2983 - A Cross-Sectional Survey of Global Patient Education Methods for Radiation Therapy in Low- and Middle-Income Countries
Presenter(s)
R. K. Patel1,2, E. C. Dee3, A. T. Price4, E. Kruse5, M. Caicedo-Martinez6, C. Kueny7, G. G. Vega8, P. Zimmerman2, L. M. Katz9, D. W. Golden10, P. Mohindra1, and B. Li5,11; 1Department of Radiation Oncology, University Hospitals Cleveland Medical Center/ Seidman Cancer Center, Cleveland, OH, 2Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, 3Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, 4Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, 5Rayos Contra Cancer, Seattle, WA, 6Centro Javeriano de Oncología, Bogotá, Colombia, 7Missouri University Science & Technology, Rolla, MO, 8Radiotherapy Department, Instituto Nacional de Pediatria, Mexico City, Mexico, 9Department of Radiation Oncology, Columbia University Medical Center, New York, NY, 10Department of Radiation Oncology, RUSH University Medical Center, Chicago, IL, 11Department of Radiation Oncology, Fred Hutch Cancer Center, University of Washington, Seattle, WA
Purpose/Objective(s):
Effective patient education (PE) about radiation therapy (RT) is essential yet understudied in low- and middle-income countries (LMICs). We evaluated PE practices and regional differences amongst RT professionals in LMICs, focusing on timing, resources, content and impact.Materials/Methods:
An international cross-sectional survey of RT professionals from LMICs (World Bank) was distributed evenly across Latin America (LATAM), Eastern Europe (EE), Africa, Middle East (ME) and Asia via email/texting groups (n=2143, 9/2024–1/2025). A 26-item English/Spanish survey covered roles, individual and institutional practices for PE. This included PE on rationale, logistics, and side effects for RT, methods for PE (verbal, brochures, videos, etc.), PE timing, and Likert scale (1-5) ratings of perceived patient understanding. Descriptive, thematic and statistical analyses evaluated regional differences using Fisher/Chi-squared tests, pairwise comparisons, and multivariate analyses.Results:
398 responses (19%) included physicians (35%), radiation therapists (32%), physicists (18%), nurses (6%), advanced practitioners (5%) and dosimetrists (4%), representing LATAM (45%), Africa (17%), Asia (14%), ME (12%), and EE (12%). Majority of RT professionals spent =20 minutes per patient on PE (65%), and 38% spent =10 min. Verbal-only PE was used most in Africa (62%), Asia (41%) and LATAM (36%). Respondents considered verbal (37%) and audiovisual (36%) PE methods as most effective, due to ease in understanding, reinforcement/retention, and health literacy/language needs. Patients most frequently asked about side effects (41%), logistics (19%), and RT safety (11%) across regions (p<0.01). PE delivery varied by content, with rationale most discussed during consultation (40%), logistics explained during CT simulation (79%), acute side effects addressed during on-treatment visits (48%), long-term side effects lacking a common time point (32% reporting no discussion at all). Overall, respondents rated perceived patient understanding 2.9/5 for rationale, 2.9/5 for logistics, 3.2/5 for acute side effects, and 3.1/5 for long-term side effects. Limited educational understanding (score 1-2) was reported in Africa (47%), ME (42%) LATAM (42%), Asia (32%), and EE (27%) across all domains. Subgroup analysis by region and by role show statistically significant differences (p<0.05) across time spent on PE, PE methods and sources, time point of PE delivery, and patients’ concerns and perceived understanding.Conclusion:
Across LMICs and professional roles, limited time for PE and verbal-only education are common. Additionally, significant differences exist among type, timing, and perceived impact of PE provided among regions, with limited use of PE materials. Opportunities exist to bridge the PE gap with context- and region-specific interventions.