Abstract 546P
Background
Gaps within the healthcare system and management of locally advanced oral cavity squamous cell carcinoma (LA-OCSCC) contribute to disease burden and outcomes. Yet, few studies have holistically explored multiple-stakeholder experiences in Asia-Pacific. Our study aimed to identify unmet needs and challenges in managing LA-OCSCC.
Methods
In-depth interviews were conducted with 115 participants (11 stakeholder groups) in Australia, Hong Kong, South Korea, Taiwan, and Vietnam. The Capability, Opportunity, Motivation, Behaviour (COM-B) model guided research design and analysis.
Results
Findings of gaps in timely diagnosis and treatment, patient-centred care and therapeutic alliance were found. Most patients and caregivers lacked knowledge of LA-OCSCC symptoms, perceived them as innocuous and delayed medical attention. Compared to other cancers, LA-OCSCC-related patient information resources and support organisations were limited or absent. General practitioners (GPs) were perceived to have less experience and diagnostic skills to diagnose LA-OCSCC accurately and promptly but dentists were seen to be more informed. Insufficient numbers of nurse coordinators or oncology nurses to support integrated head and neck cancer multidisciplinary team care discussions, counselling, patient education and to relay patients’ needs to specialists, compromised patient-centric care. Psychotherapeutic services were limited to well-resourced hospitals and absent in others, prompting nurses and supportive care professionals to overextend themselves to bridge the gap.
Conclusions
Our findings highlight the need to boost patient and caregiver awareness and knowledge of LA-OCSCC and improve GP knowledge and skills in early diagnosis and prompt referral pathways. Increasing access to evidence-based resources and support for health professionals, care coordination, and supportive care, throughout the care continuum are crucial. Clinical and community collaboration is essential to address gaps in patient-centred care from diagnosis and treatment to survivorship, to improve patient outcomes including health-related quality of life.
Clinical trial identification
Editorial acknowledgement
The authors acknowledge the editorial support from Oracle Corporation Singapore Pte Ltd (Oracle Life Sciences).
Legal entity responsible for the study
Oracle Corporation Singapore Pte Ltd (Oracle Life Sciences).
Funding
MSD International GmbH (Singapore Branch).
Disclosure
E.P. Hui: Financial Interests, Personal, Advisory Board: MSD; Financial Interests, Institutional, Research Grant: MSD, Pfizer. K. Nguyen Tuan: Financial Interests, Personal and Institutional, Invited Speaker: MSD, Merck Group, Roche, AstraZeneca. C. Stylianou: Other, Personal, Full or part-time Employment: MSD, Merck & Co Inc. All other authors have declared no conflicts of interest.