Capacity to Treat Retinoblastoma in the Philippines
Sandra Joan Worak-Tan MD1 , Ma. Theresa B. Sampang MD1 , Maria Victoria A. Rondaris MD2
1Department of Health Eye Center, East Avenue Medical Center, Quezon City
2University of Santo Tomas Hospital, Manila
Correspondence: Sandra Joan Worak-Tan MD1
Clinic Address: Department of Health Eye Center, East Avenue Medical Center, East Avenue, Quezon City Email Address: Sandee.worak@gmail.com
Clinic Phone Number: +639190043979
Disclosure: All authors report no financial disclosures or conflict of interest.
ABSTRACT
Objective: This study determined the capacity to treat retinoblastoma (RB) in the Philippines.
Method: This was a cross-sectional study which included all Department of Health (DOH) hospitals and all government and private tertiary hospitals in the Philippines. An online modified questionnaire taken from the St. Jude Children’s Research Hospital study on RB assessment was emailed to 143 hospitals in all 17 regions. Primary outcome measures were human resources capacity, treatment capacity and education and network capacity. Availability, frequency and confidence of use were assessed for treatment capacity. An asset-based tier classification of hospitals was created based on the human resources capacity and treatment capacity.
Results: This assessment survey had a 49% response rate. There were 3 regions that had zero correspondence. A general ophthalmologist, a subspecialized ophthalmologist, and a general pathologist were the most available physicians in the management of RB. Almost all respondents had the necessary diagnostic technology in their hospitals, but frequency and confidence of use were low. A quarter of the respondents (23%) used a standardized treatment protocol, while only 26% had established a referral network in their area. Tier classification was able to differentiate capacities for particular resources only. Only 23% of the participating hospitals have the capacity to treat RB through its trained human resources, available diagnostic and treatment technology, and education and network programs. Distribution of hospitals identified as tier I, II and III were 18%, 8%, and 41%, respectively.
Conclusion: Capacity to treat RB in the Philippines is evident only in a few hospitals, majority of which are located in the National Capital Region. However, tier 3 hospitals were identified in 10 other regions, making accessibility to RB care possible to patients in the provinces. Although human resource and technology are made available, utilization of these resources is low in many hospitals for the management of RB. Clinical practice guidelines for RB is still lacking. Connecting the different tiers in each region as a form of referral network can improve capacity and management of RB.
Keywords: retinoblastoma, treatment, capacity, survey, assessment