Patient Navigation to Enhance Access to Care for Underserved Patients with a Suspicion or Diagnosis of Cancer (original) (raw)
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Patient navigation services for cancer care in low-and middle-income countries: A scoping review
PLoS One, 2019
Background Nearly 70% of all cancer deaths occur in low- and middle-income countries (LMICs) and many of these cancer deaths are preventable. In high-income countries (HICs), patient navigation strategies have been successfully implemented to facilitate the patient’s journey at multiple points along the cancer care continuum. The purpose of this scoping review is to understand and describe the scope of patient navigation interventions and services employed in LMICs. Methods A systematic search of published articles was conducted including Medline, Biosis, Embase, Global Health, and Web of Science. Articles were examined for evidence of patient navigation interventions used in cancer care in LMICs. Evidence was synthesized by navigation service provided and by type of outcome. Results Fourteen studies reported on patient navigation interventions in cancer care in low-income and middle-income countries in Asia, South America, and Africa. Most studies reported on women’s cancers and included navigation interventions at most points along the cancer care continuum i.e. awareness, education, screening participation, adherence to treatment and surveillance protocols. Conclusion Few studies report on cancer patient navigation in LMICs. With the use of an implementation science framework, patient navigation research can explore a broader range of outcomes to better evaluate its potential role in improving cancer control in LMICs.
Impact of patient navigation on timely cancer care: the Patient Navigation Research Program
Journal of the National Cancer Institute, 2014
Patient navigation is a promising intervention to address cancer disparities but requires a multisite controlled trial to assess its effectiveness. The Patient Navigation Research Program compared patient navigation with usual care on time to diagnosis or treatment for participants with breast, cervical, colorectal, or prostate screening abnormalities and/or cancers between 2007 and 2010. Patient navigators developed individualized strategies to address barriers to care, with the focus on preventing delays in care. To assess timeliness of diagnostic resolution, we conducted a meta-analysis of center- and cancer-specific adjusted hazard ratios (aHRs) comparing patient navigation vs usual care. To assess initiation of cancer therapy, we calculated a single aHR, pooling data across all centers and cancer types. We conducted a metaregression to evaluate variability across centers. All statistical tests were two-sided. The 10521 participants with abnormal screening tests and 2105 with a ...
National Cancer Institute Patient Navigation Research Program
Cancer, 2008
Background-Patient, provider, and systems barriers contribute to delays in cancer care, lower quality of care, and poorer outcomes in vulnerable populations, including low income, underinsured, and racial/ethnic minority populations. Patient navigation is emerging as an intervention to address this problem, but navigation requires a clear definition and a rigorous testing of its effectiveness. Pilot programs have provided some evidence of benefit, but have been limited by evaluation of single-site interventions and varying definitions of navigation. To overcome these limitations, a nine-site National Cancer Institute Patient Navigation Research Program (PNRP) was initiated.
Cancer, 2009
Background-Patient navigators--individuals who assist patients through the healthcare system to improve access to and understanding of their health and health care-are increasingly utilized for underserved individuals at risk for or with cancer. Navigation programs can improve access, but it is unclear whether they improve the efficiency and efficacy of cancer diagnostic and therapeutic services at a reasonable cost, such that they would be considered cost effective.
The Oncologist, 2020
Background The early integration of supportive care in oncology improves patient-centered outcomes. However, data are lacking regarding how to achieve this in resource-limited settings. We studied whether patient navigation increased access to multidisciplinary supportive care among Mexican patients with advanced cancer. Materials and Methods This randomized controlled trial was conducted between August 2017 and April 2018 at a public hospital in Mexico City. Patients aged ≥18 years with metastatic tumors ≤6 weeks from diagnosis were randomized (1:1) to a patient navigation intervention or usual care. Patients randomized to patient navigation received personalized supportive care from a navigator and a multidisciplinary team. Patients randomized to usual care obtained supportive care referrals from treating oncologists. The primary outcome was the implementation of supportive care interventions at 12 weeks. Secondary outcomes included advance directive completion, supportive care ne...
IJCCD, 2022
As immigrant and refugee populations continue to enter American shores, multiple factors such as lack of health and healthcare knowledge, cultural and linguistic barriers, and obstacles related to the social determinants of health (SDOH) limit the timely uptake of healthcare screenings, particularly cancer screening. Although acculturation experiences are unique to immigrants and refugees, similar to several other minority communities, these groups also face financial and other access-related challenges to cancer screening and treatment. Furthermore, the ongoing COVID-19 pandemic has likely exacerbated these issues. Therefore, exploring novel methods to reduce cancer related inequities among these populations is critical. Accordingly, in this article, we describe the importance of culturally tailored educational tools and patient navigation to reduce cancer-related disparities. Specifically, this article examines historical aspects of patient navigation, highlights experiences and studies using patient navigation to promote cancer screening and treatment within immigrant and refugee populations and discusses the unmet needs and future directions for patient navigator models along the cancer care continuum.
Establishing effective patient navigation programs in oncology
Supportive Care in Cancer, 2019
Purpose Recent advances in cancer treatment have resulted in greatly improved survival, and yet many patients in the USA have not benefited due to poor access to healthcare and difficulty accessing timely care across the cancer care continuum. Recognizing these issues and the need to facilitate discussions on how to improve navigation services for patients with cancer, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine (NASEM) held a workshop entitled, BEstablishing Effective Patient Navigation Programs in Oncology. The purpose of this manuscript is to disseminate the conclusions of this workshop while providing a clinically relevant review of patient navigation in oncology. Design Narrative literature review and summary of workshop discussions Results Patient navigation has been shown to be effective at improving outcomes throughout the spectrum of cancer care. Work remains to develop consensus on scope of practice and evaluation criteria and to align payment incentives and policy. Conclusion Patient navigation plays an essential role in overcoming patient-and system-level barriers to improve access to cancer care and outcomes for those most in need.
Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health, 2013
Research suggests that cancer patient navigation improves care, but few reports describe the variety of patients managed by a hospital-based navigation program. Differences in navigated patients by the intensity (low, medium, or high) of navigation services they received were examined. The 835 clients seen by the navigators in a hospital-based cancer center were first stratified by quarter and by four ethnic groups. Randomized selection from each group assured there would be equal representation for analysis of Hawaiians, Filipinos, Japanese, and Whites and even numbers over all time intervals. Five professionals extracted data from these case records on demographics, type/stage of cancer, diagnosis and treatment dates, barriers, and navigator actions. Clients had breast (30.0%), lung (15.8%), esophageal (6.7%), colon (5.8%), ovarian (4.2%), prostate (3.3%), and other cancers (34.2%). The median number of actions taken on behalf of a client was 4 (range 1-83), and the median number ...
Evaluation of a Patient Navigation Program
Clinical Journal of Oncology …, 2011
This study examined the value and effectiveness of a patient navigation program in terms of timeliness of access to cancer care, resolution of barriers, and satisfaction in 55 patients over a six-month period. Although not statistically significant, the time interval between diagnostic biopsy to ...
Cancer Patient Navigator Tasks across the Cancer Care Continuum
Journal of Health Care for the Poor and Underserved, 2012
Cancer patient navigation (PN) programs have been shown to increase access to and utilization of cancer care for poor and underserved individuals. Despite mounting evidence of its value, cancer patient navigation is not universally understood or provided. We describe five PN programs and the range of tasks their navigators provide across the cancer care continuum (education and outreach, screening, diagnosis and staging, treatment, survivorship, and end-of-life). Tasks are organized by their potential to make cancer services understandable, available, accessible, affordable, appropriate, and accountable. Although navigators perform similar tasks across the five programs, their specific approaches reflect differences in community culture, context, program setting, and funding. Task lists can inform the development of programs, job descriptions, training, and evaluation. They also may be useful in the move to certify navigators and establish mechanisms for reimbursement for navigation services.