Practice patterns of multidisciplinary team meetings in Korean cancer care and patient satisfaction with this approach
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Background/Aims: The multidisciplinary team (MDT) approach is a cornerstone of clinical oncology. This study investigated the current state of MDT care, including patient satisfaction, in Korea. Methods: We obtained the annual number of cancer patients who have received MDT care since 2014 from the registry of the Health Insurance Review and Assessment Service (HIRA). In addition, patients who received MDT care from August 2014 to May 2017 at four university hospitals were further characterized, and patient satisfaction was measured prospectively using a patient-reported questionnaire. Results: The total number of patients who received MDT care increased from 2014 to 2016 (2,113 to 9,998 patients, respectively) in the HIRA Cohort. The type of cancer that most often required MDT was breast cancer (23.8%), followed by colorectal cancer (19.1%). In the Representative Cohort (n = 1,032), MDT was requested by the surgeon more than half the time (55.7%). The main focus of MDT was decision making for further treatment planning (99.0%). The number of doctors participating in the MDT was usually five (70.0%). After initiating an MDT approach, the treatment plan changed for 17.4% of patients. Among these patients, 359 completed a prospective satisfaction survey regarding their MDT care. The overall satisfaction with the MDT approach was very high, with an average score of 9.6 out of 10 points. Conclusions: The application of MDT care is a rapidly growing trend in clinical oncology, and shows high patient satisfaction. Further research is needed to determine which types of cancer patients could benefit most from MDT, and to enable MDT care to operate more efficiently so that it may expand successfully throughout Korea.
Abstract
Background/Aims: The multidisciplinary team (MDT) approach is a cornerstone of clinical oncology. This study investigated the current state of MDT care, including patient satisfaction, in Korea. Methods: We obtained the annual number of cancer patients who have received MDT care since 2014 from the registry of the Health Insurance Review and Assessment Service (HIRA). In addition, patients who received MDT care from August 2014 to May 2017 at four university hospitals were further characterized, and patient satisfaction was measured prospectively using a patient-reported questionnaire. Results: The total number of patients who received MDT care increased from 2014 to 2016 (2,113 to 9,998 patients, respectively) in the HIRA Cohort. The type of cancer that most often required MDT was breast cancer (23.8%), followed by colorectal cancer (19.1%). In the Representative Cohort (n = 1,032), MDT was requested by the surgeon more than half the time (55.7%). The main focus of MDT was decision making for further treatment planning (99.0%). The number of doctors participating in the MDT was usually five (70.0%). After initiating an MDT approach, the treatment plan changed for 17.4% of patients. Among these patients, 359 completed a prospective satisfaction survey regarding their MDT care. The overall satisfaction with the MDT approach was very high, with an average score of 9.6 out of 10 points. Conclusions: The application of MDT care is a rapidly growing trend in clinical oncology, and shows high patient satisfaction. Further research is needed to determine which types of cancer patients could benefit most from MDT, and to enable MDT care to operate more efficiently so that it may expand successfully throughout Korea.
참고문헌 (40)
- Ubel PA, "Physicians recommend different treatments for patients than they would choose for themselves", Arch Intern Med, 171, pp.630~634 (2011)
- Hewitt M, "Cancer prevalence and survivorship issues : analyses of the 1992 National Health Interview Survey", J Natl Cancer Inst, 91, pp.1480~1486 (1999)
- Saini KS, "Role of the multidisciplinary team in breast cancer management : results from a large international survey involving 39 countries", Ann Oncol, 23, pp.853~859 (2012)
- European Partnership Action Against Cancer consensus group, "Policy statement on multidisciplinary cancer care", Eur J Cancer, 50, pp.475~480 (2014)
- Korman H, "Impact of a prostate multidisciplinary clinic program on patient treatment decisions and on adherence to NCCN guidelines : the William Beaumont Hospital experience", Am J Clin Oncol, 36, pp.121~125 (2013)
- Liao CT, "Association between multidisciplinary team care approach and survival rates in patients with oral cavity squamous cell carcinoma", Head Neck, 38(Suppl 1), pp.E1544~E1553 (2016)
- Pillay B, "The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: a systematic review of the literature", Cancer Treat Rev, 42, pp.56~72 (2016)
- Kelly SL, "Multidisciplinary clinic care improves adherence to best practice in head and neck cancer", Am J Otolaryngol, 34, pp.57~60 (2013)
- Jung SM, "Impact of a multidisciplinary team approach for managing advanced and recurrent colorectal cancer", World J Surg, 42, pp.2227~2233 (2018)
- Lee B, "Efficacy of the multidisciplinary tumor board conference in gynecologic oncology:a prospective study", Medicine (Baltimore), 96, pp.e8089~ (2017)
- 김도연, "Survey of Medical Oncology Status in Korea (SOMOS-K): A National Survey of Medical Oncologists in the Korean Association for Clinical Oncology (KACO)", Cancer Research and Treatment, 49(3), pp.588~594 (2017), 대한암학회
- 이윤규, "Practice Patterns Regarding Multidisciplinary Cancer Management and Suggestions for Further Refinement: Results from a National Survey in Korea", Cancer Research and Treatment, 49(4), pp.1164~1169 (2017), 대한암학회
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2015", Cancer Research and Treatment, 50(2), pp.303~316 (2018), 대한암학회
- Reames BN, "Critical evaluation of oncology clinical practice guidelines", J Clin Oncol, 31, pp.2563~2468 (2013)
- Gnant M, "Guidelines: usefulness and limitations", Breast Care(Basel), 8, pp.172~173 (2013)
- Lamb BW, "Multidisciplinary team working across different tumour types : analysis of a national survey", Ann Oncol, 23, pp.1293~1300 (2012)
- Griffith C, "United Kingdom national health service, cancer services collaborative “improvement partnership”, redesign of cancer services: a national approach", Eur J Surg Oncol, 30(Suppl 1), pp.1~86 (2004)
- Lamb BW, "Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care : a survey study", BMC Health Serv Res, 14, pp.377~ (2014)
- Taylor C, "No decision about me without me” in the context of cancer multidisciplinary team meetings: a qualitative interview study", BMC Health Serv Res, 14, pp.488~ (2014)
- Bunnell CA, "Models of multidisciplinary cancer care : physician and patient perceptions in a comprehensive cancer center", J Oncol Pract, 6, pp.283~288 (2010)
- Greer HO, "Impact of a weekly multidisciplinary tumor board conference on the management of women with gynecologic malignancies", Int J Gynecol Cancer, 20, pp.1321~1325 (2010)
- Wheless SA, "A prospective study of the clinical impact of a multidisciplinary head and neck tumor board", Otolaryngol Head Neck Surg, 143, pp.650~654 (2010)
- Kurpad R, "A multidisciplinary approach to the management of urologic malignancies : does it influence diagnostic and treatment decisions", Urol Oncol, 29, pp.378~382 (2011)
- De Ieso PB, "A study of the decision outcomes and financial costs of multidisciplinary team meetings (MDMs) in oncology", Br J Cancer, 109, pp.2295~2300 (2013)
- van Hagen P, "Impact of a multidisciplinary tumour board meeting for upper-GI malignancies on clinical decision making : a prospective cohort study", Int J Clin Oncol, 18, pp.214~219 (2013)
- Santoso JT, "Tumor board in gynecologic oncology", Int J Gynecol Cancer, 14, pp.206~209 (2004)
- Cohen P, "The multidisciplinary tumor conference in gynecologic oncology: does it alter management?", Int J Gynecol Cancer, 19, pp.1470~1472 (2009)
- Chinai N, "Does every patient need to be discussed at a multidisciplinary team meeting", Clin Radiol, 68, pp.780~784 (2013)
- Acher PL, "Improving outcomes in urological cancers:the impact of “multidisciplinary team meetings”", Int J Surg, 3, pp.121~123 (2005)
- Davies AR, "The multidisciplinary team meeting improves staging accuracy and treatment selection for gastro-esophageal cancer", Dis Esophagus, 19, pp.496~503 (2006)
- Freeman RK, "The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with lung cancer", Eur J Cardiothorac Surg, 38, pp.1~5 (2010)
- Newman EA, "Changes in surgical management resulting from case review at a breast cancer multidisciplinary tumor board", Cancer, 107, pp.2346~2351 (2006)
- Aein F, "Giving bad news : a qualitative research exploration", Iran Red Crescent Med J, 16, pp.e8197~ (2014)
- Kissane DW, "Communication skills training for oncology professionals", J Clin Oncol, 30, pp.1242~1247 (2012)
- Otani H, "Burden on oncologists when communicating the discontinuation of anticancer treatment", Jpn J Clin Oncol, 41, pp.999~1006 (2011)
- Saviani-Zeoti F, "Breaking bad news : doctors’feelings and behaviors", Span J Psychol, 10, pp.380~387 (2007)
- Whiteman AR, "The high-risk surgical patient : a role for a multi-disciplinary team approach", Br J Anaesth, 116, pp.311~314 (2016)
- Hojat M, "A brief instrument to measure patients’overall satisfaction with primary care physicians", Fam Med, 43, pp.412~417 (2011)
- Ogden J, "I want more time with my doctor : a quantitative study of time and the consultation", Fam Pract, 21, pp.479~483 (2004)