Effectiveness of the One-Window Services Model (OWSM) in Enhancing Cancer Patients' Competence in Accessing and Using Immunotherapies: A Quasi-Experimental Study in Pakistan

Abstract

Background: The global burden of cancer is rising, particularly in Asia, with significant challenges in accessing treatments such as surgery, radiotherapy, chemotherapy, and immunotherapy in low- and middle-income countries. In Pakistan, the One Window Services Model (OWSM) aims to streamline access to public services, including healthcare. This study evaluated the impact of OWSM on cancer patients' competence in accessing and utilizing immunotherapies.

Methodology: A quasi-experimental study was conducted in two university hospitals in Pakistan from January 26 to April 26, 2023. A total of 152 cancer patients, equally divided into intervention (n=76) and comparison (n=76) groups, participated. Patients were aged 18 or older and eligible for immunotherapies, excluding those with a history of drug reactions or stage 4 cancer. Data were collected using a questionnaire based on Andersen's model, assessing demographics, social structure, health beliefs, enabling factors, and competence in accessing immunotherapies. The intervention group received educational sessions over three months, while the comparison group received standard care. Statistical analyses, including Chi-square and Fisher’s exact tests, were conducted using SPSS version 26.

Results: Baseline assessments showed no significant differences between groups (P>0.05). Post-intervention, the intervention group demonstrated substantial improvements in "Knowledge of the import process," "Ability to fill and submit forms," and the "Competence index," with increases from 6.6% to 97.4% (P<0.0001). Immunotherapy usage rose to 96.1% in the intervention group compared to 2.6% in the comparison group (P<0.0001). Patient satisfaction in the intervention group was 90.8%.

Conclusion: The OWSM significantly enhanced cancer patients' competence in accessing and using immunotherapies, with high levels of patient satisfaction. The model holds promise for improving healthcare delivery in other areas, meriting further investigation into its broader and long-term impacts.