ASPO Abstracts
Lessons learned from implementing a coordinated/collaborative care model for metastatic breast cancer (Project ADAPT)
Category: Behavioral Science & Health Communication
Conference Year: 2023
Abstract Body:
Purpose: To improve metastatic breast cancer (MBC) care, we adapted a multilevel collaborative care model between academic and referring community oncology practices (ADAPT). Methods: We adapted core features of Ending Metastatic Breast Cancer for Everyone (EMBRACE) from the Dana Farber Cancer Institute for our local setting using the Dynamic Adaptation Process based on the Exploration, Preparation, Implementation, and Sustainment framework. Siteman Cancer Center (Siteman) partnered with 3 community hospitals in the St. Louis region that covered both rural and urban settings. For the Exploration phase, we recruited 10 female patients with MBC who were referred to Siteman from community hospitals and 11 Siteman breast oncologists to complete surveys assessing acceptability and satisfaction of the current referral process. We summarized quantitative data using descriptive statistics and conducted a content analysis for free response questions. Data from the Exploration phase were used to guide the strategies and surveys for the Preparation and Implementation phases. Results: During the Exploration phase, patient participants: 1) highlighted the importance of communication between Siteman and community providers; 2) expressed frustration at not knowing clinical trial information before their referral appointment and earlier in their treatment plans; and 3) shared they were not well informed about ancillary services. The Exploration phase data and engagement with our partner sites helped inform our next phases by determining key priorities, evaluating procedures, and identifying areas for improvement. We conducted a soft launch to test the new procedures, modified our approach, and officially launched in November 2022. The ADAPT Coordinator will: 1) provide information on clinical trials that patients may be eligible for; 2) connect Siteman and community providers; and 3) streamline the referral pathway to reduce patient and provider burden. Conclusions: Using this dynamic adaptation approach, we were able to collect real-time data to be responsive to the processes of each site. During the Implementation phase, our aim is to create a sustainable model that improves patient and provider care coordination across various clinical oncology practice settings.
Keywords: Metastatic breast cancer, implementation science, coordinating care model