Most cancer clinic staff prefer a team-based approach to supportive cancer care services over a technology-based approach, according to the results of a mixed-methods study of supportive care perceptions that was published in JNCCN—Journal of the National Comprehensive Cancer Network. The study also highlighted that many institutions face significant infrastructural, organizational, and policy barriers to implementing supportive cancer care services.
“The broad support for team-based models using community health workers was surprising, given the increasing reliance on technology to deliver supportive cancer care," stated senior author Manali Patel, MD, MPH, MS, Associate Professor of Medicine, Stanford Cancer Institute. "Most of the participants believed that peer support models would be most effective and many noted that prioritizing and funding this work is crucial to ensure that all patients receive supportive care."
Study Methods
The study authors conducted a cluster-randomized, multisite, mixed-methods study to assess team-based vs technology-based approaches to supportive cancer care. The study wanted to explore the barriers to implementing greater supportive care for patients with cancer and to evaluate factors that impacted effectiveness, implementation, adoption, and sustainability of the different approaches to supportive cancer care.
The researchers conducted 45-minute semistructured interviews and provided 71-question surveys to study staff at 26 cancer clinics. Both methods were analyzed and the findings were merged.
For the purposes of the study, team-based approaches to supportive cancer care referred to community health workers or peer support. and technology-based approaches referred to electronic medical records and digitally sharing common supportive care education with patients.
Key Study Findings
All of the participants in the study and survey agreed that supportive care is essential for patients with cancer, but noted several infrastructural and cultural barriers to implementation of supportive care services such as funding constraints, limited organizational prioritization, stigma, and the varying needs of different patient populations.
Under one-third (31.3%) of respondents thought that their center could financially afford to build a sustain a team-based supportive care service option, but more than one-third (37.5%) felt that their center could handle the technology-based approach resource-wise. Most respondents believed that their organization's leadership was open to the idea of adapting care processes to include more supportive care services.
Respondents generally preferred team-based approaches (87.5%) to supportive cancer care and suggested that technology-based delivery of supportive care could, in fact, worsen cancer disparities. Only 25% of participants reported that technology-based supportive care could improve patient care. The respondents also suggested that the cost of these approaches could potentially convince payer organizations to reimburse more for supportive care services.
“Studies show when people have appropriate symptom control and have discussions regarding their goals, values, and preferences for care, there are long-term cost savings. Proactive approaches to address symptoms and discuss patient goals can reduce unnecessary and unwanted hospital visits down the line,” added Dr. Patel.
Loretta Erhunmwunsee, MD, FACS, Vice President, Chief Health Access and Community Enrichment Officer, City of Hope, who previously helped lead an NCCN Working Group on health-related social needs for patients with cancer, commented: “This study suggests that in supportive cancer care, technology alone may not be the answer to effective symptom management and advance care planning. The greatest impact will come from technology embedded within strong, equity-driven, team-based systems that center the patient experience. We must therefore design digital innovations that strengthen relationships, continuity, and equity across the care journey. Perhaps the path forward is not team vs tech, but rather both—guided by equity.”
Disclosure: For full disclosures of the study authors, visit jnccn.org.
