A multidisciplinary approach for patients with metastatic breast cancer: a mixed method study.

PURPOSE: We evaluated the impact of a multidisciplinary clinic model on patient care experience and referral to specialists compared to monodisciplinary visits.

METHODS

This convergent parallel mixed-method study was conducted in two outpatient clinics at an Italian cancer center and involved 80 female patients (mean age 67.2) with advanced or metastatic breast cancer. One clinic used a traditional single specialist model, the other offered additional access to multidisciplinary clinic for selected cases. Patient reported data were collected using the ESAS-r, Distress Thermometer, and a customized care experience tool (score range 1-5), developed to assess key domains of patient-centered care, where 1 indicates "not at all" and 5 indicates "very much." Independent t-test compared group differences in care experience scores. Qualitative data were collected through in-depth interviews.

RESULTS

Forty patients were enrolled in each group. The multidisciplinary group experienced better care in terms of time to obtain follow-up appointments (1.7 vs 2.8) and more information on psychosocial referrals (2.8 vs 1.8), while patients in the monodisciplinary group reported clearer information about side effects (3.6 vs 2.8) and less doubt about proposed treatments (1.2 vs 1.7). Qualitative interviews revealed high satisfaction with both models and emphasized the role of the nurse case manager in supporting care integration.

CONCLUSION

The multidisciplinary model improved psychosocial care referral and perceived time-to-test intervals, but reduced clarity in communication about treatment. Nurse case manager emerged as key figure to facilitate communication and integration of care. Future studies should examine the feasibility and cost-effectiveness of this model.