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. 2017 Feb 8;3(5):666-670.
doi: 10.1200/JGO.2016.006353. eCollection 2017 Oct.

Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings

Surbhi Grover  1 , Sebathu Philip Chiyapo  1 , Priya Puri  1 , Mohan Narasimhamurthy  1 , Babe Eunice Gaolebale  1 , Neo Tapela  1 , Doreen Ramogola-Masire  1 , Mukendi K A Kayembe  1 , Thabo Moloi  1 , Ponatshego Andrew Gaolebale  1
Affiliations

Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings

Surbhi Grover et al. J Glob Oncol. .

Abstract

Purpose: Cervical cancer is a major cause of mortality in low- and middle-income countries (LMICs) and the most common cancer diagnosed in women in Botswana. Most women present with locally advanced disease, requiring chemotherapy and radiation. Care co-ordination requires input from a multidisciplinary team (MDT) to deliver appropriate, timely treatment. However, there are limited published examples of MDT implementation in LMICs.

Methods: In May 2015, a weekly MDT clinic for gynecologic cancer care was initiated at Botswana's national referral facility. The MDT clinic served as a forum for discussion and coordination of patients with gynecologic cancer and consisted of a gynecologist, pathologist, medical oncologist, radiation oncologist, palliative care specialist, and nurse coordinator.

Results: Between May 2015 and December 2015, 135 patients were seen in the MDT clinic. The mean age of the patients was 49 years. Most (60%) of the patients were HIV positive. The most common diagnosis was cervical cancer (60%), followed by high-grade cervical intraepithelial neoplastic lesions (12%) and vulvar cancer (11%). Only data up to September 2015 were assessed for treatment delays. It was found that only 38% of patients needed more than one visit for care coordination before treatment initiation. Among patients with cervical cancer, the median delay from date of biopsy to start of radiation treatment was 39 days (interquartile range, 34 to 57 days) for patients treated after MDT initiation, compared with 108 days (interquartile range, 71 to 147 days) for patients treated before MDT initiation (P < .001).

Conclusion: Implementation of MDT clinics in LMICs is feasible and can help reduce delays in treatment initiation, as demonstrated by a gynecologic MDT clinic in Botswana. Streamlining care through MDT clinics can enhance care coordination and improve clinical outcomes. This model can apply to cancer care in other LMICs.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc. Surbhi GroverNo relationship to discloseSebathu Philip ChiyapoNo relationship to disclosePriya PuriNo relationship to discloseMohan NarasimhamurthyNo relationship to discloseBabe Eunice GaolebaleNo relationship to discloseNeo TapelaNo relationship to discloseDoreen Ramogola-MasireNo relationship to discloseMukendi K.A. KayembeNo relationship to discloseThabo MoloiNo relationship to disclosePonatshego Andrew GaolebaleNo relationship to disclose

References

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