A scoping review of the economics of multidisciplinary teams in oncology care

Available online 4 November 2020Background: Multidisciplinary Teams (MDTs) are widely used in oncology care, but their cost-effectiveness has not been established. Evidence suggests they are an expensive service to provide and that their effectiveness varies by attendee and patient mix, meeting format, cancer type, stage of disease and specific hospital setting. The aim of this scoping review is to summarise the current literature on resource use and costs of MDTs in oncology care. Methods: PubMed, Embase, Cochrane, and the NHS Economic Evaluation Database (NHS EED) were searched for papers reporting on MDT costs in the treatment of patients with cancer. Results: Database and manual searching identified 2 878 unique potential papers, 2 810 were excluded based on title and abstract screening, and a further 53 were excluded based on full-text review for a final 15 papers for inclusion. Reported costs and resource use required to support an MDT varied considerably across the included studies. No papers reported on the full costs of including MDT discussion as part of patient care and limited detail was provided on MDT configurations and the methodologies employed to calculate costs and resource use. Conclusions: Evidence suggests that specific MDT configurations may likely represent cost-effective care for specific patients in certain contexts, we therefore recommend future investigations into the costs and/or effects of MDTs consider comparisons between different MDT configurations and patient prioritisation processes rather than comparisons between MDT versus no MDT.Laura Catherine Edney, Jodi Gray, Jonathan Karno

Mapping a decade of interventions to address the supportive care needs of individuals living with or beyond cancer: a scoping review of reviews

Published online: 14 January 2022PURPOSE: Individuals diagnosed with cancer have a range of supportive care needs that are often unmet despite substantial evidence supporting interventions to address them. Addressing this knowledge-translation gap represents a significant opportunity to improve health outcomes. A scoping review of reviews was conducted to map the breadth of evidence for interventions, highlighting those with an existing evidence base, as well as those requiring further research. METHODS: Systematic or meta-analytic reviews that examined interventions targeting supportive care needs of adults and children with cancer published between 2009 and 2019 were identified via searches in Medline, PsycINFO, CINAHL, Scopus and Cochrane. RESULTS: Five hundred fifty-one systematic reviews, including 250 meta-analyses, of interventions addressing supportive care needs, were included. Most reviews focused on interventions to address the physical and psychosocial needs of individuals with few reviews identified to address practical needs. Interventions using mental health therapies and physical activity were most commonly used to address all supportive care needs, followed by the use of pharmaceutical and medical devices, complementary and alternative therapies, information and education resources, dietary information and specific spirituality and return-to-work interventions. CONCLUSION: This scoping review of reviews presents the first broad overview of the literature addressing the supportive care needs of people living with or beyond cancer. It provides a database that health service providers can search to identify appropriate interventions. Results highlight specific research gaps, particularly for practical needs, where reviews are needed. It highlights where a substantial evidence base exists that researchers and policy-makers can consider when implementing interventions.Laura Catherine Edney, Jacqueline Roseleur, Jodi Gray, Bogda Koczwara and Jonathan Karno