Prioritising patient-centredness and service equity for long-term survivors of BMT: a qualitative study of healthcare professionals

Purpose: Survivors of blood and marrow transplant (BMT) for malignancies experience significant morbidity and mortality resulting from the long-term and late effects of transplant, necessitating life-long care. The purpose of this study was to explore the perceptions of specialist BMT advanced practice nurses (APNs), physicians, and primary care practitioners regarding the challenges of delivering long-term care for survivors of BMT. Methods: This descriptive qualitative study used semi-structured interviews with 13 purposefully selected healthcare professionals (HCPs) experienced in providing long-term care to survivors of BMT. Data were analysed using thematic analysis. Results: Two themes were identified: (1) prioritising patient-centred care and (2) equity and access to services. Prioritising patient-centred care included the sub-themes of (a) the burden of survivorship and complexity of long-term care, (b) education and preparation for long-term follow-up, and (c) adherence with long-term follow-up care. Equity and access included the four sub-themes of, (a) the tyranny of distance, (b) the price of survival, (c) primary care and the availability of GPs, and (d) access to appropriate long-term care. Conclusions: HCPs need to adopt patient-centred strategies to improve optimal care and equity for long-term BMT survivors. Practical approaches include providing comprehensive education and personalised care, performing routine needs assessments, implementing flexible models of care that integrate primary care such as shared care and telehealth. Using digital health platforms and advocating for reduced financial barriers can further address challenges in access and equity. These efforts have the potential to enhance long-term care delivery, improve outcomes, and ultimately enhance quality of life for BMT survivors.