HEALTHCARE

Relationship between volume and outcome in lung cancer

SUMMARY

The use of survival data to compare hospitals remains controversial. Recently three studies could not find an association between outcome and volume. More important than the volume of surgery seems to be the concentration of oncological care in centres with multidisciplinary teams around the patient. A framework for implementing Value-Based health care has to be defined, measuring outcomes that matter to patients and cost.

(BELG J MED ONCOL 2022;16(2):70–3)

Moving forward together: The power of collaboration via networks

(BELG J MED ONCOL 2022;16(1):33-6)

Palliative Care: A Shift in Paradigm

SUMMARY

The integration of palliative care (PC) in standard oncological care (SOC) has become ‘state-of-the art’. Its benefits have increasingly been appreciated and extensively studied, and guidelines have been developed to achieve this goal. However, an integrated, patient-centred approach also implies detecting patients care needs at an earlier stage and defining PC in a different way, i.e. based on care needs instead of life expectancy only. The ‘Palliative Care Indicator Tool’ PICT is instrumental in identifying the palliative patient and distinguishing different levels of needs in the palliative population. The status of ‘palliative patient’, access to PC benefits and facilities and the organisation and reimbursement of PC services should be based on care needs instead of life expectancy. Palliative care for every palliative patient requires an educated workforce, particularly with regard to communication skills, and the presence of a multidisciplinary team. Discussing goals of care (GoC), advance care planning (ACP) and end-of-life decisions (ELD) should be the basis for ‘negotiated care’.

(BELG J MED ONCOL 2021;15(6):315-20)

The Belgian practice and attitudes towards introducing genomics in clinical oncology

SUMMARY

For most people, being in good health represents the most important factor to wellbeing. While environmental elements such as physical, chemical, biological, social and psychosocial factors in the environment are key for a person’s wellbeing, also the genome of the individual and its interaction with the environment play an important role. In this paper, we will focus on attitudes towards genomics in the field of personalised medicine in oncology. We will document opinions encountered by patients and citizens on sharing health-related information for various purposes (e.g., research, cost-effectiveness, patient support) aiming to maximise the benefits for cancer patients. We will discuss ethical and legal considerations to be taken into account at the Belgian level to provide a secure, transparent framework for the use of genomics in the healthcare system.

(BELG J MED ONCOL 2021;15(4):177-85)

Role of the pharmacist in oncology: pharmaceutical care for patients treated with oral anticancer drugs

SUMMARY

Over the last decades, the development and use of oral anticancer drugs has increased substantially. Although oral anticancer drugs are associated with numerous advantages, they also entail important challenges for patients and for healthcare professionals. In contrast to intravenous chemotherapy and immunotherapy, the administration of oral anticancer drugs takes place at the patients’ home. This implies a greater autonomy and responsibility for patients in their own care. To achieve an adequate level of self-management in patients and to provide effective self-management support by health care professionals, an interdisciplinary approach is crucial. However, the (potential) contribution of hospital pharmacists and community pharmacists to support adequate patient self-management in oncology, has not been described in policy documents (EPAAC, ESMO, ASCO, BeNCP) and is rather unknown for most health care professionals and patients. Therefore, this review aims to summarise the evidence on the role of the pharmacist, both in the hospital and in primary care, in the care process for patients treated with oral anticancer drugs and to discuss future opportunities for the evolvement of this role.

Different approaches and interventions, led by a hospital pharmacist, have been described and tested to improve quality and safety of the care for patients treated with oral anticancer drugs. Several of these interventions resulted in significant improvements in adherence, safety and other patient outcomes, which shows the added value of the involvement of a hospital pharmacist in the care for patients treated with oral anticancer drugs. However, the impact of interventions performed by a community pharmacist on outcomes in patients treated with oral anticancer drugs remains unclear.

Based on the evidence in literature, this article further describes the potential roles of the hospital pharmacist and community pharmacist in the total care process for patients treated with oral anticancer drugs. This ranges from checking doses and regimens and evaluation of potential drug interactions over dispensing and patient counselling to assessment and management of toxicity and adherence. Based on what we found in literature, we can conclude that involvement of both the hospital and the community pharmacist seems crucial to obtain an adequately individualised treatment and monitoring plan, with respect to comorbidities and concomitant medication.

(BELG J MED ONCOL 2020;14(7):355-63)

Role of vaccination in oropharyngeal cancer prevention

SUMMARY

As in the rest of the Western world, the incidence of oropharyngeal carcinoma is increasing in Belgium. This increase is attributed to infections with the sexually transmittable human papilloma virus (HPV). In total, 80 to 90% of sexually active adolescents get infected with this virus during life. Later in life, this viral infection can lead to the development of different types of cancer, amongst which oropharyngeal carcinoma. Vaccination offers protection against infections with many subtypes of HPV and thus prevention of cancer. Vaccines are nowadays reimbursed for both girls and boys, so let’s advocate maximal vaccination to prevent cancer.

(BELG J MED ONCOL 2020;14(2):71–3)

The direct medical cost of breast cancer: a case study in one hospital

SUMMARY

In this study direct medical costs of breast cancer were calculated in one Belgian hospital for the diagnostic phase and for the treatment phase up to 365 days after diagnosis. The study included 107 breast cancer patients diagnosed between July 2015 and December 2015. The treatment phase is much more costlier than the diagnostic phase, representing respectively 96% and 4% of total expenditures. Important differences in treatment cost are observed according to the stage of diagnosis. The results from this study inform hospital executives and policymakers to determine further decisions for financing breast cancer care.

(BELG J MED ONCOL 2020;14(1):22–27)