Expanding Myeloma Training and Care in Western Kenya Through the ECHO Model: The Pilot Phase.

Autor:	Oduor MA; AMPATH Oncology Institute, Eldoret, Kenya., Lotodo TC; Moi University School of Medicine, Eldoret, Kenya., Severance T; University of Missouri, School of Medicine, Columbia, MO., Jepngetich Melly B; Moi Teaching and Referral Hospital, Eldoret, Kenya., Omondi A; AMPATH Oncology Institute, Eldoret, Kenya., Ndenga I; AMPATH Oncology Institute, Eldoret, Kenya., Namaemba DF; AMPATH Oncology Institute, Eldoret, Kenya., Oyollo Y; AMPATH Oncology Institute, Eldoret, Kenya., Manyega KM; Kenyatta University Teaching, Referral and Research Hospital, Nairobi, Kenya., Morgan J; Indiana University School of Medicine, Indianapolis, IN., Oguda J; Indiana University Global Health, Indianapolis, IN., Loehrer P; Indiana University School of Medicine, Indianapolis, IN., Vik T; Indiana University School of Medicine, Indianapolis, IN.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2024 Apr; Vol. 10, pp. e2300416.
DOI:	10.1200/GO.23.00416
Abstrakt:	Purpose: Multiple myeloma (MM) in rural western Kenya is characterized by under and late diagnosis with poor long-term outcomes. Inadequate skilled rural health care teams are partly to blame. The Extension for Community Healthcare Outcomes (ECHO) model attempts to bridge this skills gap by linking rural primary/secondary health care teams (spokes) to myeloma experts in a tertiary care center (hub) in a longitudinal training program. Methods: A hub team comprising myeloma experts and administrators from Moi Teaching and Referral Hospital/Academic Model Providing Access to Healthcare was assembled and spoke sites were recruited from rural health care facilities across western Kenya. A curriculum was developed by incorporating input from spokes on their perceived skills gaps in myeloma. Participants joined sessions remotely through virtual meeting technology. ECHO sessions consisted of a spoke-led case presentation with guided discussion followed by an expert-led lecture. An end-of-program survey was used to evaluate participant satisfaction, knowledge, and practice patterns. Results: A total of eight sessions were conducted between April and November 2021 with a median of 40 attendees per session drawn from diverse health care disciplines. Twenty-four spoke sites were identified from 15 counties across western Kenya. The majority of attendees reported satisfaction with the ECHO program (25 of 29) and improvement in their myeloma knowledge (24 of 29). There were 74 new myeloma diagnoses made at the hub site in 2021, representing a 35% increase from the previous 3-year average despite the COVID-19 pandemic that suppressed health care access globally. Recommendations: The pilot ECHO model was successfully implemented in myeloma training for rural-based health care teams. Key attributes included collaborative curriculum development, interactive case-based bidirectional learning, and multidisciplinary engagement.
Databáze:	MEDLINE
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