Aims: This paper will report on lessons learnt from a study undertaken to implement and evaluate a multidisciplinary team (MDT) model of care for women with MBC and its impact on their care needs.
Methods: An exploratory, longitudinal repeated measures design. Women with stage IV MBC who received care at Peter MacCallum Cancer Centre (Peter Mac), aged over 18 years were recruited over 12 months. The MDT model consisted of a face-to-face meeting with a breast care nurse and social worker, being discussed at an MDT meeting and receiving a personalised care plan. Follow up time points were at 3, 6 and 9 months following receipt of a care plan.
Results: Sixty-two women (60%) who were an average of 2.7 years post diagnosis of MBC (SD=2.5) and 8.6 years post first diagnosis of breast cancer (SD=8.6) consented to take part. MBC was the first cancer diagnosis for 39% of women. The average age of participants was 60 years (SD=12). Lessons learnt: 1) there is considerable heterogeneity across cohorts of women living with MBC. This makes designing robust service enhancement studies challenging; 2) the requirement for scheduling face-to-face nurse and social worker consultations impacted on timely administration of follow up procedures and added considerably to existing social worker and nurse workloads; 3) despite considerable heterogeneity in unmet needs reported at baseline and at follow up time points, there were important commonalities including: fear about cancer spreading (46%), concerns about the worries of those close to you (35%) and uncertainty about the future (52%).
Conclusions: Our study failed to demonstrate impact on the care needs of women living with MBC. Lessons learnt have been invaluable to informing a new study to develop and test a patient-informed supportive care intervention that can accommodate the commonalities, heterogeneity and fluctuating needs of women living with MBC.