Objectives All gynecologic oncology patients in Qatar receive treatment recommendations according to guidelines developed after reviewing international best practice (e.g., NCCN; ESGO; BGCS guidelines) by our multidisciplinary team (MDT). However, despite a highly-regarded and highly-affordable or free national health service, many women travel overseas for treatment. We wished to investigate if the decision to travel resulted in any difference in treatment received, and whether that was of any benefit or harm to the patients.
Methods We performed a retrospective review of all patients discussed in the MDT meeting over a 3yr period to identify those who received treatment overseas. The treatment received was reviewed for each case and compared with our MDT plan.
Results Approximately 1 in 7 (15.1%) patients (n=129/850) discussed by the MDT sought treatment overseas between 4/2015 and 3/2018. Patients travelled to 28 different destinations, most commonly; U.S.A(15.7%); Philippines (15%); UK(10.5%) and Thailand(9.2%). 25% of patients received different treatment to that recommended by our MDT. One had been referred to an overseas centre due to the unusual nature of her disease. Two patients opted for unrecognized and unproven treatment by alternative practitioners. Many patients were subjected to unnecessary investigations, surgery, chemotherapy or radiotherapy.
Conclusions Most women who travelled abroad received the same treatment to that recommended by the Qatar MDT. Commonly, where there was different treatment, we considered that treatment received was inappropriate according to our guidelines and international best practice. There was a tendency for patients to receive additional or unnecessary treatment after travelling.
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