Global Study of Perceptions of Patient Navigation for Older Adults With Cancer

Older adults with cancer have distinct and amplified needs compared with younger populations. Patient navigation enhances access to health care systems and services by mitigating barriers. However, evidence related to patient navigation specific to older adults with cancer is limited. The purpose of this study was to understand current patient navigation practices for older adults with cancer from the perspectives of those working in navigator roles around the world.

We used a convergent mixed-methods study design, with concurrent online survey and virtual focus groups/interviews. Participants were recruited by e-mail through national and international organizations. We used descriptive statistics to analyze survey data, while focus group and interview transcripts underwent thematic analysis. Quantitative and qualitative findings were integrated at the results stage.

Responses from 222 participants across 38 countries were analyzed, with a median participant age of 47.6 years. Findings showed the navigator role was implemented variably across contexts. Most of the participants reported addressing the domains of care and patient navigation (eg, care coordination and advocacy). The barriers and facilitators to patient navigation were similar in both survey open-text responses and focus groups (n = 22)/interviews (n = 8). Responses included feeling that (1) navigation was an anchor in complex systems, (2) navigation uniquely recognized and addressed older adults' needs, and (3) additional resources are required to strengthen navigation.

The patient navigator role is perceived differently across countries, dependent on available resources and access to formalized geriatric oncology services. The need to establish and implement structured guidelines for patient navigation at the organizational level is warranted to facilitate communication across health care teams and to provide necessary and timely support for older adults with cancer.