What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study.

general medicine (see internal medicine) organisation of health services respiratory tract tumours

Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
04 08 2020
Historique:
entrez: 6 8 2020
pubmed: 6 8 2020
medline: 15 5 2021
Statut: epublish

Résumé

Patients with lung cancer with comorbidity often require treatment and care by different health professionals, in different settings and at different points in time during the course of the disease. In order to organise and coordinate healthcare efficiently, effective information exchange and collaboration between all involved care providers are required. The aim of this study was to assess the views of patients with advanced lung cancer with comorbidity regarding coordination of treatment and care across healthcare sectors. This qualitative study, as part of the main study, The Heidelberg Milestones Communication Approach, used face-to-face guide-based semistructured interviews with patients with advanced lung cancer and their informal caregivers to explore cross-sectoral information exchange and collaboration in Germany. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA. In 15 interviews, participants reported that cross-sectoral collaboration functioned well, if treatments occurred as planned. However, treatment gaps were experienced, especially regarding medication and regimen. As a result, participants felt insecure and obliged to take responsibility for the coordination of healthcare. Patients reported to be in favour of an active patient role but felt that healthcare coordination should still be a responsibility of a care provider. A more intensive information exchange, potentially by using an electronic platform, was expected to strengthen cross-sectoral collaboration. Patients with lung cancer are uncertain about their role in the coordination of treatment and care across healthcare sectors. Healthcare providers should be more aware of care recipients' willingness of taking on a more active role in healthcare coordination. DRKS00013469.

Sections du résumé

BACKGROUND
Patients with lung cancer with comorbidity often require treatment and care by different health professionals, in different settings and at different points in time during the course of the disease. In order to organise and coordinate healthcare efficiently, effective information exchange and collaboration between all involved care providers are required. The aim of this study was to assess the views of patients with advanced lung cancer with comorbidity regarding coordination of treatment and care across healthcare sectors.
METHODS
This qualitative study, as part of the main study, The Heidelberg Milestones Communication Approach, used face-to-face guide-based semistructured interviews with patients with advanced lung cancer and their informal caregivers to explore cross-sectoral information exchange and collaboration in Germany. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA.
RESULTS
In 15 interviews, participants reported that cross-sectoral collaboration functioned well, if treatments occurred as planned. However, treatment gaps were experienced, especially regarding medication and regimen. As a result, participants felt insecure and obliged to take responsibility for the coordination of healthcare. Patients reported to be in favour of an active patient role but felt that healthcare coordination should still be a responsibility of a care provider. A more intensive information exchange, potentially by using an electronic platform, was expected to strengthen cross-sectoral collaboration.
CONCLUSION
Patients with lung cancer are uncertain about their role in the coordination of treatment and care across healthcare sectors. Healthcare providers should be more aware of care recipients' willingness of taking on a more active role in healthcare coordination.
TRIAL REGISTRATION NUMBER
DRKS00013469.

Identifiants

pubmed: 32753449
pii: bmjopen-2019-036495
doi: 10.1136/bmjopen-2019-036495
pmc: PMC7406021
doi:

Banques de données

DRKS
['DRKS00013469']

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e036495

Informations de copyright

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Jasmin Bossert (J)

Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany Jasmin.Bossert@med.uni-heidelberg.de.

Johanna Forstner (J)

Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany.

Matthias Villalobos (M)

Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany.

Anja Siegle (A)

Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany.

Corinna Jung (C)

Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany.
Department Pädagogik und Soziales, MSB Medical School Berlin GmbH, Berlin, Germany.

Nicole Deis (N)

Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany.

Michael Thomas (M)

Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany.

Michel Wensing (M)

Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany.

Katja Krug (K)

Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany.

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Classifications MeSH