Integrated cancer care – next steps in best practice

With changes experienced to the healthcare system during the COVID-19 global pandemic, multidisciplinary, integrated care for cancer patients is more important than ever.^1-5 Like many aspects of life, the pandemic impacted cancer care across multiple areas, including a greater reliance on online consultation, and disruptions around how healthcare workers could perform their roles and responsibilities.⁵  For patients and carers alike, particular importance centered around having the confidence that continual ongoing treatment would occur.⁵

Integrated care

Integrated care is a general overarching term used to describe the various methods and models that facilitate the improvement of the patient treatment experience by enhancing coordination and continuity of care.^6,7 By using relevant areas of the healthcare system, integrated care aims to achieve the best outcomes possible for each patient, especially for older more vulnerable patients.^7-9 Active patient involvement is crucial for good integrated care, and an integrated system must aim to deliver customised services to patients and have them at the centre of care rather than the services providing that care.^7,10 To be more effective, integrative care should have clear governance and accountability.⁷

The role of an integrated care model in the treatment of cancer

Cancer care is multifaceted – that is, patients often require a number of support services during the their treatment journey.¹¹ Care often requires many treatment modalities including:

• specialists
• surgery
• chemotherapy
• radiation therapy
• support services such as rehabilitation for physical strength, and
• management of the often-complex emotional issues that arise with such a diagnosis.^11,12

In addition to having cancer, many patients often have pre-existing health conditions, and these also need to be carefully managed and not neglected during treatment.¹³

Primary health care providers also play a vital role in helping patients access timely and appropriate cancer care.¹³ General practitioners provide comprehensive ongoing care and connect the community with the rest of the healthcare sector.^14,15 Upwards of 85% of cancers are diagnosed following symptomatic presentation to a primary-care provider.¹⁵

Integrated cancer care in a post-pandemic world

Global statistics suggest there is a rising trend in increasing complex cancer cases; with more patients presenting with metastatic disease due to delayed diagnosis and treatment.^18,19 Hence a multidisciplinary, integrated approach to complex cancer cases is critical for optimising patient outcomes.¹⁹

Coordination is at the centre of the integrated model – especially:

• ensuring continuity of care is integrated with the patient’s needs, both physically and emotionally²⁰
• a more seamless transition of primary into secondary care²¹
• allied health – which may include internal or external providers²²
• health promotion and secondary prevention (particularly relevant for effective survivorship).²³

The benefits of integrative care are broad reaching

Integrated cancer care may contribute to improved experiences for people affected by cancer and all their healthcare providers.²⁴ The results of a recent systematic review and meta-analysis indicate that integrated care showed both significant reduction in costs and improvement in outcomes compared with usual care, especially in studies with a follow-up period over a year.²⁵

Disclaimer

Any medical procedure or treatment involving the use of radiation carries risks, including skin irritation and associated pain. Before proceeding with treatment, you should discuss the risks and benefits of the treatment with an appropriately qualified health practitioner. Individual treatment outcomes and experiences will vary.