Implementation of a Multidisciplinary Model of Care for Women With Metastatic Breast Cancer: Challenges and Lessons Learned

• Published in: Clinical breast cancer Vol. 19; no. 2; pp. e327 - e336
• Main Authors: Blaschke, Sarah-May, Gough, Karla C., Chua, Boon H., Francis, Prudence A., Cockerell, Robyn, Drosdowsky, Allison F., Sheeran, Lisa, Krishnasamy, Meinir
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2019
• Subjects: Adult; Aged; Aged, 80 and over; Australia - epidemiology; Breast Neoplasms - epidemiology; Breast Neoplasms - nursing; Breast Neoplasms - secondary; Cancer Care Facilities; Delivery of Health Care - methods; Delivery of Health Care - standards; Delivery of Health Care - statistics & numerical data; Health Services Research; Humans; Implementation study; Interdisciplinary Communication; Longitudinal Studies; Metastatic breast cancer; Middle Aged; Mixed methods; Models, Nursing; Multidisciplinary care; Patient Acceptance of Health Care; Patient Care Team - organization & administration; Patient Care Team - standards; Patient Reported Outcome Measures; Prospective Studies; Australia; Metastatic breast cancer; Implementation study; Mixed methods; Multidisciplinary care; Health services research
• ISSN: 1526-8209; 1938-0666
• DOI: 10.1016/j.clbc.2018.12.014

The present study examined the implementation of a multidisciplinary team model of care for 62 women with metastatic breast cancer who had accessed specialist services at a large Australian cancer center. The model of care strengthened team collaboration and assisted in the delivery of personalized assessment and complex care plans. However, new resources were required to deliver consistent care.
The present study examined the feasibility and effects of integrating a multidisciplinary team (MDT) model of care for women with metastatic breast cancer (MBC) into a large Australian cancer center. The challenges encountered and lessons learned are described.
In the present prospective, longitudinal, mixed-methods implementation study, the MDT model included face-to-face consultations with a breast care nurse and social worker, followed by a MDT case discussion and face-to-face delivery of a personalized management plan. Data were collected to describe the cohort of women living with MBC who had attended a specialist breast cancer service and their supportive care needs.
A total of 62 women with median age of 60 years (interquartile range [IQR], 37-82 years) participated. The median interval from the first breast cancer diagnosis was 5.7 years (IQR, 2.0-11.6 years), and the median interval from the diagnosis of MBC was 2.0 years (IQR, 0.9-3.6 years). The MDT care model required new resources and cross-sector participation. However, the participants indicated a preference for personalized needs assessment and care planning at the diagnosis of MBC.
The results highlight the challenges of implementing and evaluating an MDT care model for women with MBC. The model coordinated MDT collaboration to strengthen the delivery of complex care plans. Investment in cross-sector partnerships to optimize care coordination for women with MBC was needed.