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: A systematic review of the literature." Cancer treatment reviews, 2016; vol.42, 56-72.
https://doi.org/10.1016/j.ctrv.2015.11.007 DOI: https://doi.org/10.1016/j.ctrv.2015.11.007
12. Saini KS, Taylor C, Ramirez AJ et al. "Role of the multidisciplinary team in breast cancer management: Results from a large international survey involving 39 countries" . J.Ann Oncol 2012; 23: 853-859.
https://doi.org/10.1093/annonc/mdr352 DOI: https://doi.org/10.1093/annonc/mdr352
13. Field KM, Rosenthal MA, Dimon J et al., "Communication and clinician satisfaction with multidisciplinary team meetings in neuro oncology" . J of clinical neuroscience, 2010, vol.17 (9): 1130-1135.
https://doi.org/10.1016/j.jocn.2010.03.001 DOI: https://doi.org/10.1016/j.jocn.2010.03.001
14. Licitra L, Keilholz U, Tahara M et al., "Evaluation of the benefits and use of multidisciplinary teams in the treatment of head and neck cancer" . Oral oncology 2016; vol/59, 73-79.
https://doi.org/10.1016/j.oraloncology.2016.06.002 DOI: https://doi.org/10.1016/j.oraloncology.2016.06.002
15. Lan Y, Lin J, Jiang J., "Effects of a multidisciplinary team on colorectal cancer treatment" J. of surgery 2015; vol.48 (5): 145-150.
https://doi.org/10.1016/j.fjs.2015.07.003 DOI: https://doi.org/10.1016/j.fjs.2015.07.003
16. Valdagni A. "Multidisciplinary team meetings in cancer care : We could and should do better than this" . Clinical oncology, 2016; vol.28 (12), 799-800.
https://doi.org/10.1016/j.clon.2016.08.015 DOI: https://doi.org/10.1016/j.clon.2016.08.015
17. Haward R, Amir Z, Borrill C. et al. "Breast cancer teams: the impact of constitution, new cancer workload, and methods of operation on their effectiveness". British Journal of Cancer 2003.; vol.89: 15-22.
https://doi.org/10.1038/sj.bjc.6601073 DOI: https://doi.org/10.1038/sj.bjc.6601073
18. Nouraei S, Philpott J, Maude D. et al., "Reducing referral-to-treatment waiting times in cancer patients using a multidisciplinary database,". Annals of Royal College of Surgeons of England 2007; 89(2): 113-117.
https://doi.org/10.1308/003588407X155455 DOI: https://doi.org/10.1308/003588407X155455
19. Kane B, Luz S, O'Brian et al . , "Multidisciplinary team meetings and their impact on workflow in radiology and pathology departments". BMC Medicine 2006; 5(15). [Online]. Available:
https://doi.org/10.1186/1741-7015-5-15 DOI: https://doi.org/10.1186/1741-7015-5-15
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1919390.
20. Walsh J, Harrison JD, Young JM. et al., "What are the current barriers to effective cancer care co-ordination? A qualitative study". BMC Health Service Research 2010; 10(132).
https://doi.org/10.1186/1472-6963-10-132 DOI: https://doi.org/10.1186/1472-6963-10-132
21. Scott F, Herve Ch, Leroy P. et al., "Supportive care organization in France : A national in depth survey among pateints and oncologists". Supportive care in cancer 2017; vol.25(7) 2111-2118.
https://doi.org/10.1007/s00520-017-3615-x DOI: https://doi.org/10.1007/s00520-017-3615-x
22. Harris J, Taylor C, Sevdalis N. Z et al., "Development and testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT)" . International J. for quality in health care, 2016; vol.28 (3), 332-338.
https://doi.org/10.1093/intqhc/mzw030 DOI: https://doi.org/10.1093/intqhc/mzw030
23. Carlson E."Collective wisdom and multidisciplinary tumor boards" . J of oral and maxillofascial surgery. 2014; vol.72(2): 235-236.
https://doi.org/10.1016/j.joms.2013.12.002 DOI: https://doi.org/10.1016/j.joms.2013.12.002
24. Soukup T, Petrides K, Lamb BW et al., "The anatomy of clinical decision- making in multidisciplinary cancer meetings. A cross-sectional observational study of teams in a natural context" . Medicine (Baltimore) 2016; vol 95(24): e 3885.
https://doi.org/10.1097/MD.0000000000003885 DOI: https://doi.org/10.1097/MD.0000000000003885
25. Soukup T, Lamb BW, Sarkar S et al. "Predictors of treartment decisions in multidisciplinary oncology meetings: A quantitative observational study" .Ann Surg oncol 2016; vol 23 (13) : 4410-4417.
https://doi.org/10.1245/s10434-016-5347-4 DOI: https://doi.org/10.1245/s10434-016-5347-4
26. Hahlweg P, Didi S., Kriston L et al. "Process quality of decision- making in multidisciplinary cancer team meetings : A structured observational study". BMC cancer 2017; vol.17(1): 772.
https://doi.org/10.1186/s12885-017-3768-5 DOI: https://doi.org/10.1186/s12885-017-3768-5
27. Balasubramanian R, Subesinghe M, Smith JT. "The proliferation of multidisciplinary team meetings (MDTMs): How can radiology departments continue to support them all ?" Eur.Radiol. 2015; vol.25(12): 3648-3679.
https://doi.org/10.1007/s00330-015-3760-x DOI: https://doi.org/10.1007/s00330-015-3760-x
28. Caudron A, Chaby G, Dadban A et al. "Multidisciplinary team meetings in oncology: First analysis of benefits and evaluation of activity in a dermatology unit in France" . Eur J Dermatol 2010; vol.20 (6): 778-784.
29. Nguyen NP, Vos P, Lee H et al., "Impact of tumor board recommendations on treatment outcome for locally advanced head and neck cancer" . J Oncology 2008; vol.75:186-191.
https://doi.org/10.1159/000163058 DOI: https://doi.org/10.1159/000163058
30. Cohen P, Tan AL, Penman A. "The multidisciplinary tumor conference in gynecologic oncology-Does it alter management?" Int J Gynecol Cancer 2009; vol.19:1470-1472.
https://doi.org/10.1111/IGC.0b013e3181bf82df DOI: https://doi.org/10.1111/IGC.0b013e3181bf82df
31. Blazeby JM, Wilson L, Metcalfe C et al., "Analysis of clinical decision-making in multidisciplinary cancer teams" . Ann Oncol 2006; 17:457-460. https://doi.org/10.1093/annonc/mdj102 DOI: https://doi.org/10.1093/annonc/mdj102
32. Pawlik TM, Laheru D, Hruban RH et al., "Evaluating the impact of a single-day multidisciplinary clinic on the management of pancreatic cancer" . Ann Surg Oncol 2008; 15:2081-2088.
https://doi.org/10.1245/s10434-008-9929-7 DOI: https://doi.org/10.1245/s10434-008-9929-7
33. Kurtz JE, Heitz D, Serra S et al. , "Adjuvant chemotherapy in elderly patients with colorectal cancer. A retrospective analysis of the implementation of tumor board recommendations in a single institution" . Crit Rev Oncol Hematol 2010; vol.74:211-217.
https://doi.org/10.1016/j.critrevonc.2009.05.003 DOI: https://doi.org/10.1016/j.critrevonc.2009.05.003
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Copyright (c) 2019 Ibtisam Hussein Al Obaidi
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