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How to improve the treatment of elderly oncological patients – project by Croatian Society for Pharmacoeconomics and Health Economics - CSPHE and Oncology Foundation

Considering the fact that life expectancy is constantly increasing and the share of elderly people continues to increase and in some areas it is higher than 25%, the number of oncological patients is also constantly increasing. As a rule, oncological patients are elderly people who often live alone. Because of their old age, but also because of their primary and other chronic diseases, they have a decreased mental and physical condition for a normal life, and especially for the treatment of oncologic diseases. Aim/Objective In the aim to additionally improve the treatment of oncologic patients in the Republic of Croatia, Zaklada Onkologija (Oncology Foundation) and Croatian Society for Pharmacoeconomics and Health Economics – CSPHE) initiated the project Improve the treatment of oncological patients in Croatia – Together against cancer. Oncological patients themselves can do a lot for their treatment. Experience has shown that active participation in one’s own treatment is equally important as the good prevention or state-of-the-art therapy. Therefore, the patient has to know, want, ask for, and actively participate in his treatment. The obligation of the medical profession and of patients’ associations is to continuously warn about that. Objectives of the project: 1. To educate patients, their families and associations of patients on the importance of proactive involvement in the process of self-treatment. 2. To improve cooperation between the profession, the Ministry of Health and Croatian Institute of Public Health with the aim to adopt an action plan to fight cancer, networking of all cancer centres, raising the level of oncology business organization and to ensure equal access and quality of cancer treatment in the Republic of Croatia. 3. To promote and enhance a multidisciplinary approach to treatment due to increased complexity of treatment and the impossibility for one specialty to encompass all aspects and modalities of diagnostics and treatment of cancer patients. 4. To achieve the full utilization of the existing and introduction of new diagnostic-therapeutic procedures in prevention, diagnosis, treatment and palliative care of cancer patients. Summary of materials/examinees and methods Continuous education for the patients and for patients’ associations is performed on the importance of proactive inclusion into the process of one’s own treatment. Special care is provided, especially for elderly patients and their families. The cooperation between the medical profession, the Ministry and CHIF (Croatian Health Insurance Fund) is improved, in the aim of networking all oncological centers, of placing the organization of oncological activities to a higher level, and in the aim of having equal availability and quality of oncological care in the Republic of Croatia. Key messages: o Only a multi-disciplinary approach to the treatment provides good results - a multidisciplinary team consists of: oncologist, surgeon, pathologist, cytologist, radiologist, psychologist, "oncology" family medicine doctor, nurse and visiting nurse o Education and active participation of patients in the treatment process is extremely important for a positive outcome. According to studies and reports of the World Health Organization, in developed countries, following the instructions on the proper intake of long-term therapy for chronic conditions averages 50%, and in developing countries only 26% - 43% of patients take the medication for a chronic disease in a proper manner. According to research, 70% of non-compliance with the prescribed therapy is INTENTIONAL! (e.g. "Internet says ..., the medicine makes me feel worse, I think the doctor is not right, I'm afraid, I'm better ...". 30% ACCIDENTALLY do not comply (“…have I took the medicine ?, I lost medication, I never know when to take it ... ") o Efficient logistics of cancer care is the basis for achieving significant progress in the fight against cancer - Better organization of oncology in Croatia involves the establishment of a network of oncology units, continuous information exchange, constant education of all levels of health care professionals and the standardization of procedures in the diagnosis and treatment of cancer patients. o The application of innovative therapies is not necessarily the most expensive solution in fight against cancer. Research in the field of clinical oncology, pharmacoeconomics, public health and clinical pharmacology, indicates that initially expensive drugs are not really the most expensive, because the consequences of non-treatment or inadequate treatment of cancer represent the largest financial burden on the budget. The situation can be further improved by a stricter implementation of evidence-based medicine - improving care + cost control (critical evaluation, rational prescribing, continuing medical training for all involved) Summary of results Multidisciplinary approaches to treatment of oncological patients have been promoted and improved because of the increased complexity of treatment and because of the impossibility for one specialty to comprise all the aspects and modalities of diagnostics and treatment of oncological patients. Activities are performed for the integral use of harmonized procedures, and for the introduction of new diagnostic-therapeutic procedures in the prevention, diagnostics, treatment and palliative care of oncological patients, especial elderly ones. Conclusions Patients do not know everything about their illness and treatment. Due to the complexity of treatment, it is necessary that all the participants in the treatment procedure participate in the process of informing the patient. The patient has to be motivated ; he has to have enough courage and persistency to walk along the arduous path till his cure, till remission, till the improvement, till a longer survival, till the rational palliative care. The patient has to be informed about his right to ask for the best therapy, without hesitation, because in the relation with a doctor there is often a problem of “false consideration”.

How to improve the treatment of elderly oncological patients – project by Croatian Society for Pharmacoeconomics and Health Economics - CSPHE and Oncology Foundation

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