Patient experiences of waiting times in standardised cancer patient pathways in Norway \u2013 a qualitative interview study

Marit Solbjør,Line Melby,Kari Sand,Bente Ervik

doi:10.1186/s12913-021-06679-8

Abstract

ObjectiveStandardised cancer patient pathways (CPP) are implemented within cancer care with an aim to ensure standardised waiting times for diagnosis and treatment. This article investigates how patients in Norway experience waiting times within a CPP.MethodsQualitative semi-structured interviews with 19 patients who had been through CPP for breast cancer, prostate cancer or malignant melanoma in Norway.ResultsFew patients knew about the term CPP but trusted that waiting times were standardised to decrease mortality. Their experiences of waiting depended on their expectations as much as the period they waited. Patients generally felt safe about the timing of treatment, but not all expectations of a rapid response from health services were met. Short waiting times were interpreted as a sign of urgency, and a change of pace between urgent action and prolonged periods of waiting were disturbing.ConclusionsPatients are comforted by knowing they are within a structured CPP that ensures rapid diagnosis and start of treatment. CPPs still need to be improved to avoid delays, allow for adaptions to patient needs, and include more information to avoid stress.

Highlights

Changing pace between shorter and longer waiting times could cause distress when rapid action is interpreted by patients as signalling urgency
Experiences of waiting times within a cancer patient pathways (CPP) relies on patient expectations to CPP time frames
Reducing the waiting time between symptom presentation and a cancer diagnosis may reduce mortality, the association between time and survival varies between different forms of cancer [1,2,3]

Summary

Introduction

Reducing the waiting time between symptom presentation and a cancer diagnosis may reduce mortality, the association between time and survival varies between different forms of cancer [1,2,3]. Longer diagnostic intervals are associated with increasing 5-year mortality for colorectal, lung, melanoma, breast and prostate cancers [4]. Unwanted variance in waiting times between regions and hospitals have been identified in several countries (e.g., Denmark and Sweden) [4, 5]. To decrease differences in health services and reduce waiting times for cancer patients, Scandinavian countries have implemented standardised cancer patient pathways (CPP). CPPs are time-bound, standardised patient pathways describing the organisation of diagnosis and treatment, as well as communication with the patient. The Scandinavian CPPs cover the period from suspicion of cancer to the start of treatment and identifies

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Discussion

Conclusion