Pchela І. MULTIDISCIPLINARY COOPERATION: LESSONS LERNED FROM OTHER COUNTRIES

Abstract: The brief analyses how lessons learned from Cyprus, Lebanon, and Israel can be applied to promote the use of multidisciplinary teams (MDTs) to treat and rehabilitate Ukrainian cancer patients and cancer survivors. The analysis is informed by the observation that although the use of MDTs is associated with increased survival rates, growing life expectancy, and better quality of life in patients diagnosed with a malignant disease, the practice is uncommon in national healthcare settings. The lessons learned from several Middle Easter countries suggests that the use of MDTs is facilitated by increasing oncologists awareness of the potential encapsulated in multidisciplinary cooperation and extending nurses’ autonomy of decision-making.
Keywords: Cancer, malignant disease, multidisciplinary team (MDT), multidisciplinary care, survival rate, quality of life, lessons.
Although the use of multidisciplinary care is associated with a range of benefits for cancer patients and cancer survivors, the use of multidisciplinary teams (MDTs) is not common in Ukrainian healthcare settings. The purpose of this brief is to analyse the lessons learned from Cyprus, Lebanon, Israel, and other countries so as to shift the paradigm in treatment and rehabilitation of cancer survivors.
The lesson learned from the Cyprus Association of Cancer Patients of Friends (PASYKAF) suggests that increasing oncologists’ awareness of the potential encapsulated in MDTs can improve the quality of treatment provided to cancer patients and cancer survivors. Similar to their Ukrainian counterparts, Cyprian oncologists act as gatekeepers, which means they control patients’ referrals to other experts [1]. Oncologists’ erroneous perception that they can do all the care themselves translates into the under-referral to MDTs, which implies lower quality of care for cancer patients. One task of the PASYKAF is to inform oncologists of the benefits associated with the use of MDTs and to encourage them challenge own status-quo rooted in the conventional “doctor-patient” dyad.
The insights obtained from the analysis of Israeli experience resonate with Cyprian lessons and emphasize the need to challenge oncologists’ status quo so to provide space for multidisciplinary cooperation. In Israeli healthcare facilities, nurses are provided with a greater autonomy of decision-making, which eventually translates into highly personally oriented and better quality treatment for cancer patients and cancer survivors [1]. The logic behind the model adopted in Israeli clinic suggests that in contrast to other staff, nurses spend the greater share of their worktime at patients’ beside, hence, have quite an accurate understanding of customers’ needs and expectations.
Comparison of Israeli experience and Lebanese experience suggests that greater autonomy of decision making provided to members of MDTs can increase survival rates and life expectancy in cancer patients. According to Silbermann et al [1], the main problem with the treatment model in which the major role is played by oncologists is that it increases the number of patients who delay treatment and see the surgical oncologist at an advanced stage, when prognoses are grim. Noteworthy, similar scenario is observed in Ukrainian oncological facilities, where nearly half of all patients will die within the first year after being diagnosed with a malignant disease [2]. Providing nurses and other members of MDTs with greater autonomy of decision-making will help to shift the paradigm and engage more patients in preventive care.
In summary, lessons learned from other countries suggest there is a relationship between the use of MDTs and survival rate, life expectancy, and quality of life in individuals who have been diagnosed with a malignant disease. The use of MDTs implies shifting the paradigm by challenging oncologists’ status quo as gatekeepers and providing other staff with greater autonomy of decision-making.
References:
1. Silbermann, M., Pitsillides, B., Al-Alfi, N., Omran, S., Al-Jabri, K., Elshamy, K., GHrayeb, I., Livneh, J., Daher, M., Charalambous, H., Jafferri, A., Fink, R., El-Shamy, M. Multidisciplinary care team for cancer patients and its implementation in several Middle Eastern countries. Annals of oncology. 2013. Vol. 24. doi: 10.1093/annonc/mdt265
2. Fedorenko, Z., Michailovich, Y., Goulak, L., Gorokh, Y., Ryzhov, A., Soumkina, O., Koustenko, L.: Cancer in Ukraine: 2018-2019. База даних «Національний канцер реєстр». URL: http://www.ncru.inf.ua/publications/BULL_21/index_e.htm (дата звернення: 15.01. 2021)

If in Ukraine, Israel and Cyprus cancer patients association exists the programs of reabilitation for the reabilitation cancer patients?......ukrainian cancer patients???

As far as I am concerned, rehabilitation initiatives are not quite common in Ukraine. The problem is that our healthcare system lacks resources for such initiatives, and patients are skeptical about them. Nevertheless, analysis of other healthcare systems, resembling Ukrainian one, can help in developing strategies so to promote rehabilitation initiatives in our own country.
Best Regards