of Asia: Provision of Patient-Centered Care in Oral Cavity Cancer: A Qualitative Study With Patients, Caregivers, and Healthcare Professionals in Five Asia-Pacific Regions

Abstract

Aim Locoregionally advanced oral cavity squamous cell carcinoma (LA-OCSCC) imposes a high disease burden, significantly affecting patients' quality of life. We aimed to identify unmet needs and challenges faced by patients, caregivers, and healthcare professionals (HCPs) in diagnosis and managing LA-OCSCC.Methods In-depth interviews were conducted across Australia, Hong Kong, South Korea, Taiwan, and Vietnam with LA-OCSCC patients (n = 28), caregivers (n = 27), and HCPs (surgeons, clinical, radiation, and medical oncologists [n = 30]; nurses, case managers/coordinators, psychologists, speech therapists, dieticians, and dentists [n = 30]). Patients who received post-operative chemoradiotherapy for Stage III-IVB LA-OCSCC, their caregivers, and HCPs were eligible. The interview guide, design, and analysis were based on the Capability, Opportunity, Motivation, Behavior (COM-B) model.Results Major service gaps in timely diagnosis, treatment, patient-centered care, and therapeutic alliance were identified. Limited awareness of LA-OCSCC led to overlooked symptoms, delaying medical attention. General practitioners were perceived as less experienced in identifying LA-OCSCC symptoms accurately and promptly, with dentists being more informed. A shortage of nurses to support integrated multidisciplinary team discussions, patient education, and to relay patients' needs to specialists, compromised patient-centric care. Psychotherapeutic services were scarce, with supportive care professionals overextending to bridge the gap.Conclusion This study examined LA-OCSCC care management in five Asia-Pacific countries/territories with varying healthcare systems and infrastructure. Given LA-OCSCC's aggressive nature and high burden from disease and treatment, patients and caregivers require support beyond medical interventions. A multi-stakeholder approach with clinical and community care is essential to ensure a comprehensive and sustainable approach to patient-centered care within the different health systems.