Delivering high-quality care to patients with a non-Hodgkin's lymphoma: barriers perceived by patients and physicians.
BACKGROUND
Despite the presence of non-Hodgkin's lymphoma (NHL) guidelines, there are still gaps between best evidence as described in guidelines and quality of care in daily practice. Little is known about factors that affect this discrepancy. We aim to identify barriers that influence the delivery of care and to explore differences between patients' and physicians' experiences, as well as between the different disciplines involved.


METHODS
Patients and physicians involved in NHL care were interviewed about their experiences with NHL care. The barriers identified in these interviews were quantified in a web-based survey. Differences were tested using Chi-square tests.


RESULTS
Barriers frequently perceived by patients concerned lack of patient information and emphatic contact (12-43%), long waiting times (19-35%) and lack of guidance and support (39%). Most barriers mentioned by physicians concerned the unavailability of the guideline (32%), lack of an up-to-date guideline (66%), lack of standardised forms for diagnostics (56-70%) and of multidisciplinary meetings (56%). Perceived barriers concerning the guideline and standardised forms significantly varied between the disciplines involved (range 14-84%, p.
Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud university medical center, Nijmegen, the Netherlands.
J J C
JJ
Stienen
P B
PB
Ottevanger
L
L
Wennekes
S A M
SA
van de Schans
H M
HM
Dekker
N M A
NM
Blijlevens
R W M
RW
van der Maazen
J H J M
JH
van Krieken
R P M G
RP
Hermens
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D037001:Directive Counseling; D005260:Female; D054625:Healthcare Disparities / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D012944:Social Support; D014850:Waiting Lists