Development of One Window Services Model in Accessing Immunotherapies by Cancer Patients in a Hospital in Rawalpindi, Pakistan: A Mixed Methods Study

Abstract

Background: The primary cause of mortality, cancer, is predicted to rise 1.7 times in 2040 compared to 2018. Immunotherapies have transformed cancer treatment for advanced malignancies. Due to inadequate information, there are well-documented hurdles to getting cancer immunotherapies, increasing the disease's burden. This study aims to develop a One-Window Services Model (OWSM) for gaining access to cancer immunotherapies. Methods: This was a sequential explanatory mixed-method study. The quantitative part used interviewer-administered questionnaires including data on knowledge and attitude in conveniently selected 20 cancer patients, and data were analyzed through SPSS. The qualitative part used an open-ended questionnaire for In-depth interviews (IDIs) along with the results of the quantitative part in purposively selected seven tumor panel physicians (TPP) and analyzed by grounded theory. The study was conducted in a specialized tertiary care bone marrow hospital in Rawalpindi, Pakistan. Results: The findings of the quantitative part presented that 80% of cancer patients had poor knowledge about processes, and 90% had a positive attitude towards their cancer immunotherapies.  The findings of the qualitative part presented additional evidence that explained some unclear issues and expanded the results of quantitative data, which were presented as a broader theme “tools for OWSM” through IDI and followed by development of ten steps of OWSM. Conclusion: The sequential explanatory mixed method was considered appropriate for developing the ten steps of OWSM since it involved knowledge and attitude as integral parts of behavior change of patients based on Andersen’s theoretical framework of health service use and the advice of experts. Moreover, the model will be tested in an experimental effectiveness trial planned in next phase .