Contemporary Patterns of Multidisciplinary Care in Patients With Muscle-invasive Bladder Cancer

Lauren C. Harshman, Abhishek Tripathi, Matthew G. Kaag, Jason A. Efstathiou, Andrea B. Apolo, Jean H. Hoffman-Censits, Walter M. Stadler, Evan Y. Yu, Bernard H. Bochner, Eila C. Skinner, Tracy Downs, Anne E. Kiltie, Dean F. Bajorin, Khurshid Guru, William U. Shipley, Gary D. Steinberg, Noah M. Hahn, Srikala S. Sridhar

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Multidisciplinary care is crucial for the optimal treatment of patients with muscle-invasive bladder cancer. We surveyed practitioners regarding the multidisciplinary care models currently used in their practices. Most providers used some form of multidisciplinary care, with sequential clinic visits on different days the most common approach. However, most providers preferred an integrated multidisciplinary care protocol involving same-day concurrent or sequential clinic visits. Background: Multidisciplinary clinics integrate the expertise of several specialties to provide effective treatment to patients. This exposure is especially relevant in the management of muscle-invasive bladder cancer (MIBC), which requires critical input from urology, radiation oncology, and medical oncology, among other supportive specialties. Materials and Methods: In the present study, we sought to catalog the different styles of multidisciplinary care models used in the management of MIBC and to identify barriers to their implementation. We surveyed providers from academic and community practices regarding their currently implemented multidisciplinary care models, available resources, and perceived barriers using the Bladder Cancer Advocacy Network and the Genitourinary Medical Oncologists of Canada e-mail databases. Results: Of the 101 responding providers, most practiced at academic institutions in the United States (61%) or Canada (29%), and only 7% were from community practices. The most frequently used model was sequential visits on different days (57%), followed by sequential same-day (39%) and concurrent (1 visit with all providers; 22%) models. However, most practitioners preferred a multidisciplinary clinic involving sequential same-day (41%) or concurrent (26%) visits. The lack of clinic space (58%), funding (41%), staff (40%), and time (32%) were the most common barriers to implementing a multidisciplinary clinic. Conclusion: Most surveyed practitioners at academic centers use some form of a multidisciplinary care model for patients with MIBC. The major barriers to more integrated multidisciplinary clinics were limited time and resources rather than a lack of provider enthusiasm. Future studies should incorporate patient preferences, further evaluate practice patterns in community settings, and assess their effects on patient outcomes.

Original languageEnglish (US)
Pages (from-to)213-218
Number of pages6
JournalClinical Genitourinary Cancer
Volume16
Issue number3
DOIs
StatePublished - Jun 1 2018

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Urinary Bladder Neoplasms
Patient Care
Muscles
Ambulatory Care
Canada
Radiation Oncology
Medical Oncology
Patient Preference
Urology
Postal Service
Databases
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

Cite this

Harshman, L. C., Tripathi, A., Kaag, M. G., Efstathiou, J. A., Apolo, A. B., Hoffman-Censits, J. H., ... Sridhar, S. S. (2018). Contemporary Patterns of Multidisciplinary Care in Patients With Muscle-invasive Bladder Cancer. Clinical Genitourinary Cancer, 16(3), 213-218. https://doi.org/10.1016/j.clgc.2017.11.004
Harshman, Lauren C. ; Tripathi, Abhishek ; Kaag, Matthew G. ; Efstathiou, Jason A. ; Apolo, Andrea B. ; Hoffman-Censits, Jean H. ; Stadler, Walter M. ; Yu, Evan Y. ; Bochner, Bernard H. ; Skinner, Eila C. ; Downs, Tracy ; Kiltie, Anne E. ; Bajorin, Dean F. ; Guru, Khurshid ; Shipley, William U. ; Steinberg, Gary D. ; Hahn, Noah M. ; Sridhar, Srikala S. / Contemporary Patterns of Multidisciplinary Care in Patients With Muscle-invasive Bladder Cancer. In: Clinical Genitourinary Cancer. 2018 ; Vol. 16, No. 3. pp. 213-218.
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abstract = "Multidisciplinary care is crucial for the optimal treatment of patients with muscle-invasive bladder cancer. We surveyed practitioners regarding the multidisciplinary care models currently used in their practices. Most providers used some form of multidisciplinary care, with sequential clinic visits on different days the most common approach. However, most providers preferred an integrated multidisciplinary care protocol involving same-day concurrent or sequential clinic visits. Background: Multidisciplinary clinics integrate the expertise of several specialties to provide effective treatment to patients. This exposure is especially relevant in the management of muscle-invasive bladder cancer (MIBC), which requires critical input from urology, radiation oncology, and medical oncology, among other supportive specialties. Materials and Methods: In the present study, we sought to catalog the different styles of multidisciplinary care models used in the management of MIBC and to identify barriers to their implementation. We surveyed providers from academic and community practices regarding their currently implemented multidisciplinary care models, available resources, and perceived barriers using the Bladder Cancer Advocacy Network and the Genitourinary Medical Oncologists of Canada e-mail databases. Results: Of the 101 responding providers, most practiced at academic institutions in the United States (61{\%}) or Canada (29{\%}), and only 7{\%} were from community practices. The most frequently used model was sequential visits on different days (57{\%}), followed by sequential same-day (39{\%}) and concurrent (1 visit with all providers; 22{\%}) models. However, most practitioners preferred a multidisciplinary clinic involving sequential same-day (41{\%}) or concurrent (26{\%}) visits. The lack of clinic space (58{\%}), funding (41{\%}), staff (40{\%}), and time (32{\%}) were the most common barriers to implementing a multidisciplinary clinic. Conclusion: Most surveyed practitioners at academic centers use some form of a multidisciplinary care model for patients with MIBC. The major barriers to more integrated multidisciplinary clinics were limited time and resources rather than a lack of provider enthusiasm. Future studies should incorporate patient preferences, further evaluate practice patterns in community settings, and assess their effects on patient outcomes.",
author = "Harshman, {Lauren C.} and Abhishek Tripathi and Kaag, {Matthew G.} and Efstathiou, {Jason A.} and Apolo, {Andrea B.} and Hoffman-Censits, {Jean H.} and Stadler, {Walter M.} and Yu, {Evan Y.} and Bochner, {Bernard H.} and Skinner, {Eila C.} and Tracy Downs and Kiltie, {Anne E.} and Bajorin, {Dean F.} and Khurshid Guru and Shipley, {William U.} and Steinberg, {Gary D.} and Hahn, {Noah M.} and Sridhar, {Srikala S.}",
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Harshman, LC, Tripathi, A, Kaag, MG, Efstathiou, JA, Apolo, AB, Hoffman-Censits, JH, Stadler, WM, Yu, EY, Bochner, BH, Skinner, EC, Downs, T, Kiltie, AE, Bajorin, DF, Guru, K, Shipley, WU, Steinberg, GD, Hahn, NM & Sridhar, SS 2018, 'Contemporary Patterns of Multidisciplinary Care in Patients With Muscle-invasive Bladder Cancer', Clinical Genitourinary Cancer, vol. 16, no. 3, pp. 213-218. https://doi.org/10.1016/j.clgc.2017.11.004

Contemporary Patterns of Multidisciplinary Care in Patients With Muscle-invasive Bladder Cancer. / Harshman, Lauren C.; Tripathi, Abhishek; Kaag, Matthew G.; Efstathiou, Jason A.; Apolo, Andrea B.; Hoffman-Censits, Jean H.; Stadler, Walter M.; Yu, Evan Y.; Bochner, Bernard H.; Skinner, Eila C.; Downs, Tracy; Kiltie, Anne E.; Bajorin, Dean F.; Guru, Khurshid; Shipley, William U.; Steinberg, Gary D.; Hahn, Noah M.; Sridhar, Srikala S.

In: Clinical Genitourinary Cancer, Vol. 16, No. 3, 01.06.2018, p. 213-218.

Research output: Contribution to journalArticle

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AU - Tripathi, Abhishek

AU - Kaag, Matthew G.

AU - Efstathiou, Jason A.

AU - Apolo, Andrea B.

AU - Hoffman-Censits, Jean H.

AU - Stadler, Walter M.

AU - Yu, Evan Y.

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AU - Skinner, Eila C.

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AU - Kiltie, Anne E.

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