Acta Scientific Cancer Biology (ASCB)

Research Article Volume 4 Issue 3

Improvement of the "Law of 60 Days" by Implementing Patient Navigation Within the Breast Cancer Program: Pilot Project in Rio De Janeiro

Maria Luisa Marsillac1,2*, Sandra Gioia2,3,5, Fernanda Campos da Silva1, Cristiane Torres2, Lucia Brigadão2, Sandra San Miguel4, Alexandra Bukowski5, Lindsay Krush5 and Paul E Goss5

1Federal University of the State of Rio de Janeiro(UNIRIO), Rio de Janeiro, Brazil
2State Secretariat of Health, Rio De Janeiro, Brazil
3Brazilian National Cancer Institute (INCA), Rio De Janeiro, Brazil
4National Cancer Institute, Rockville, Maryland, USA
5Global Cancer Institute, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts, USA

*Corresponding Author: Maria Luisa Marsillac, MD; PPGMED/DECIGE. University Hospital Gaffrée e Guinle(HUGG) - UNIRIO, 2° Floor. Rua Mariz e Barros, 775 - Rio de Janeiro, RJ, Brazil. E-mail: malumarsillac@gmail.com

Received: January 17, 2020; Published: January 28, 2020

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Abstract

Background: Patient Navigation Program (PNP) assists patients to reduce delays in diagnosis and treatment. A study was conducted on how PNP in Rio de Janeiro, Brazil, could promote adherence to the "Law of 60 Days", which states that all patients with cancer within the public system should start treatment within 60 days after diagnosis of cancer.

Materials and Methods: From August 2017 to May 2018, 105 patients aged 33-80 years (mean 59 years) were recruited for Patient Navigator. Follow-up was by phone, email, or text message. PNP implemented at Rio Imagem was designed to: 1) collect important data on specific barriers, and 2) ensure that at least 70% of the patients recruited with breast cancer initiate treatment within the mandatory 60-days period.

Results: Patients presented with stage 0 (4%), I-IIA (38%), IIB-IIIB (48%) and IV (5%). These included barriers to compliance with the law: fear and fatalistic thoughts (99%), financial burden (79%), uncoordinated health care (76%), attitudes towards providers (75%), duplicity of pre-treatment exams (52%), patient-provider communication (52%), transport (42%), scheduling (24%), and queues for surgical treatment (12%). PNP had 100% patient satisfaction and in 52% of the cases it helped the patients to start treatment within the period established by law.

Conclusion: PNP in Rio did not reach the success rate a 70% to comply with the law, as intended (it reached 52%). However, the barriers that PN did not manage to overcome the lack of human resources and medical supplies, were informed to the health authorities and to the hospital managers.

Keywords: Patient Navigation; Breast Neoplasms; Barriers; Health Systems

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References

  1. Bray F., et al. “Global estimates of cancer prevalence for 27 sites in the adult population in 2008”. International Journal of Cancer 132.5 (2013):1133-1145.
  2. Goss PE., et al. “Planning cancer control in Latin America and the Caribbean”. The Lancet Oncology 14 (2013): 391-436.
  3. Bray F., et al. “Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries”. CA: A Cancer Journal for Clinicians 0 (2018): 1-31.
  4. Instituto Nacional de Câncer (Brasil): Estatísticas do câncer: Mortalidade (2018). http://www1.inca.gov.br/vigilância/mortalidade.asp. Accessed June 11, 2018.
  5. Instituto Nacional de Câncer (Brasil): Estimativa 2018: Incidência de câncer no (2018). http://www.inca.gov.br/estimativa/2018/sintese-de-resultados-comentarios.asp. Accessed June 11, 2018.
  6. Unger-Saldãna K. “Challenges to the early diagnosis and treatment of breast cancer in developing countries”. World Journal of Clinical Oncology 5 (2014): 465-477.
  7. Presidência da República: Lei (2012):12.732. 
  8. Federação Brasileira de Instituições Filantrópicas de Apoio a Saúde da Mama: Pesquisa: A implementação da Lei dos 60 dias (2018).
  9. Ministério da Saúde. “Relatório de Intervalo de Tempo”. Integrador RHC (2018). https://irhc.inca.gov.br/RHCNet/jasper/pdf on 04/22/2019. Accessed June 11, 2018.
  10. Bukowski A., et al. “The potential role of patient navigation in low- and middle-income countries for patients with cancer”. JAMA Oncology 2 (2016): 994-995.
  11. Bukowski A., et al. “Patient Navigation to Improve Access to Breast Cancer Care in Brazil”. Journal of Global Oncology 5 (2017): 433-437. 
  12. Valor do salário mínimo e a sua política de valorização de longo (2019). http://www.in.gov.br/materia/-/asset_publisher/Kujrw0TZC2Mb/content/id/57510734/do1esp-2019-01-01-decreto-n-9-661-de-1-de-janeiro-de-2019-57510684. Accessed May 11, 2019.
  13. Harford J., et al. “Guideline Implementation for Breast Healthcare in Low- and Middle-Income Countries”. CANCER Supplement 15.113 (2008): 2282-2296.
  14. Gioia S. “Why is breast cancer early detection important?” Mastology 27.3 (2017):173-175.
  15. Naomi Ko., et al. “Can Patient Navigation Improve Receipt of Recommended Breast Cancer Care? Evidence from the National Patient Navigation Research Program”. Journal of Clinical Oncology 32 (2014): 2758-2764.
  16. Relatório de auditoria operacional do Tribunal de Contas da União. Política Nacional de Atenção Oncológica. Brasília: TCU, Secretaria de Fiscalização e Avaliação de Programas de Governo (2011). https://portal.tcu.gov.br/lumis/portal/file/fileDownload.jsp?inline=1&fileId=8A8182A14D6E85DD014D7327C1CB5497. Accessed June 11, 2018.
  17. Tejeda S., et al. “Patient barriers to follow-up care for breast and cervical cancer abnormalities”. Journal of Women's Health (Larchmt) 22 (2013): 507-517. 
  18. Ohl ICB., et al. “Public actions for control of breast cancer in Brazil: integrative review”. Revista Brasileira de Enfermagem 69.4 (2016): 746-755.
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Citation

Citation: Maria Luisa Marsillac., et al. “Improvement of the "Law of 60 Days" by Implementing Patient Navigation Within the Breast Cancer Program: Pilot Project in Rio De Janeiro”.Acta Scientific Cancer Biology 4.3 (2020): 01-06.



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