Real-world practice patterns in multidisciplinary squamous cell carcinoma care at community oncology centers.

Abstract

261 Background: As the incidence of cutaneous squamous cell carcinoma (cSCC) continues to rise and newer systemic therapies become available, coordination of care between dermatologists and oncologists will be vital to provide quality, patient-centered care. Methods: Between 8/17/2020 and 11/30/2020, we surveyed dermatology team members (n = 50) and oncology team members (n = 54) at 5 community oncology practices to assess current practices, challenges/barriers, and areas for improvement in multidisciplinary care of cSCC. Providers then participated in audit/feedback educational sessions and developed action plans to address identified gaps. Results: A majority of providers (72%) reported “very low” or “low” levels of care coordination between oncology and dermatology teams (5-point Likert scale). The three main barriers identified by dermatology/oncology teams included lack of relationship to other specialties (36%/47%), lack of multidisciplinary tumor board (30%/36%), and difficulty with patient navigation to follow-up and monitoring (44%/29%). In addition, lack of administrative support (30%/47%), lack of time (54%/42%), and high case load (32%/16%) hindered multidisciplinary tumor board meetings. Overall, dermatology teams reported lower confidence in making treatment decisions for patients with advanced cSCC compared to oncology teams. Specific strategies were identified to bridge these gaps and improve cSCC care including improving electronic communication, coordinating treatment plans with multidisciplinary teams, integrating educational seminars between oncologists and dermatologists, and finding better multimodality therapeutic options. Conclusions: These findings reveal important challenges in multidisciplinary care of cSCC in community oncology clinics. The identified gaps may inform future implementation science initiatives, and represent key opportunities for improvement in cSCC patient care.[Table: see text]