Clues to address barriers for access to proton therapy in the Netherlands
Thijssen,Salina V. Boersma,Liesbeth J. Heising,Luca Swart,Rachelle R. Ou,Carol Roumen,Cheryl Jacobs,Maria J. G.
Thijssen,Salina V.
Boersma,Liesbeth J.
Heising,Luca
Swart,Rachelle R.
Ou,Carol
Roumen,Cheryl
Jacobs,Maria J. G.
Abstract
Background and purpose: The Netherlands has National Indication Protocols on proton therapy (PT) to select patients who benefit most from PT. However, referrals to proton therapy centres (PTCs) are lagging. The objective of this research is to identify the barriers for access to PT and to design interventions to address these barriers. Material and methods. We conducted a nationwide survey among radiation oncologists (ROs), and semi- structured in-depth interviews with ROs and patients. Subsequently, four workshops were held, in which ROs from one PTC and ROs from referring hospitals participated. The workshops were based on design-thinking research, where ideas were co-created on a multidisciplinary basis to encourage joint problem ownership. Kruskal Wallis and X2 tests were used to analyze data. Results: The most prominent barriers mentioned by ROs were patient selection, poor logistics, and logistical worries about the combination of radiation treatment with chemotherapy. Patients pointed out the inefficient coordination between organisations, poor communication, travel issues and discomfort during treatment. Clues to increase referrals revealed the need for additional tools for patient selection and innovative ways to improve logistics. A case manager was identified as beneficial to the patients’ journey as part of a multidisciplinary approach. Such an approach should include the active involvement of medical oncologists, surgeons and pulmonologists. Conclusion: Barriers for access to PT were identified and prioritized in the inter-organisational care- pathway of proton therapy patients in The Netherlands. Innovative solutions were co– designed to solve the barriers.
Description
Funding Information: We would like to acknowledge all radiotherapy centres and proton therapy centres in the Netherlands for their participation in the survey, and the patients and radiation oncologists for the interviews. We would also like to thank the South-eastern Dutch Proton Therapy Implementation Team for their collaboration during the workshops. Publisher Copyright: © 2022 The Authors
Date
2023-01
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Keywords
Proton therapy, Referral, Innovation implementation, Barriers, RADIOTHERAPY, PHYSICIAN, SELECTION
Citation
Thijssen, S V, Boersma, L J, Heising, L, Swart, R R, Ou, C, Roumen, C & Jacobs, M J G 2023, 'Clues to address barriers for access to proton therapy in the Netherlands', Radiotherapy and Oncology, vol. 178, 109432. https://doi.org/10.1016/j.radonc.2022.11.021