World Cancer Day, February 4th, is a reminder to come together to take action against cancer and honour those we’ve lost, support those living with cancer, and raise awareness for better prevention and treatment options. This year, a new three-year theme and campaign “United by Unique” begins. “United by Unique” focuses on placing individuals at the centre of care and their stories at the heart of the conversation about cancer.
1 in 5 people will experience cancer at some point in their lives. It's crucial to foster open, candid, conversations about cancer and expand educational resources to promote person-centred care.
What is People-Centred Care?
People-centred care is a healthcare approach that prioritises the needs, preferences, and values of individuals, families, and communities. It extends beyond the traditional patient-centred care model by incorporating a broader focus on community health, policy-making, and the social determinants of health. This approach emphasises collaboration, respect, and shared decision-making among all stakeholders, including patients, families, healthcare providers, and policymakers. It aims to treat individuals as whole persons rather than focusing solely on their diseases or conditions. Source
Key Principles of People-Centred Care Include:
- Empowerment: Engaging individuals and communities in their care.
- Collaboration: Equal partnerships between patients, families, and healthcare providers.
- Holistic Focus: Addressing physical, emotional, social, and psychological needs.
- Equity and Inclusivity: Ensuring care is accessible and fair for all, including marginalised groups. Source
What is the Impact of People-Centred Care for Cancer?
Improved Quality of Care (QOC) and Patient Outcomes
- Enhanced Quality of Life: People-centred care improves physical, emotional, and psychological well-being. Studies show that PCC models lead to better health-related quality of life, reduced anxiety, and improved emotional support. Source
- Trust and Satisfaction: PCC fosters trust in healthcare providers and increases patient satisfaction. For example, clear communication, addressing emotional needs, and involving patients in decision-making significantly improve trust and perceived quality of care. Source
- Reduced Healthcare Utilisation: A meta-analysis found that PCC reduces inpatient care utilisation and shows trends toward cost savings, though more rigorous studies are needed to confirm these effects. Source
- Psychosocial Benefits: PCC addresses unmet psychological needs, such as anxiety and depression, which are prevalent among cancer patients. For older patients, PCC improves autonomy, mobility, and functional recovery. Source
System-Level Benefits
- Efficiency and Equity: PCC minimises resource waste, reduces disparities in access, and strengthens health system resilience. Source
- Improved Communication: Patient-centred communication enhances understanding of treatment options, reduces uncertainty, and aligns care with patient values. Source
How Can We Implement People-Centred Care, What Does it Look Like in Practice?
Core Components of People-Centred Care
- Holistic Needs Assessment (HNA):
- Identifies and addresses patients' physical, emotional, social, and spiritual needs.
- Proven effective in improving satisfaction and directing patients to appropriate support services. Source
- Shared Decision-Making:
- Involves patients and families in care planning, ensuring alignment with their preferences and values.
- Tools like decision aids and treatment plans enhance patient engagement. Source
- Multidisciplinary Collaboration:
- Teams of oncologists, nurses, social workers, and palliative care specialists work together to provide integrated care.
- Geriatric assessments (GA) for older patients improve communication and satisfaction. Source
- Patient Navigation:
- Navigators help patients understand their treatment options, manage appointments, and access resources.
- Programs like UCSF's Decision Services have shown significant improvements in communication and care coordination. Source
- Technology Integration:
- AI and electronic medical records (EMRs) enhance PCC by combining clinical data with patient-reported outcomes.
- Telehealth, especially during the COVID-19 pandemic, has been a valuable tool for maintaining PCC, though it requires careful implementation to address its limitations. Source
Training and Education
- Clinician Training:
- Formal training in communication skills, cultural competence, and shared decision-making is essential.
- Role-playing and feedback-based methods are effective in improving clinician-patient interactions. Source
- Patient Education:
- Providing clear, accessible information about treatment options, side effects, and costs empowers patients to make informed decisions. Source
Policy and System-Level Changes
- Financial Incentives:
- Payment models like the Oncology Care Model (OCM) incentivize high-quality, coordinated care through performance-based payments. Source
- Standardis
- ed Guidelines:
- Guidelines like those developed by Cancer Care Ontario (CCO) provide a framework for implementing PCC in oncology services. Source
Addressing Challenges
- Barriers:
- Time constraints, fragmented care systems, and lack of training are common obstacles.
- Emotional distress and low health literacy among patients also hinder effective PCC. Source
- Solutions:
- Streamlining care coordination, integrating palliative care early, and addressing cultural and emotional needs can overcome these barriers. Source
What is the Impact of People-Centred Care?
- Improved Research Design and Outcomes:
- People-centred research involves participants as equal partners, ensuring studies address real-world needs and are inclusive. This approach enhances trust, accessibility, and the relevance of findings. For example, the UK Health Research Authority's initiative on people-centred clinical research identified barriers and enablers, leading to recommendations for improving equity, diversity, and inclusion in research. Source
- Studies have shown that involving patients in research design improves outcomes, reduces waste, and ensures findings are applicable to diverse populations. Source
- Ethical and Practical Benefits:
- People-centred research fosters ethical practices by addressing participants' concerns about safety, confidentiality, and respect. It also improves recruitment and retention rates by making participation more accessible and meaningful. Source
- Examples of Impact:
- A systematic review of controlled trials found that people-centred care interventions improved physical function, reduced hospital stays, and enhanced cost-effectiveness. For instance, individualised care plans for diabetes patients led to significant improvements in health outcomes like lower HbA1c levels. Source
What is the Impact of People-Centred Care in Clinical Trials?
- Enhanced Trial Design:
- People-centred clinical trials prioritise participant needs by incorporating real-world outcomes, patient-reported measures, and adaptive designs. This ensures trials are more relevant and impactful. For example, pragmatic trials include diverse populations and focus on outcomes that matter to participants, improving the applicability of results. Source
- Improved Participation and Retention:
- By addressing barriers like cost, complexity, and accessibility, people-centred trials increase participation rates and reduce dropout rates. Communication tools and patient engagement strategies further enhance the trial experience. Source
- Examples of Success:
- Adaptive trials, which adjust based on interim results, have improved safety and efficiency while reducing exposure to ineffective treatments. These designs align with people-centred principles by prioritising participant well-being. Source
What is the Impact of People-Centred Care in Advocacy?
- Policy and Systemic Changes:
- People-centred care has influenced healthcare policies worldwide. For example, the World Health Organisation's Integrated People-Centred Health Services (IPCHS) framework has been adopted to improve equity, quality, and responsiveness in healthcare systems. Source
- In the UK, advocacy efforts have led to reforms in care for individuals with learning disabilities and autism, emphasising co-production of care plans and expanding access to advocacy services. Source
- Case Studies and Success Stories:
- Hospitals in Victoria, Australia, have implemented people-centred initiatives like therapeutic gardens for dementia patients and personalised nutrition programs, leading to improved patient satisfaction and clinical outcomes. Source
- Advocacy campaigns, such as the "Ask Listen Do" initiative in the UK, have improved communication and responsiveness in healthcare settings. Source
- Global Initiatives:
- The OECD's PaRIS survey collects data on people-centred care outcomes, such as quality of life and care integration, across 20 countries. This initiative aims to benchmark and improve care for individuals with chronic conditions. Source
How Can I Learn More? Research Papers & Further Resources
- "Patient-centred care: making cancer treatment centres accountable"
- Focus: Six domains of PCC and their implementation in cancer care.
- Published in: Support Care Cancer (2014).
- Read here
- "The patient-centered oncology care on health care utilisation and cost: A systematic review and meta-analysis"
- Focus: Impact of PCC on healthcare utilisation, cost, and quality.
- Published in: Health Care Manage Rev (2020).
- Read here
- "Patient-centered cancer treatment planning: improving the quality of oncology care"
- Focus: Challenges and solutions for implementing PCC in oncology.
- Published in: The Oncologist (2011).
- Read here
- "Bringing person-centered care to practice with CCO’s guideline for person-centred care in adult oncology services"
- Focus: Development and implementation of PCC guidelines in Ontario.
- Published in: Journal of Clinical Oncology (2016).
- Read here
People-centred care represents a transformative approach to healthcare, emphasising collaboration, respect, and inclusivity. People-centred care in oncology significantly improves patient outcomes, satisfaction, and trust while addressing psychosocial and systemic challenges. Its impact is evident across research, clinical trials, and healthcare systems, where it has improved outcomes, enhanced patient satisfaction, and influenced policy reforms.
However, challenges like resource constraints, cultural resistance, and limited implementation in low-income settings highlight the need for continued advocacy, research, and investment to fully realise its potential, which why this theme is important to be discussed.
People-centred care and the mission of World Cancer Day align with our mission to make a meaningful impact. By starting conversations around cancer and increasing awareness of people-centred care, we take action to come together and take action against cancer.
For more resources and information about World Cancer Day visit: https://www.worldcancerday.org/
Further References & Resources to Learn More:
- Ramello, M. and Audisio, R.A. (2020). The value of patient centred care in oncology. European Journal of Surgical Oncology, [online] 47(3), pp.492–494. doi:https://doi.org/10.1016/j.ejso.2020.06.010.
- Balogh, E.P., Ganz, P.A., Murphy, S.B., Nass, S.J., Ferrell, B.R. and Stovall, E. (2011). Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care. Summary of an Institute of Medicine Workshop. The Oncologist, [online] 16(12), pp.1800–1805. doi:https://doi.org/10.1634/theoncologist.2011-0252.
- Treiman, K., Kranzler, E.C., Moultrie, R., Arena, L., Mack, N., Fortune, E., Garcia, R. and Street, R.L. (2022). Patients’ Experiences with Cancer Care: Impact of the COVID-19 Pandemic. Journal of Patient Experience, [online] 9, p.237437352210925-237437352210925. doi:https://doi.org/10.1177/23743735221092567.
- Levit, L., Balogh, E., Nass, S., Ganz, P.A., Aging, an, Board and Institute of Medicine (2013). Patient-Centered Communication and Shared Decision Making. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK202146/ [Accessed 4 Feb. 2025].
- Zucca, A., Sanson-Fisher, R., Waller, A. and Carey, M. (2014). Patient-centred care: making cancer treatment centres accountable. Supportive Care in Cancer, [online] 22(7), pp.1989–1997. doi:https://doi.org/10.1007/s00520-014-2221-4.
- Cms.gov. (2016). Oncology Care Model | CMS. [online] Available at: https://www.cms.gov/priorities/innovation/innovation-models/oncology-care [Accessed 4 Feb. 2025].
- Moody, L., Nicholls, B., Shamji, H., Johnson, N., Zwaal, C., Stevens, C., Biddy, R., Griffin, C., Laroque, G., Messersmith, H. and Singh, S. (2016). Bringing person-centered care to practice with CCO’s guideline for person-centred care in adult oncology services. Journal of Clinical Oncology, [online] 34(7_suppl), pp.65–65. doi:https://doi.org/10.1200/jco.2016.34.7_suppl.65.
- Health Research Authority. (2020). People-Centred Clinical Research. [online] Available at: https://www.hra.nhs.uk/planning-and-improving-research/best-practice/people-centred-clinical-research/ [Accessed 4 Feb. 2025].
- Mullins, C.D., Vandigo, J., Zheng, Z. and Wicks, P. (2014). Patient-Centeredness in the Design of Clinical Trials. Value in Health, [online] 17(4), pp.471–475. doi:https://doi.org/10.1016/j.jval.2014.02.012.
- World (2020). Integrated people-centred care - GLOBAL. [online] Who.int. Available at: https://www.who.int/health-topics/integrated-people-centered-care#tab=tab_1 [Accessed 4 Feb. 2025].
- Cqc.org.uk. (2022). People’s experience of person-centred care - Care Quality Commission. [online] Available at: https://www.cqc.org.uk/publications/themes-care/rss22_02_person-centred [Accessed 4 Feb. 2025].
- Australia, V. (2024). Implementation case studies. [online] Vic.gov.au. Available at: https://www.health.vic.gov.au/older-people-in-hospital/supporting-information-for-older-people-in-hospital/implementation-case-studies [Accessed 4 Feb. 2025].
- Liang, H., Tao, L., Ford, E.W., Beydoun, M.A. and Eid, S.M. (2018). The patient-centered oncology care on health care utilization and cost: A systematic review and meta-analysis. Health Care Management Review, [online] 45(4), pp.364–376. doi:https://doi.org/10.1097/hmr.0000000000000226.
- Moody, L., Nicholls, B., Shamji, H., Johnson, N., Zwaal, C., Stevens, C., Biddy, R., Griffin, C., Laroque, G., Messersmith, H. and Singh, S. (2016). Bringing person-centered care to practice with CCO’s guideline for person-centred care in adult oncology services. Journal of Clinical Oncology, [online] 34(7_suppl), pp.65–65. doi:https://doi.org/10.1200/jco.2016.34.7_suppl.65.
This research summary and sources were written with the assistance of Ergodic Platform’s Search API, becoming available in the next few weeks.
