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September 2017 VOL 8, NO 9
The Role of the Patient Navigator in a Successful AYA Program
Building a collaborative, multidisciplinary adolescent and young adult (AYA) oncology program relies heavily on patient navigation, according to Damon Reed, MD, Director of the AYA Program at Moffitt Cancer Center in Tampa, FL.
According to Dr Reed, AYAs with cancer have traditionally fallen into a gap in the delivery of quality healthcare. Survival rates in this population have not seen considerable improvement since 1975, which could be attributed to factors like delayed diagnosis and an oncologic setting specialized in very young or very old treatment modalities.
Moffitt has developed a growing and nationally recognized AYA oncology program that seeks to meet the specialized medical and psychosocial needs of these patients through multidisciplinary collaboration. The program sees approximately 1500 new patients per year and has 100 to 150 unique outpatient visits per day. “Most weeks we find that every clinic has seen an AYA patient,” he said.
At the APOS Annual Conference, Dr Reed discussed the unique aspects of the AYA program at Moffitt, highlighting the importance of navigation in this patient population.
The Patient Navigator at Moffitt
Navigators have been associated with improvements in rates of cancer screening, reductions in late-stage disease, reductions in delays, improvements in adherence to diagnostic and clinical care, and improvements in survival. The strategic aims of the patient navigator are not just to reduce barriers and improve disease outcomes, but also to reduce distress and enhance quality of life for the patient and family.
Moffitt introduced a patient navigator intervention model designed to reduce healthcare disparities by assisting patients in overcoming health system barriers to care. “We think the more touchpoints, open doors, and people interacting with our AYA patients, the better the program will do,” said Dr Reed. “And the patient navigator will go a long way to that end.”
He said the use of pathways can facilitate common ground and reduce barriers. “We believe in pathways. If we set a goal as to when we want a patient to go to genetics or fertility, we need to hold ourselves accountable to make it happen,” he said. “I think the navigator will go a long way in facilitating this.”
The ideal patient navigator at their cancer center “understands the Moffitt side of patient care,” and also the nuances of what it means to be a young adult with cancer. The navigator should anticipate problems and get patients to the right people who can address them, he added.
A randomized controlled trial designed to assess the efficacy of the navigator in reducing distress and enhancing quality of life in newly diagnosed AYA patients and their families is currently under way at Moffitt. “Of course, having a navigator sounds intuitive,” said Dr Reed. “You wouldn’t be against another person helping a patient get around; it’s like being anti-literacy or something, but in order to get it paid for, we need to show what it’s doing.”
Moffitt will also be exploring the possibility of building an AYA database with a robust group of tissue samples to further AYA research.
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