Jaques van Heerden1,2, Marc Hendricks3,4, Janet Poole5, Ané Büchner6, Gita Naidu7, Jan du Plessis8, Barry van Emmenes9, Anel van Zyl10, Ronelle Uys10, Johani Johani11, G P Hadley12, Derek Harrison13, Biance Rowe7, Mairi Bassingthwaighte7, Nicolene Moonsamy14, Mariana Kruger10. 1. Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa. Jaques.vanheerden@uza.be. 2. Paediatric Haematology and Oncology, Department of Paediatrics, Antwerp University Hospital, Drie Eikenstraat 655, 2650, Edegem, Antwerp, Belgium. Jaques.vanheerden@uza.be. 3. Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 4. Paediatric Haematology and Oncology Service, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. 5. Faculty of Health Sciences, Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Witwatersrand, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa. 6. Paediatric Haematology and Oncology, Department of Paediatrics, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa. 7. Faculty of Health Sciences, Division of Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. 8. Division of Paediatric Haematology and Oncology, Department of Paediatrics, Faculty of Health Sciences, Universitas Hospital, University of the Free State, Bloemfontein, South Africa. 9. Division of Paediatric Haematology and Oncology Hospital, Department of Paediatrics, Frere Hospital, East London, South Africa. 10. Paediatric Haematology and Oncology, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa. 11. Paediatric Haematology Oncology, Department of Paediatrics and Child Health, Port Elizabeth Provincial Hospital, Walter Sisulu University, Port Elizabeth, South Africa. 12. Department of Paediatric Surgery, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. 13. Faculty of Health Sciences, Department of Paediatric Surgery, University of the Witwatersrand, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. 14. Department of Paediatric Haematology and Oncology, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Inkosi Albert Luthuli Academic Hospital, Durban, South Africa.
Abstract
PURPOSE: The aim of the World Health Organization-International Paediatric Oncology Society is to improve childhood cancer survival in low- and middle-income countries to 60% by 2030. This can be achieved using standardised evidence-based national treatment protocols for common childhood cancers. The aim of the study was to describe the development and implementation of the SACCSG NB-2017 neuroblastoma (NB) treatment protocol as part of the treatment harmonisation process of the South African Children's Cancer Study Group. METHODS: The Consolidated Framework for Implementation Research was used to identify factors that could influence the implementation of the national NB protocol as a health care intervention. The evaluation was done according to five interactive domains for implementation: intervention characteristics, inner setting, outer setting, individual or team characteristics and the implementation process. RESULTS: The protocol was developed over 26 months by 26 physicians involved in childhood cancer management. The process included an organisational phase, a resource identification phase, a development phase and a research ethics approval phase. Challenges included nationalised inertia, variable research ethical approval procedures with delays and uncoordinated clinical trial implementation. CONCLUSION: The implementation of the national NB protocol demonstrated the complexity of the implementation of a national childhood cancer treatment protocol. However, standardised paediatric cancer treatment protocols based on local expertise and resources in limited settings are feasible.
PURPOSE: The aim of the World Health Organization-International Paediatric Oncology Society is to improve childhood cancer survival in low- and middle-income countries to 60% by 2030. This can be achieved using standardised evidence-based national treatment protocols for common childhood cancers. The aim of the study was to describe the development and implementation of the SACCSG NB-2017 neuroblastoma (NB) treatment protocol as part of the treatment harmonisation process of the South African Children's Cancer Study Group. METHODS: The Consolidated Framework for Implementation Research was used to identify factors that could influence the implementation of the national NB protocol as a health care intervention. The evaluation was done according to five interactive domains for implementation: intervention characteristics, inner setting, outer setting, individual or team characteristics and the implementation process. RESULTS: The protocol was developed over 26 months by 26 physicians involved in childhood cancer management. The process included an organisational phase, a resource identification phase, a development phase and a research ethics approval phase. Challenges included nationalised inertia, variable research ethical approval procedures with delays and uncoordinated clinical trial implementation. CONCLUSION: The implementation of the national NB protocol demonstrated the complexity of the implementation of a national childhood cancer treatment protocol. However, standardised paediatric cancer treatment protocols based on local expertise and resources in limited settings are feasible.
Entities:
Keywords:
Children; Consolidated Framework for Implementation Research; National protocols; Neuroblastoma; South Africa
Authors: Jaques Van Heerden; Marc Hendricks; Jennifer Geel; Benn Sartorius; G P Hadley; Jan Du Plessis; Ané Büchner; Gita Naidu; Barry Van Emmenes; Anel Van Zyl; Mariana Kruger Journal: Pediatr Blood Cancer Date: 2019-07-31 Impact factor: 3.167