SIOP-PODC adapted risk stratification and treatment guidelines: Recommendations for neuroblastoma in low- and middle-income settings

Abstract Background The use of clinical practice guidelines in clinical and organizational decision-making improves the care of patients and patient safety. Guidelines make healthcare consistent and efficient. In many low- and middle income countries healthcare workers depend on guidelines developed in higher income countries. For these to be useful and accepted they need to be adapted to the local setting. The aim of the study was to implement pre-hospital treatment guidelines into an organization that was not currently using guidelines. The study was partnership between a Swedish pre-hospital training organization and local ambulance service organizations in Kosovo. Methods An iterative process of implementing the guidelines was used: Identify guidelines appropriate for the local organization.In sets of five, have the guidelines translated into Albanian.Adapt the guidelines to the local conditions and context.Approval of guidelines by an expert group.Begin using the guidelines within the target organization. Results The first set of five guidelines was translated, approved, and implemented into the organizations. To improve acceptance, both practitioners and decision-makers were involved in the process. Seven workshops were held, with a total of 104 participants. In follow-up discussions participants said they accepted the guidelines and that they would be useful in their daily work. Conclusions It is important to evaluate to what extent the guidelines have been accepted, understood, and used. The success and acceptance is due to the flexible procedure managing the full implementation process. Adapting guidelines to fit with local needs and requirements using local experts made the guidelines accessible and useful. The workshop discussions established justification and approval. Key messages Involve local experts in contextualising guidelines to increase acceptance from the start. Support building a robust local implementation organization to assist and administer change.

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SIOP PODC–adapted treatment guidelines for craniopharyngioma in low‐ and middle‐income settings

Pediatric Blood & Cancer ◽

10.1002/pbc.28493 ◽

2020 ◽

Author(s):

Nisreen Amayiri ◽

Ariane Spitaels ◽

Mohamed Zaghloul ◽

Anthony Figaji ◽

Sergio Cavalheiro ◽

...

Keyword(s):

Treatment Guidelines ◽

Middle Income ◽

Low And Middle Income

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Oncology Guidelines Usage in a Low- and Middle-Income Country

Journal of Global Oncology ◽

10.1200/jgo.17.00136 ◽

2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Nofisat Ismaila ◽

Omolola Salako ◽

Jimoh Mutiu ◽

Oladeji Adebayo

Keyword(s):

Treatment Guidelines ◽

Guideline Implementation ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Patients With Cancer ◽

Radiation Oncologists ◽

Local Setting ◽

American Society ◽

Low And Middle Income

Purpose There is a paucity of data about current usage of oncology guidelines in low- and middle-income countries (LMICs), specifically in terms of the availability and quality of those guidelines. Our objective was to determine usage of oncology guidelines and the barriers and facilitators to their usage among radiation oncologists in LMICs. Methods An online cross-sectional survey was conducted among practicing radiation oncologists in Nigeria via e-mail and the social media database of the Association of Radiation and Clinical Oncologists of Nigeria. In addition, paper questionnaires were administered at regional clinical meetings. Results The survey response rate was 53.4% in a sample of 101 radiation oncologists from the database. Sixty-nine percent of respondents were consultants and 30% were residents. Approximately 43% had < 5 years’ experience. All of the respondents were involved in administering chemotherapy during the treatment of patients with cancer, whereas approximately half were involved in diagnosing cancer. Ninety-three percent reported using guidelines in treating patients, the top two guidelines being those from the National Comprehensive Cancer Network (90%) and the American Society of Clinical Oncology (50%). The two major barriers to guideline usage were that facilities were inadequate for proper guideline implementation and that the information in guidelines were too complex to understand. Potential facilitators included providing adequate facilities, developing local guidelines, and increasing awareness of guideline usage. Conclusion Our study shows that clinicians involved in the treatment of patients with cancer in LMICs are aware of cancer treatment guidelines. However, implementation of these guidelines hinders their usage because the facilities are inadequate, guidelines are not applicable to the local setting, and the information in the guidelines is too complex.

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SIOP PODC Adapted treatment guidelines for low grade gliomas in low and middle income settings

Pediatric Blood & Cancer ◽

10.1002/pbc.26737 ◽

2017 ◽

Vol 64 ◽

pp. e26737 ◽

Cited By ~ 5

Author(s):

Laila Hessissen ◽

Jeannette Parkes ◽

Nisreen Amayiri ◽

Naureen Mushtaq ◽

Nongnuch Sirachainan ◽

...

Keyword(s):

Treatment Guidelines ◽

Low Grade ◽

Middle Income ◽

Low Grade Gliomas ◽

Low And Middle Income

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How Useful Are International Treatment Guidelines in Low- and Middle-Income Countries?

Journal of Global Oncology ◽

10.1200/jgo.2016.008250 ◽

2017 ◽

Vol 3 (5) ◽

pp. 441-443 ◽

Cited By ~ 5

Author(s):

Stewart Kerr ◽

Abdul-Rahman Jazieh ◽

David Kerr

Keyword(s):

Treatment Guidelines ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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Host-Based Prognostic Biomarkers to Improve Risk Stratification and Outcome of Febrile Children in Low- and Middle-Income Countries

Frontiers in Pediatrics ◽

10.3389/fped.2020.552083 ◽

2020 ◽

Vol 8 ◽

Author(s):

Núria Balanza ◽

Clara Erice ◽

Michelle Ngai ◽

Rosauro Varo ◽

Kevin C. Kain ◽

...

Keyword(s):

Risk Stratification ◽

Prognostic Biomarkers ◽

Middle Income ◽

Middle Income Countries ◽

Improve Risk Stratification ◽

Low And Middle Income

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Oncology guidelines usage in a low and middle-income country.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e18211 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e18211-e18211

Author(s):

Nofisat Ismaila ◽

Omolola Salako ◽

Adebayo Oladeji

Keyword(s):

Cancer Patients ◽

Treatment Guidelines ◽

Guideline Implementation ◽

Healthcare Providers ◽

Developed Countries ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional ◽

Middle Income ◽

Low And Middle Income

e18211 Background: Healthcare providers often rely on clinical practice guidelines to help inform and optimize patient care. However, most of these guidelines are from reputable organizations that are based in developed countries. There is a paucity of data about the status of guidelines in low and middle-income countries (LMIC), specifically in terms of their availability, usage and quality. Objective: To determine utilization of oncology guideline and potential barriers to usage in a LMIC among clinical and radiation oncologist (RADONCS) Methods: A cross-sectional survey was conducted with the use of an online questionnaire that was administered to practicing RADONCS in Nigeria via the Association’s email and social media database. In addition, paper questionnaires were administered in person at regional clinical meetings. Results: Survey response rate was 53.4% in a sample of 101 RADONCS from the database. Sixty-nine percent of respondents were consultants and 30% were residents. About 17% had greater than ten years’ experience managing cancer patients, while 43% had less than five years’ experience. All of the respondents are involved in the chemotherapy administration while only about half are involved in the screening and diagnosis of cancer patients. Ninety-three percent report using guidelines in managing patients and the top 3 guidelines used were National Comprehensive Cancer Network (90%), American Society of Clinical Oncology (50%) and European Society of Medical Oncology (46%). The major three barriers to guideline utilization were inadequate facilities for proper guideline implementation, the guideline is not applicable to setting and information in guideline is overwhelming. Potential facilitators include providing adequate facilities, developing local guidelines and increase awareness on the use of guidelines. Almost all respondents are in favour of using guidelines that are adapted to their practice setting. Conclusions: Our study shows that clinicians involved in the management of cancer patients in a LMIC are aware of cancer treatment guidelines. However, issues like inadequate facilities, inapplicability of guideline to local setting and complexity of information in guidelines hinder their usage.

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