Benefits of multidisciplinary teamwork in the management of breast cancer
Identifieur interne : 003855 ( Main/Exploration ); précédent : 003854; suivant : 003856Benefits of multidisciplinary teamwork in the management of breast cancer
Auteurs : Cath Taylor ; Amanda Shewbridge [Royaume-Uni] ; Jenny Harris ; James S. Green [Royaume-Uni]Source :
- Breast Cancer : Targets and Therapy [ 1179-1314 ] ; 2013.
Abstract
The widespread introduction of multidisciplinary team (MDT)-work for breast cancer management has in part evolved due to the increasing complexity of diagnostic and treatment decision-making. An MDT approach aims to bring together the range of specialists required to discuss and agree treatment recommendations and ongoing management for individual patients. MDTs are resource-intensive yet we lack strong (randomized controlled trial) evidence of their effectiveness. Clinical consensus is generally favorable on the benefits of effective specialist MDT-work. Many studies have shown the benefits of receiving treatment from a specialist center, and evidence continues to accrue from comparative studies of clinical benefits of an MDT approach, including improved survival. Patients’ views of the MDT model of decision-making (and in particular its impact on involvement in decisions about their care) have been under-researched. Barriers to effective teamwork and poor decision-making include excessive caseload, low attendance at meetings, lack of leadership, poor communication, role ambiguity, and failure to consider patients’ holistic needs. Breast cancer nurses have a key role in relation to assessing holistic needs, and their specialist contribution has also been associated with improved patient experience and quality of life. This paper examines the evidence for the benefits of MDT-work, in particular for breast cancer. Evidence is considered within a context of growing cancer incidence at a time of increased financial restraint, and it may now be important to reevaluate the structure and models of MDT-work to ensure that MDTs are an efficient use of resources.
Url:
DOI: 10.2147/BCTT.S35581
PubMed: 24648761
PubMed Central: 3929250
Affiliations:
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Green</name><affiliation wicri:level="3"><nlm:aff id="af3-bctt-5-079">Department of Urology, Barts Health NHS Trust, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Urology, Barts Health NHS Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="af4-bctt-5-079">Department of Health and Social Care, London South Bank University, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Health and Social Care, London South Bank University, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></analytic><series><title level="j">Breast Cancer : Targets and Therapy</title><idno type="eISSN">1179-1314</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The widespread introduction of multidisciplinary team (MDT)-work for breast cancer management has in part evolved due to the increasing complexity of diagnostic and treatment decision-making. An MDT approach aims to bring together the range of specialists required to discuss and agree treatment recommendations and ongoing management for individual patients. MDTs are resource-intensive yet we lack strong (randomized controlled trial) evidence of their effectiveness. Clinical consensus is generally favorable on the benefits of effective specialist MDT-work. Many studies have shown the benefits of receiving treatment from a specialist center, and evidence continues to accrue from comparative studies of clinical benefits of an MDT approach, including improved survival. Patients’ views of the MDT model of decision-making (and in particular its impact on involvement in decisions about their care) have been under-researched. Barriers to effective teamwork and poor decision-making include excessive caseload, low attendance at meetings, lack of leadership, poor communication, role ambiguity, and failure to consider patients’ holistic needs. Breast cancer nurses have a key role in relation to assessing holistic needs, and their specialist contribution has also been associated with improved patient experience and quality of life. This paper examines the evidence for the benefits of MDT-work, in particular for breast cancer. Evidence is considered within a context of growing cancer incidence at a time of increased financial restraint, and it may now be important to reevaluate the structure and models of MDT-work to ensure that MDTs are an efficient use of resources.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Polyak, K" uniqKey="Polyak K">K Polyak</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Saini, Ks" uniqKey="Saini K">KS Saini</name></author><author><name sortKey="Taylor, C" uniqKey="Taylor C">C Taylor</name></author><author><name sortKey="Ramirez, Aj" uniqKey="Ramirez A">AJ Ramirez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Henson, De" uniqKey="Henson D">DE Henson</name></author><author><name sortKey="Frelick, Rw" uniqKey="Frelick R">RW Frelick</name></author><author><name sortKey="Ford, Lg" uniqKey="Ford L">LG 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Tarrant</name></author><author><name sortKey="Ramirez, Aj" uniqKey="Ramirez A">AJ Ramirez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Taylor, C" uniqKey="Taylor C">C Taylor</name></author><author><name sortKey="Brown, K" uniqKey="Brown K">K Brown</name></author><author><name sortKey="Lamb, B" uniqKey="Lamb B">B Lamb</name></author><author><name sortKey="Harris, J" uniqKey="Harris J">J Harris</name></author><author><name sortKey="Sevdalis, N" uniqKey="Sevdalis N">N Sevdalis</name></author><author><name sortKey="Green, Js" uniqKey="Green J">JS Green</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Taylor, C" uniqKey="Taylor C">C Taylor</name></author><author><name sortKey="Brown, Kb" uniqKey="Brown K">KB Brown</name></author><author><name sortKey="Sevdalis, N" uniqKey="Sevdalis N">N Sevdalis</name></author><author><name sortKey="Green, Jsa" uniqKey="Green J">JSA Green</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Harris, Jenny" sort="Harris, Jenny" uniqKey="Harris J" first="Jenny" last="Harris">Jenny Harris</name><name sortKey="Taylor, Cath" sort="Taylor, Cath" uniqKey="Taylor C" first="Cath" last="Taylor">Cath Taylor</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Shewbridge, Amanda" sort="Shewbridge, Amanda" uniqKey="Shewbridge A" first="Amanda" last="Shewbridge">Amanda Shewbridge</name></region><name sortKey="Green, James S" sort="Green, James S" uniqKey="Green J" first="James S" last="Green">James S. 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