Duration of intervals in the care seeking pathway for lung cancer in Bangladesh: A journey from symptoms triggering consultation to receipt of treatment
Timeliness in seeking care is critical for lung cancer patients' survival and better prognosis. The care seeking trajectory of patients with lung cancer in Bangladesh has not been explored, despite the differences in health systems and structures compared to high income countries. This study in...
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Published in | PloS one Vol. 16; no. 9; p. e0257301 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
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Public Library of Science
10.09.2021
Public Library of Science (PLoS) |
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Abstract | Timeliness in seeking care is critical for lung cancer patients' survival and better prognosis. The care seeking trajectory of patients with lung cancer in Bangladesh has not been explored, despite the differences in health systems and structures compared to high income countries. This study investigated the symptoms triggering healthcare seeking, preferred healthcare providers (including informal healthcare providers such as pharmacy retailers, village doctors, and "traditional healers"), and the duration of intervals in the lung cancer care pathway of patients in Bangladesh. A cross-sectional study was conducted in three tertiary care hospitals in Bangladesh among diagnosed lung cancer patients through face-to-face interview and medical record review. Time intervals from onset of symptom and care seeking events were calculated and compared between those who sought initial care from different providers using Wilcoxon rank sum tests. Among 418 study participants, the majority (90%) of whom were males, with a mean age of 57 ±9.86 years, cough and chest pain were the most common (23%) combination of symptoms triggering healthcare seeking. About two-thirds of the total respondents (60%) went to informal healthcare providers as their first point of contact. Living in rural areas, lower levels of education and lower income were associated with seeking care from such providers. The median duration between onset of symptom to confirmation of diagnosis was 121 days, between confirmation of diagnosis and initiation of treatment was 22 days, and between onset of symptom and initiation of treatment was 151 days. Pre-diagnosis durations were longer for those who had sought initial care from an informal provider (p<0.05). Time to first contact with a health provider was shorter in this study compared to other developed and developing countries but utilizing informal healthcare providers caused delays in diagnosis and initiation of treatment. Encouraging people to seek care from a formal healthcare provider may reduce the overall duration of the care seeking pathway. |
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AbstractList | Timeliness in seeking care is critical for lung cancer patients’ survival and better prognosis. The care seeking trajectory of patients with lung cancer in Bangladesh has not been explored, despite the differences in health systems and structures compared to high income countries. This study investigated the symptoms triggering healthcare seeking, preferred healthcare providers (including informal healthcare providers such as pharmacy retailers, village doctors, and “traditional healers”), and the duration of intervals in the lung cancer care pathway of patients in Bangladesh. A cross-sectional study was conducted in three tertiary care hospitals in Bangladesh among diagnosed lung cancer patients through face-to-face interview and medical record review. Time intervals from onset of symptom and care seeking events were calculated and compared between those who sought initial care from different providers using Wilcoxon rank sum tests. Among 418 study participants, the majority (90%) of whom were males, with a mean age of 57 ±9.86 years, cough and chest pain were the most common (23%) combination of symptoms triggering healthcare seeking. About two-thirds of the total respondents (60%) went to informal healthcare providers as their first point of contact. Living in rural areas, lower levels of education and lower income were associated with seeking care from such providers. The median duration between onset of symptom to confirmation of diagnosis was 121 days, between confirmation of diagnosis and initiation of treatment was 22 days, and between onset of symptom and initiation of treatment was 151 days. Pre-diagnosis durations were longer for those who had sought initial care from an informal provider (
p
<0.05). Time to first contact with a health provider was shorter in this study compared to other developed and developing countries but utilizing informal healthcare providers caused delays in diagnosis and initiation of treatment. Encouraging people to seek care from a formal healthcare provider may reduce the overall duration of the care seeking pathway. Timeliness in seeking care is critical for lung cancer patients' survival and better prognosis. The care seeking trajectory of patients with lung cancer in Bangladesh has not been explored, despite the differences in health systems and structures compared to high income countries. This study investigated the symptoms triggering healthcare seeking, preferred healthcare providers (including informal healthcare providers such as pharmacy retailers, village doctors, and "traditional healers"), and the duration of intervals in the lung cancer care pathway of patients in Bangladesh. A cross-sectional study was conducted in three tertiary care hospitals in Bangladesh among diagnosed lung cancer patients through face-to-face interview and medical record review. Time intervals from onset of symptom and care seeking events were calculated and compared between those who sought initial care from different providers using Wilcoxon rank sum tests. Among 418 study participants, the majority (90%) of whom were males, with a mean age of 57 ±9.86 years, cough and chest pain were the most common (23%) combination of symptoms triggering healthcare seeking. About two-thirds of the total respondents (60%) went to informal healthcare providers as their first point of contact. Living in rural areas, lower levels of education and lower income were associated with seeking care from such providers. The median duration between onset of symptom to confirmation of diagnosis was 121 days, between confirmation of diagnosis and initiation of treatment was 22 days, and between onset of symptom and initiation of treatment was 151 days. Pre-diagnosis durations were longer for those who had sought initial care from an informal provider (p<0.05). Time to first contact with a health provider was shorter in this study compared to other developed and developing countries but utilizing informal healthcare providers caused delays in diagnosis and initiation of treatment. Encouraging people to seek care from a formal healthcare provider may reduce the overall duration of the care seeking pathway. |
Audience | Academic |
Author | Lewis, Virginia Rahman, Muhammad Aziz McDonald, Christine Faye Ansar, Adnan Liu, Chaojie |
AuthorAffiliation | 5 University of Melbourne, Melbourne, Australia 8 Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh 1 School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Melbourne, Australia 9 Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia 2 Institute for Breathing and Sleep (IBAS), Melbourne, Australia 4 Department of Respiratory & Sleep Medicine, Austin Health, Melbourne, Australia 3 Australian Institute for Primary Care and Aging, La Trobe University, Melbourne, Australia University of Tripoli, LIBYA 7 School of Health, Federation University Australia, Berwick, Australia 6 School of Psychology and Public Health, La Trobe University, Melbourne, Australia |
AuthorAffiliation_xml | – name: University of Tripoli, LIBYA – name: 9 Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia – name: 8 Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh – name: 2 Institute for Breathing and Sleep (IBAS), Melbourne, Australia – name: 1 School of Nursing and Midwifery, College of Science Health and Engineering, La Trobe University, Melbourne, Australia – name: 3 Australian Institute for Primary Care and Aging, La Trobe University, Melbourne, Australia – name: 5 University of Melbourne, Melbourne, Australia – name: 7 School of Health, Federation University Australia, Berwick, Australia – name: 6 School of Psychology and Public Health, La Trobe University, Melbourne, Australia – name: 4 Department of Respiratory & Sleep Medicine, Austin Health, Melbourne, Australia |
Author_xml | – sequence: 1 givenname: Adnan orcidid: 0000-0001-6052-8657 surname: Ansar fullname: Ansar, Adnan organization: Institute for Breathing and Sleep (IBAS), Melbourne, Australia – sequence: 2 givenname: Virginia surname: Lewis fullname: Lewis, Virginia organization: Australian Institute for Primary Care and Aging, La Trobe University, Melbourne, Australia – sequence: 3 givenname: Christine Faye surname: McDonald fullname: McDonald, Christine Faye organization: University of Melbourne, Melbourne, Australia – sequence: 4 givenname: Chaojie orcidid: 0000-0003-0877-0424 surname: Liu fullname: Liu, Chaojie organization: School of Psychology and Public Health, La Trobe University, Melbourne, Australia – sequence: 5 givenname: Muhammad Aziz surname: Rahman fullname: Rahman, Muhammad Aziz organization: Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia |
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CitedBy_id | crossref_primary_10_3389_fonc_2023_1257003 crossref_primary_10_1038_s41533_024_00359_w crossref_primary_10_3390_medicina58101392 crossref_primary_10_3390_healthcare10030424 crossref_primary_10_3390_ijerph19148596 crossref_primary_10_1186_s12913_023_09154_8 crossref_primary_10_3390_healthcare10122525 crossref_primary_10_1002_cam4_6993 |
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Copyright | COPYRIGHT 2021 Public Library of Science 2021 Ansar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2021 Ansar et al 2021 Ansar et al |
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Title | Duration of intervals in the care seeking pathway for lung cancer in Bangladesh: A journey from symptoms triggering consultation to receipt of treatment |
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