From Gaps to Solutions: Semi-Structured Interviews to Identify Care Gaps in Breast Cancer Care and How to Solve Them with Digital Solutions

Abstract

Background

Standardized treatment pathways should make it easier for medical staff and patients to achieve the best possible individual treatment outcome by making sure all relevant information are taken into consideration. The aim of this paper is to identify gaps in care along the treatment pathway through semi-structured patient interviews. Subsequently, it will be discussed if mobile health applications can close these identified gaps in care.

Material and Methods

Nine semi-structured interviews of patients with invasive lobular breast cancer were conducted in March 2023 in German at the breast cancer center at Charité Universitätsmedizin Berlin, which were subsequently transcribed word for word and processed using a thematic analysis approach.

Results

Eight recurring themes are identified in the patient interviews: 1. Limited capacity to absorb information, 2. Discrepancy between information needs and information provision, 3. Need for individual initiative, 4. Uncertainty, 5. not being seen and heard, 6. Patient’s desires and suggestions for improvement, 7. Use of mobile health apps, 8. Support through an app for patients.

Conclusions

The identified gaps in care of breast cancer patients can be largely addressed through the use of digital health solutions after the establishment of regulatory frameworks, thus improving care for patients with early breast cancer.

Trial Registration

The interviews were done within a registry for which ethical approval was obtained by the Ethics Committee of Charité Universitätsmedizin Berlin EA4/180/17.

Zusammenfassung

Hintergrund

Standardisierte Behandlungspfade sollten es dem medizinischen Personal und den Patienten erleichtern, das bestmögliche individuelle Behandlungsergebnis zu erzielen, indem sichergestellt wird, dass alle relevanten Informationen berücksichtigt werden. Ziel dieses Beitrags ist es, durch halbstrukturierte Patienteninterviews Versorgungslücken entlang des Versorgungspfads zu identifizieren. Anschließend wird erörtert, wie mobile Gesundheitsanwendungen diese identifizierten Versorgungslücken schließen können.

Material und Methoden

Im März 2023 wurden im Brustkrebszentrum der Charité Universitätsmedizin Berlin 9 halbstrukturierte Interviews mit Patientinnen mit invasivem lobulären Brustkrebs in deutscher Sprache geführt, die anschließend wortwörtlich transkribiert und mithilfe eines thematischen Analyseansatzes verarbeitet wurden.

Ergebnisse

In den Patienteninterviews wurden 8 wiederkehrende Themen identifiziert: 1. Begrenzte Fähigkeit, Informationen aufzunehmen, 2. Diskrepanz zwischen Informationsbedarf und Informationsangebot, 3. Notwendigkeit von Eigeninitiative, 4. Unsicherheit, 5. nicht gesehen und gehört zu werden, 6. Wünsche und Verbesserungsvorschläge der Patienten, 7. Nutzung von mobilen Gesundheits-Apps, 8. Unterstützung durch eine App für Patienten.

Zusammenfassung

Die identifizierten Versorgungslücken können nach der Schaffung von rechtlichen Rahmenbedingungen durch die Nutzung von mobilen Gesundheitsanwendungen zum großen Teil geschlossen werden und somit die Versorgung von Patientinnen mit frühem Brustkrebs verbessern.

Registrierung der Studie

Die Interviews wurden im Rahmen eines Registers durchgeführt, für das die Ethikkommission der Charité Universitätsmedizin Berlin EA4/180/17 ein positives Votum vergeben hat.

Keywords

breast cancer - treatment pathway - patient pathway - patient journey - care gap - mHealth - eHealth - digital health - oncology

Schlüsselwörter

Brustkrebs - Behandlungspfad - Patientenpfad - Patientenreise - Versorgungslücke - mHealth - eHealth - Digital Health - Onkologie

Publication History

Received: 15 April 2024

Accepted after revision: 17 July 2024

Article published online:
02 September 2024

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