Potlako: A Programmatic Intervention to Improve Access to Timely Oncology Care

Potlako: A Programmatic Multi-facility Level Intervention to Improve Access to Timely Oncology Care in Botswana

Diagnostic and treatment delays contribute substantially to disparities in cancer morbidity and mortality between low- and middle- income countries (LMICs) and high-income countries. Individuals present with advanced stage disease resulting in minimal chance for cure or long-term survival.

The Potlako project will implement and evaluate a multifaceted intervention to test the hypothesis that a package of enhanced coordination of care including an electronic messaging, transportation support, and training targeted at generalist clinicians at primary and secondary level facilities, can reduce time to diagnosis and stage at diagnosis for HIV-infected individuals with cancer.

Study Overview

• Status: Completed
• Conditions: Neoplasms; HIV; Healthcare Disparity
• Intervention / Treatment: Other: Potlako intervention

• Study Type: Interventional
• Enrollment (Actual): 979
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Botswana
  • Gaborone, Botswana
    • Botswana Harvard AIDS Institute

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Citizen of Botswana
• Suspected or diagnosed cancer

Exclusion Criteria:

• Involuntary incarceration

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Kweneng East District; Patient presenting with possible cancer symptoms/sign to a clinic or hospital in Kweneng East District during study period.	Other: Potlako intervention; Multicomponent intervention including: provider training on early detection and diagnostic approaches to cancer; patient education on importance of obtaining timely cancer diagnosis; provision of a patient navigator to facilitate diagnosis and entry into care; provision of transportation support to vulnerable patients
No Intervention: All other districts; Patient presenting with possible cancer symptoms/sign to a clinic or hospital in all other districts of Botswana (or Kweneng East prior to implementation of intervention).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Cancer stage	1 day visit
Time from initial clinic visit with cancer symptom/sign to entry into oncology care	1 day visit

Collaborators and Investigators

• Sponsor: Harvard School of Public Health (HSPH)
• Collaborators: Dana-Farber Cancer Institute; Brigham and Women's Hospital; Botswana Harvard AIDS Institute Partnership; Botswana Ministry of Health

Publications and helpful links

General Publications

• Tapela NM, Peluso MJ, Kohler RE, Setlhako II, Botebele K, Gabegwe K, Nkele I, Narasimhamurthy M, Mmalane M, Grover S, Barak T, Shulman LN, Lockman S, Dryden-Peterson S. A Step Toward Timely Referral and Early Diagnosis of Cancer: Implementation and Impact on Knowledge of a Primary Care-Based Training Program in Botswana. Front Oncol. 2018 May 29;8:187. doi: 10.3389/fonc.2018.00187. eCollection 2018.

Study record dates

Study Major Dates

• Study Start (Actual): May 13, 2016
• Primary Completion (Actual): July 21, 2020
• Study Completion (Actual): July 21, 2020

Study Registration Dates

• First Submitted: April 22, 2016
• First Submitted That Met QC Criteria: April 25, 2016
• First Posted (Estimate): April 26, 2016

Study Record Updates

• Last Update Posted (Actual): July 23, 2020
• Last Update Submitted That Met QC Criteria: July 21, 2020
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Other Study ID Numbers: BHP078