Josep M Borras1, Tit Albreht2, Riccardo Audisio3, Erik Briers4, Paolo Casali5, Hélène Esperou6, Birgitte Grube7, Marc Hamoir8, Geoffrey Henning9, Joan Kelly10, Susan Knox11, Maria Nabal12, Marco Pierotti13, Claudio Lombardo13, Wim van Harten13, Graeme Poston14, Joan Prades15, Milena Sant16, Luzia Travado17, Vincenzo Valentini18, Cornelis van de Velde19, Saskia van den Bogaert20, Marc van den Bulcke21, Elke van Hoof22, Ingrid van den Neucker23, Robin Wilson24. 1. Catalonian Institute of Oncology (ICO) & University of Barcelona (UB), Barcelona, Spain. Electronic address: jmborras@iconcologia.net. 2. EPAAC, Work Package 10 Cancer Plans & National Institute of Public Health of Slovenia (IVZ), Ljubljana, Slovenia. 3. International Society of Geriatric Oncology (SIOG). 4. European Cancer Patients Coalition (ECPC). 5. European Society of Medical Oncology (ESMO). 6. European Hospital and Healthcare Federation (HOPE) & UNICANCER. 7. European Oncology Nursing Society (EONS). 8. Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium. 9. EuropaColon. 10. Association of European Cancer Leagues(ECL) & Work Package 5 Health Promotion Prevention. 11. Europa Donna - The European Breast Cancer Coalition. 12. European Association for Palliative Care (EAPC). 13. Organisation of European Cancer Institutes (OECI). 14. European Society of Surgical Oncology (ESSO). 15. EPAAC, Work Package 7 Healthcare & Catalonian Cancer Plan, Barcelona, Spain. 16. EPAAC, Work Package 9 Information Systems & Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. 17. International Psycho-Oncology Society (IPOS). 18. European SocieTy for Radiology & Oncology (ESTRO). 19. European CanCer Organisation (ECCO). 20. Scientific Institute of Public Health, Ministry of Health, Brussels, Belgium. 21. Belgium Cancer Center (BCC), Brussels, Belgium. 22. Vrije Universitet, Brussels, Belgium. 23. EPAAC, Work Package 8 Research & European CanCer Organisation (ECCO). 24. EUSOMA - European Society of Breast Cancer Specialists.
Abstract
BACKGROUND: Cancer care is undergoing an important paradigm shift from a disease-focused management to a patient-centred approach, in which increasingly more attention is paid to psychosocial aspects, quality of life, patients' rights and empowerment and survivorship. In this context, multidisciplinary teams emerge as a practical necessity for optimal coordination among health professionals and clear communication with patients. The European Partnership for Action Against Cancer (EPAAC), an initiative launched by the European Commission in 2009, addressed the multidisciplinary care from a policy perspective in order to define the core elements that all tumour-based multidisciplinary teams (MDTs) should include. To that effect, a working group conference was held in January 2013 within the EPAAC Work Package 7 (on Healthcare) framework. METHODS: The consensus group consisted of high-level representatives from the following European scientific societies, patient associations and stakeholders: European CanCer Organisation (ECCO), European SocieTy for Radiology & Oncology (ESTRO), European Society for Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO), International Society of Geriatric Oncology (SIOG), European Association for Palliative Care (EAPC), European Oncology Nursing Society (EONS), International Psycho-Oncology Society (IPOS),European Cancer Patient Coalition (ECPC), EuropaColon, Europa Donna - The European Breast Cancer Coalition, Association of European Cancer Leagues (ECL), Organisation of European Cancer Institutes (OECI), EUSOMA - European Society of Breast Cancer Specialists, European Hospital and Healthcare Federation (HOPE) and EPAAC Work Packages 5 (Health promotion and prevention), 7, 8 (Research), 9 (Information systems) and 10 (Cancer plans). A background document with a list of 26 core issues drawn from a systematic review of the literature was used to guide the discussion. Five areas related to MDTs were covered: care objectives, organisation, clinical assessment, patients' rights and empowerment and policy support. Preliminary drafts of the document were widely circulated for consultation and amendments by the working group before final approval. RESULTS: The working group unanimously formulated a Policy Statement on Multidisciplinary Cancer Care to define the core elements that should be implemented by all tumour-based MDTs. This document identifies MDTs as the core component in cancer care organisation and sets down the key elements to guide changes across all European health systems. CONCLUSION: MDTs are an essential instrument of effective cancer care policy, and their continued development crucial to providing patients the care they need and deserve. While implementation must remain in local hands, European health systems can still benefit from having a basis for an effective multidisciplinary model of cooperation. This policy statement is intended to serve as a reference for policymakers and healthcare providers who wish to improve the services currently provided to the cancer patients whose lives and well-being depend on their action.
BACKGROUND:Cancer care is undergoing an important paradigm shift from a disease-focused management to a patient-centred approach, in which increasingly more attention is paid to psychosocial aspects, quality of life, patients' rights and empowerment and survivorship. In this context, multidisciplinary teams emerge as a practical necessity for optimal coordination among health professionals and clear communication with patients. The European Partnership for Action Against Cancer (EPAAC), an initiative launched by the European Commission in 2009, addressed the multidisciplinary care from a policy perspective in order to define the core elements that all tumour-based multidisciplinary teams (MDTs) should include. To that effect, a working group conference was held in January 2013 within the EPAAC Work Package 7 (on Healthcare) framework. METHODS: The consensus group consisted of high-level representatives from the following European scientific societies, patient associations and stakeholders: European CanCer Organisation (ECCO), European SocieTy for Radiology & Oncology (ESTRO), European Society for Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO), International Society of Geriatric Oncology (SIOG), European Association for Palliative Care (EAPC), European Oncology Nursing Society (EONS), International Psycho-Oncology Society (IPOS),European CancerPatient Coalition (ECPC), EuropaColon, Europa Donna - The European Breast Cancer Coalition, Association of European Cancer Leagues (ECL), Organisation of European Cancer Institutes (OECI), EUSOMA - European Society of Breast Cancer Specialists, European Hospital and Healthcare Federation (HOPE) and EPAAC Work Packages 5 (Health promotion and prevention), 7, 8 (Research), 9 (Information systems) and 10 (Cancer plans). A background document with a list of 26 core issues drawn from a systematic review of the literature was used to guide the discussion. Five areas related to MDTs were covered: care objectives, organisation, clinical assessment, patients' rights and empowerment and policy support. Preliminary drafts of the document were widely circulated for consultation and amendments by the working group before final approval. RESULTS: The working group unanimously formulated a Policy Statement on Multidisciplinary Cancer Care to define the core elements that should be implemented by all tumour-based MDTs. This document identifies MDTs as the core component in cancer care organisation and sets down the key elements to guide changes across all European health systems. CONCLUSION: MDTs are an essential instrument of effective cancer care policy, and their continued development crucial to providing patients the care they need and deserve. While implementation must remain in local hands, European health systems can still benefit from having a basis for an effective multidisciplinary model of cooperation. This policy statement is intended to serve as a reference for policymakers and healthcare providers who wish to improve the services currently provided to the cancerpatients whose lives and well-being depend on their action.
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