Abstract
ABSTRACTObjectives:Prostate cancer is the most common and fatal cancer amongst Brazilian males. The quality of prostate cancer care in Brazil was systematically reviewed and compared to United Kingdom (UK) National Institute for Health and Care Excellence (NICE) guidelines, which are considered an international benchmark in care, to deter- mine any treatment gaps in Brazilian practice.Materials and Methods:A systematic review of Brazilian and UK literature was under- taken. Additionally, quality of life scores was measured using a FACT-P questionnaire of 36 prostate cancer patients attending the Farmácia Universitária da Universidade de São Paulo (FARMUSP). These scores were compared against NICE care measures for patient safety, clinical efficacy and quality of life indicators determined by either quantitative or qualitative methods.Key findings:The quality of prostate cancer care in Brazil was considered good when compared to NICE guidelines. However, FACT-P data strongly indicated a poor under- standing of treatment received by Brazilian patients and that their mental health needs were not being met.Conclusions:NICE quality statements that address the holistic needs of patients should be implemented into Brazilian outpatient care plans. Addressing the non-medical concerns of patients may improve quality of life and can be easily rolled-out through existing Brazilian pharmacy services at no financial cost to the Brazilian Unified Health System (SUS).
Highlights
Survival rates amongst prostate cancer patients receiving treatment from the public healthcare system in Brazil (Unified Health System-SUS) are poor (1)
We aim to identify whether elements of National Institute for Health and Care Excellence (NICE) guidance can be used to improve the management of prostate cancer patients post-treatment, in the Brazilian public healthcare system
This study systematically reviewed the literature on the quality of care of patients during and after treatment for prostate cancer in Brazil, in comparison to patient experiences and NICE guidance in the United Kingdom
Summary
Survival rates amongst prostate cancer patients receiving treatment from the public healthcare system in Brazil (Unified Health System-SUS) are poor (1). In Brazil, there were ibju | Quality indicators for prostate cancer care approximately 75.000 new cases in 2017, more than any other cancer (2). 1.8% of men aged 40-60 have prostate cancer with the incidence increasing dramatically to over 14% for men aged 60-80 (3). Brazil has followed a global trend and improved quality of prostate cancer treatment in parallel with the country’s socioeconomic development (7, 8). Current treatment options include surgery, chemotherapy, androgen deprivation therapy and radiotherapy (including brachytherapy). Each of these treatments can have adverse effects such as a decrease in libido, erectile dysfunction and osteoporosis which can have a psychological impact on patients causing them to experience anxiety and depression during treatment (9, 10)
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