Innovative Methodology for Strengthening a Multidisciplinary Team Approach in Cities in Low- and Middle-Income Countries

Abstract

PURPOSE Delivering high-quality cancer care to patients through a multidisciplinary team (MDT) care approach remains a challenge, particularly in low- and middle-income countries characterized by fragmented health systems and limited human resources for cancer care. City Cancer Challenge (C/Can) is supporting cities in low- and middle-income countries as they work to improve access to equitable quality cancer care. C/Can has developed an innovative methodology to address the MDT gap, piloted in four cities—Asunciòn, Cali, Kumasi, and Yangon. METHODS Collaborating with a network of partners, C/Can and ASCO have developed a package of technical cooperation support focusing on two priority areas that have emerged as core needs: first developing consensus-based, city-wide patient management guidelines for the most common cancers and second, building capacity for the implementation of MDTs in institutions providing cancer care in the city. RESULTS The real-time application of C/Can's MDT approach in Cali and Asuncion underlined the importance of engaging the right stakeholders early on and embedding MDT guidelines in local and national regulatory frameworks to achieve their sustainable uptake. The results in Cali and Asuncion were essential for informing the process in Yangon, asserting the clear benefits of city-to-city knowledge exchange. Finally, the global COVID-19 pandemic prompted a rapid adaptation of the methodology from an in-person to virtual format; the unexpected success of the virtual program in Kumasi has led to its application in subsequent C/Can cities. CONCLUSION The application of C/Can's methodology in this first set of cities has reinforced not only the importance of both resource appropriate guidelines and a highly trained health workforce but also the need for commitment to work across institutions and disciplines.

Cloud platform to improve efficiency and coverage of asynchronous multidisciplinary team meetings for patients with digestive tract cancer

“…There was a decrease in the number of patients discussed, and the quality of the discussion was also limited ( 59 ). During the COVID-19 pandemic, virtual multidisciplinary team meetings were held for cancer patients ( 36 , 60 , 61 ). cMDT reduced contact between medical experts and ensured quality, providing a new idea for cancer MDT during respiratory infectious disease pandemics.…”

Clinical analysis of decision implementation by a multidisciplinary team in cervical cancer cases in Ganzhou, China

“…Owing to the different levels of understanding and starting points of each specialist, they may give different or even opposite treatment opinions to patients on the basis of their professional point of view for the same disease. At the same time, clinical disciplines are gradually differentiating and refining, making it difficult for the discipline to keep abreast of the progress of other disciplines ( 17 , 18 ). However, MDT is a face-to-face discussion and exchange of conditions of patients with malignant tumors through multidisciplinary meetings held at regular intervals.…”

Innovation to Advance Cancer Control Equitably

“…A multidisciplinary team approach is characterized by four essential components including health care worker training, treatment guidelines, a decision-making process for complex cases, and auxiliary administrative support for auditing and feedback. 7 Although the engagement of stakeholders is often discussed and seen as vital to implementing strong patient-centered cancer care, the participation of patients and their representatives in cancer policies is still absent or nascent in many LMICs. Samson et al underlined the lack of sufficient literature that addresses the level of involvement of cancer patient organizations in national cancer policies and highlighted challenges and opportunities to improve the representation of those organizations in policy dialogs in LMICs.…”