Clinical Scorecard: Investigating Cancer Treatment Pathways and Contextual Factors Affecting Guideline Adoption in Nigeria

At a Glance

Key Highlights

• Barriers to guideline implementation include human resource shortages, financial constraints, and limited awareness among healthcare workers.
• Facilitators include strong communication practices and existing healthcare infrastructure.
• Social, religious influences, and caregiver roles significantly impact patient experiences and guideline adoption.

Guideline-Based Recommendations

Diagnosis

• Incorporate culturally acceptable supportive care guidelines tailored to Nigerian context.
• Recognize late presentation of cancer cases and emphasize appropriate screening and surveillance.

Management

• Implement resource-stratified survivorship care services categorized as general standard, optional, and advanced based on availability and impact.
• Leverage caregivers and social networks to support survivorship care.
• Address financial hardship explicitly within survivorship care plans.

Monitoring & Follow-up

• Develop measurable indicators for survivorship strategies distinct from palliative care.
• Use implementation science frameworks like CFIR to monitor uptake and contextual adaptation.

Risks

• Potential limited applicability of harmonized guidelines without context-specific adaptation.
• Financial constraints and human resource shortages may hinder effective implementation.
• Social and religious factors may either support or impede guideline adoption.

Patient & Prescribing Data

Cancer patients and caregivers in Nigeria experiencing survivorship care challenges

Financial barriers are predominant; social and religious contexts influence adherence and engagement with survivorship services.

Clinical Best Practices

• Develop and implement context-specific survivorship guidelines that address local financial, social, and cultural factors.
• Engage caregivers as central stakeholders in survivorship care planning and delivery.
• Utilize implementation science frameworks (e.g., CFIR) to guide guideline adoption and sustainability.
• Enhance healthcare worker awareness and training on survivorship guidelines.
• Strengthen communication practices within healthcare teams to facilitate guideline uptake.

References

• NASEM 2005 Report on Cancer Survivorship
• NCCN Harmonized Survivorship Guidelines for Sub-Saharan Africa
• Garton et al. Study on Nigerian Cancer Control Plan