The pandemic has shown the limits of our health system, too little attentive, at least until today, to the importance of territorial care. And at the same time, it has unlocked the necessary resources to overcome the problem: the funds of the PNNR and the territorial health reform put in place by the Ministry of Health represent an opportunity not to be missed for all patients, and especially for 55 thousand Italians who every year receive a diagnosis of breast cancer. A pathology for which flexibility and proximity are the watchwords today when it comes to quality of life. This is why “Onconnext. Breast cancer and territorial oncology, a necessary combination “, a document in which the main patient associations have decided to join forces, to elaborate 10 concrete proposals with which to direct the reorganization of breast cancer diagnosis and treatment paths, strengthening and reintegrating the relations between hospital and territory.
The document, presented today during a press conference in Montecitorio, brings together the proposals of ANDOS onlus, Europa Donna Italia, FAVO Donna, IncontraDonna onlus and Salute Donna onlus, and was developed with the collaboration of some of the most eminent Italian clinicians, and Roche’s unconditional contribution.
“The document presented today – commented the Onconnext signatory associations – represents an important step forward in the dialogue and inclusion of associations for the co-creation and development of local medicine. We are strongly convinced, in fact, that a new model of assistance for the patient with breast cancer cannot ignore a rethinking of local assistance which, in close connection with the breast care center, can guarantee proximity to treatment and therefore a better quality of life ”.
Breast cancer is in fact an insidious neoplasm, which in recent years has however seen enormous therapeutic and diagnostic advances that in many cases now make it a treatable pathology. In the vast majority of cases, breast cancers are now diagnosed at an early stage, and according to Aiom data, the net survival 5 years after diagnosis now exceeds 88%. This is why, according to patient associations, the goal must be to imagine a new therapeutic path, more effective, flexible and characterized by proximity, which allows to maximize both the effectiveness of the treatments and the quality of life of patients. .
In this sense, according to patient associations, the transition from patient centricity to patient involvement will be decisive, a transformation made possible by the health mission of the PNNR, which outlines a system reform that aims at strengthening hospital-territory relations and enriching the territorial offer of new structures and new intervention models. The goal is to achieve the delocalization of some services and focus on the proximity of care, as conditions of equity of access and adherence to treatment paths.
The redesign of the new paths therefore requires forms of patient involvement, with a new predisposition to dialogue and confrontation on the part of institutional actors. For this reason, the associations that collaborated in the drafting of Onconnext have decided to indicate to the political decision-makers 10 essential priorities for an optimal and continuous care of breast cancer patients.
1) The oncological path of continuity of territorial care cannot be separated from a coordinating role of the reference breast center, to which new territorial care settings are made available with dedicated teams that work in close synergy with hospital oncology.
2) The patient with breast cancer must never be abandoned during the continuity of territorial care but must have, as a point of reference, a connecting figure who is aware of her clinical history.
3) It is of central importance that patients continue to be managed by a multidisciplinary and multiprofessional team: the evolution of multidisciplinarity will ensure interconnection between professionals operating in the hospital and in the area.
4) A patient association must necessarily be present in the Community Houses project.
5) The definition of the oncological path of territorial care must be tailored to the individual, through the choice of the most suitable setting considering how therapeutic innovation can facilitate organizational models through the delocalization of some therapies directly on the territory.
6) Care paths must be guaranteed that ensure safety and quality standards equal to those that would be provided in a day-hospital context in the reference center.
7) The patient and caregivers must be aware of and personally involved in the choice of the path and setting of care.
8) Digital health must be conceived as a tool to support hospital-territory integration by facilitating communication, patient management and path optimization.
9) To guarantee the efficacy and safety of assistance, it is essential that there is continuous training / information for local health personnel and above all for patients / caregivers.
10) The introduction of territorial care must aim at improving the quality of life of patients, in line with one of the missions of the European Cancer Plan.