Analysis of 105.000 patients with cancer: have they been discussed in oncologic multidisciplinary team meetings? A nationwide population-based study in the Netherlands
Introduction: For optimal oncological care, it is recommended to discuss every patient with cancer in a multidisciplinary team meeting (MDTM). This is a time consuming and expensive practice, leading to a growing demand to change the current workflow. We aimed to investigate the number of patients discussed in MDTMs and to identify characteristics associated with not being discussed. Methods: Data of patients with a newly diagnosed solid malignant tumour in 2015 and 2016 were analysed through the nationwide population-based Netherlands Cancer Registry (NCR). We clustered tumour types in groups that were frequently discussed within a tumour-specific MDTM. Tumour types without information about MDTMs in the NCR were excluded. Multivariable logistic regression analyses were used to analyse factors associated with not being discussed. Results: Out of 105.305 patients with cancer, 91% were discussed in a MDTM, varying from 74% to 99% between the different tumour groups. Significantly less frequently discussed were patients aged ≥75 years (odds ratio [OR] = 0.7, 95% confidence interval [CI] = 0.6–0.7), patients diagnosed with disease stage I (OR = 0.5, 95% CI = 0.5–0.6), IV (OR = 0.4, 95% CI = 0.4–0.4) or unknown (OR = 0.2, 95% CI = 0.2–0.2) and patients who received no treatment (OR = 0.3, 95% CI = 0.3–0.3). Patients who received a multidisciplinary treatment were more likely to be discussed in contrary to a monodisciplinary treatment (OR = 4.6, 95% CI = 4.2–5.1). Conclusion: In general, most patients with cancer were actually discussed in a MDTM, although differences were observed between tumour groups. Factors associated with not being discussed may, at least partially, reflect the absence of a multidisciplinary question. These results form a starting point for debate on a more durable and efficient new MDTM strategy.
|Keywords||Guideline adherence, Interdisciplinary communication, Multidisciplinary care, Neoplasms/epidemiology, Patient care team/ organisation and administration, Process assessment (health care), Quality of health care|
|Persistent URL||dx.doi.org/10.1016/j.ejca.2019.08.007, hdl.handle.net/1765/119940|
|Journal||European Journal of Cancer|
Walraven, J.E.W. (J. E.W.), Desar, I.M.E, Hoeven van der, J.J.M. (J. J.M.), Aben, K.K.H, Hillegersberg van, R. (R.), Rasch, C.R.N, … Verhoeven, R.H.A. (2019). Analysis of 105.000 patients with cancer: have they been discussed in oncologic multidisciplinary team meetings? A nationwide population-based study in the Netherlands. In European Journal of Cancer (Vol. 121, pp. 85–93). doi:10.1016/j.ejca.2019.08.007