gms | German Medical Science

Background and state of research: When being diagnosed with cancer many patients feel shocked, which requires a multi-disciplinary approach of care. In contrast to inpatient clinics (case manager), central contact persons are often lacking in outpatient care. Due to this gap, the position of an oncological patient navigator in an outpatient interdisciplinary center for drug-based tumor therapy was created in 2018 and was first sponsored by a nonprofit organization.

Scientific question and objective, hypothesis: By implementing a patient navigator, patients have easier and more direct access to adequate counseling for support and treatment measures.

Method: Patients can receive the consulting offer which is provide by the patient navigator in three ways: 1) in everyday clinical practice, through inquiries from medical and nursing staff in the event of acute patient needs; 2) via a screening-questionnaire (needs-based, quality-of-life and symptoms screening – NQS2), which was developed for this purpose by an interdisciplinary team. The NQS2 is handed out to patients at the start of therapy; 3) by contacting the patient navigator directly via e-mail, telephone or information events.

Results: Between 22^nd September 2019 and 11^st April 2023, a total of 619 patients used the services provided by the patient navigator. Counseling mainly referred to authority (insurance) matters, legal and psychosocial issues, wig services, self-help groups and tumor sports. The analysis of the questionnaire showed that patients most frequently expressed needs (for additional support/information) in four out of a total of twenty five categories: “Therapy” (8.5%), “Examination results” (8.3%), “Prognosis” (7.9%) and “Side effects” (7.7%). During direct conversation with the patient navigator, it became clear that the greatest area of needed support was related to issues regarding health insurance companies/authorities - this was also the most time-consuming service provided by the patient navigator.

Discussion: Both the literature and networking with patient navigators from other institutions suggest that the tasks of the patient navigators work are adapted to the underlying care setting: in addition to research work, the above described patient navigator acts further as a patient representative, supports projects relevant for patient care and is an active member of several working groups.

Implication for research: The present project highlights that the position of a patient navigator for outpatient cancer patients can be implemented. It has implications for further research and care, e.g. with regard to future funding (so far no inclusion in standard care) and reliable evidence on the effectiveness of patient navigators on patient and healthcare system outcomes.