Cross-functional units are key tools for managing patients with cutaneous lymphomas
Cutaneous lymphoma specialists report excellent results. Functional cross block in the approach to patients who, through these multidisciplinary departments visiting one consultation with a hematologist and a dermatologist together and in real time, allowing for the development of a comprehensive holistic vision that leads to improved care.
The impact on the quality of service of this type of equipment is discussed in the program. “Practical immersion in the cross-functional unit of treatment of cutaneous T-cell lymphomas”organized University Hospital of the Jiménez Díaz Foundation And University Hospital October 12both in Madrid, with the collaboration of a biopharmaceutical company Takeda.
Comprehensive care
Cross-functional division University Hospital of the Jiménez Díaz Foundationin Madrid, has been operating for eight years. “At other centers, haematologists only see patients who need chemotherapy or intravenous treatment, but we decided to treat them in one consultation so as not to interrupt the treatment process, meaning two specialists are part of the patient’s journey from diagnosis. and throughout the entire period of his illness,” explains Raul Cordova, Coordinator of the Lymphoma Unit of the Hematology Service this hospital center. Thanks to this comprehensive care, “it does not allow the patient, if the disease progresses, to leave his usual doctor, that is, the dermatologist, and go into the hands of an unfamiliar hematologist in a situation of greater severity and complexity.” .”, he adds.
A comprehensive assessment is key because a patient with cutaneous lymphoma needs more than just skin-focused care, as this type of disease may involve lymph nodes or internal organs or alter analytical parameters. “In many cases, other specialists are needed to help manage these other changes, although the role of the hematologist is very important here, both from a diagnostic point of view and throughout the treatment process,” says this specialist.
Coinciding with him, Pablo Ortiz, Head of the Department of Dermatology at the University Hospital October 12in Madrid emphasizes that “patients treated in a cross-functional unit represent very complex cases, and bringing together doctors with different abilities and different views significantly improves their safety and the quality of their decisions.” This center has been treating cutaneous lymphomas since the 1990s and has a long history of collaboration between different hospital services to treat these patients, although “it was only three years ago that a multidisciplinary committee was created, representative of hematology, dermatology, pathology and radiotherapy, with joint consultation with a dermatologist and hematologist sitting together in front of the patient, and with general patient management protocols.
In this regard, Cordova insists that an important aspect of the creation and success of these multidisciplinary units is close collaboration between hematologists and dermatologists and integration of other specialists for example, pathologists, hospital pharmacists, oncologists and radiotherapists, as well as nursing staff.
Introduce multidisciplinary units in more centers
Both experts emphasize the need to create units of this type in Spain, where there are few of them. “There are consultations for cutaneous lymphoma, which are mainly carried out by dermatologists, during which there is communication with a hematologist in the form of an intermediate consultation, who refer to this specialist only when chemotherapy or intravenous treatment is needed, but there are very few functional cross-sections.” he states. Cordoba. However, he notes that in recent years these teams are beginning to be recognized and created through initiatives such as the hands-on immersion run by the Jiménez Díaz Foundation Hospital and the 12 October Hospital. For Ortiz, Programs of this type are needed to train specialists and this aspect needs to be promoted given the difficulties in training specialists in rare pathologies such as cutaneous lymphomas.
This project consists of a six-week theoretical-practical training, during which, from the reference units of the cutaneous lymphoma clinic, consisting of experienced dermatologists and hematologists, the interdisciplinary approach required by these patients is applied, and subsequently clinical stays that serve as training in teamwork in a functional cross division. The training program culminates with a face-to-face session that discusses each participant’s different experiences at their centers, the possible benefits they see in the model, and how they can each implement it at their centers.
This initiative “is a fantastic opportunity for both the rotators, who can see how patients are treated in the real world in experienced centers, and for the organizers, as they give us ideas to improve our practice and discover problems that we have not identified”, details Ortiz.