Abstract 79: Directly Observed Care: Establishing an Enhanced Patient Navigation Program within a New Public Oncology Treatment Program in Belize

Abstract

Abstract Purpose: Cancer patients in low-and-middle-income countries face unique economic and structural barriers to accessing and completing cancer treatment. While research has shown the efficacy of patient navigators to improve clinical outcomes for cancer patients, few patient navigation programs for cancer patients exist in resource-limited settings. In 2018, Belize launched its first-ever public oncology treatment program in collaboration with Global Oncology. We hypothesized that it would be feasible to create an enhanced patient navigation program, named “Directly Observed Care (DOC)." Methods: Two Belizean medical assistants were recruited and trained in patient navigation and education, A training handbook was created collaboratively with Belizean health professionals and utilized materials from U.S.-based patient navigation programs. Results: Between August and October 2020, 135 cancer patients were seen in the newly formed oncology clinic for a total of 330 patient visits at Karl Heusner Memorial Hospital. Average patient age was 56 and the most common diagnoses were breast cancer (34% of patients), cervical cancer (12%) and prostate cancer (7%). The DOC officers engaged with patients in 70% of all clinical visits (66% of follow-up visits). Patients who were actively in treatment at the time of the visit had the highest rates of DOC officer engagement (84%), while those completing their diagnostic workup and those in palliative care had lower engagement rates (48% and 53% respectively). DOC officers noted 233 follow-up tasks at time of engagement with patients and had completed 70% of them at time of analysis. Conclusion: Despite limited resources, an enhanced patient navigation program for cancer patients within a country's first public oncology treatment program is feasible. DOC officers, serving as patient navigators and patient educators, were able to engage with the majority of patients. In the future, we aim to evaluate the impact of the program on the patient's ability to complete treatment. Citation Format: Yannis Valtis, Philip Garrity, Ramon Yacab, Margaret Bernard, Lorna Kelly, Shanikka Arnold, Jake Lattin, Cirkine Sherry, Franklin Huang. Directly Observed Care: Establishing an Enhanced Patient Navigation Program within a New Public Oncology Treatment Program in Belize [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 79.