Health Care Delivery for Head-and-Neck Cancer Patients in Alberta: A Practice Guideline

Abstract

(1) Background: The treatment of head-and-neck cancer is complex and requires the involvement of various health care professionals with a wide range of expertise. We describe the process of developing a practice guideline with recommendations about the organization and delivery of health care services for head-and-neck cancer patients in Alberta. (2) Methods: Outcomes of interest included composition of the health care team, qualification requirements for team members, cancer centre and team member volumes, infrastructure needs, and wait times. A search for existing practice guidelines and a systematic review of the literature addressing the organization and delivery of health care services for head-and-neck cancer patients were conducted. The search included the Standards and Guidelines Evidence (sage) directory of cancer guidelines and PubMed. (3) Results: One practice guideline was identified for adaptation. Three additional practice guidelines provided supplementary evidence to inform guideline recommendations. Members of the Alberta Provincial Head and Neck Tumour Team (consisting of various health professionals from across the province) provided expert feedback on the adapted recommendations through an online and in-person review process. Selected experts in head-and-neck cancer from outside the province participated in an external online review. (4) Summary: The recommendations outlined in this practice guideline are based on existing guidelines that have been modified to fit the Alberta context. Although specific to Alberta, the recommendations lend credence to similar published guidelines and could be considered for use by groups lacking the resources of appointed guideline panels. The recommendations are meant to be a guide rather than a fixed protocol. The implementation of this practice guideline will depend on many factors, including but not limited to availability of trained personnel, adequate funding of infrastructure, and collaboration with other associations of health care professionals in the province.

Multiple symptoms in people with head and neck neoplasia: a descriptive study

“…Já os baixos níveis de escolaridade e renda encontrados são comprovadamente possíveis obstáculos ao acesso do diagnóstico, ao entendimento do tratamento e manejo de suas complicações. Estudos mostram que o diagnóstico é dado mais tardiamente em camadas socioeconômicas mais baixas (15)(16) . Tabela 3.…”

Head and neck cancer patient experience of a new dietitian-delivered health behaviour intervention: ‘you know you have to eat to survive’

“…Multidisciplinary collaboration is important to the care of patients with diverse and complex needs such as the HNC population [ 6 ]. Oncology dietitians are considered a core member of this multidisciplinary team [ 7 ].…”

Historical compliance rates for providing postoperative radiotherapy in oral cavity squamous cell carcinoma

“…The guidelines recognize that there is a lack of randomized prospective studies in the literature and therefore stresses that treatment be decided on a case-by-case basis by the multidisciplinary tumor board team. 4,13 In our center, all patients with OSCC are reviewed and discussed at the weekly tumor board rounds.…”

“…Included in the guidelines is the recommendation of implementing a weekly multidisciplinary tumor board that discusses each OSCC case individually and recommends a best treatment course given patient and tumor factors. The guidelines recognize that there is a lack of randomized prospective studies in the literature and therefore stresses that treatment be decided on a case‐by‐case basis by the multidisciplinary tumor board team . In our center, all patients with OSCC are reviewed and discussed at the weekly tumor board rounds.…”