Bridging Gaps in Survivorship Care in LMICs: A Multicenter Study on Healthcare Providers’ Perceptions of Late Effects in Pediatric Cancer in Thailand
Issued Date
2026-06-01
Resource Type
ISSN
15455009
eISSN
15455017
Scopus ID
2-s2.0-105036423523
Pubmed ID
41889292
Journal Title
Pediatric Blood and Cancer
Volume
73
Issue
6
Rights Holder(s)
SCOPUS
Bibliographic Citation
Pediatric Blood and Cancer Vol.73 No.6 (2026)
Suggested Citation
Amornsillaphachai P., Lertvivatpong N., Sirichotiwat K., Narindrarangkura P., Sinlapamongkolkul P., Pakakasama S., Isaranimitkul D., Techavichit P., Chingnawan S., Sripattanatadasakul P., Sathitsamitphong L., Winaichatsak A., Takpradit C., Sudnawa K.K., Suwannaying K., Monsereenusorn C. Bridging Gaps in Survivorship Care in LMICs: A Multicenter Study on Healthcare Providers’ Perceptions of Late Effects in Pediatric Cancer in Thailand. Pediatric Blood and Cancer Vol.73 No.6 (2026). doi:10.1002/1545-5017.70273 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116368
Title
Bridging Gaps in Survivorship Care in LMICs: A Multicenter Study on Healthcare Providers’ Perceptions of Late Effects in Pediatric Cancer in Thailand
Author's Affiliation
Siriraj Hospital
Faculty of Medicine, Chiang Mai University
Ramathibodi Hospital
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Chulalongkorn University
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Vajira Hospital
Maharaj Nakhon Ratchasima Hospital
Chonburi Regional Hospital
Ratchaburi Regional Hospital
Faculty of Medicine, Chiang Mai University
Ramathibodi Hospital
Faculty of Medicine, Khon Kaen University
Faculty of Medicine, Chulalongkorn University
Faculty of Medicine, Thammasat University
Phramongkutklao College of Medicine
Vajira Hospital
Maharaj Nakhon Ratchasima Hospital
Chonburi Regional Hospital
Ratchaburi Regional Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
Purpose: In low- and middle-income countries, including Thailand, pediatric cancer survivorship care is limited by resource constraints, lack of structured programs, and an overemphasis on recurrence surveillance. Understanding healthcare provider (HCP) perceptions is a key first step toward developing sustainable multidisciplinary survivorship guidelines. Methods: The Doctor Assessment in Late-Effects Treatment (DALET) survey was used to assess HCPs’ perceptions of late-effect care. The survey was distributed nationwide to physicians involved in childhood cancer care using a targeted dissemination strategy guided by local experts. Results: A total of 114 physicians from 37 centers participated, with only 3 centers (8.1%) having dedicated late-effect clinics. Most respondents (69.3%) reported prior training in late-effect care, and 81.6% provided post-treatment follow-up. Overall knowledge showed good alignment with the Children's Oncology Group Long-Term Follow-Up Guidelines (mean score, 71.7%), with prior training independently associated with higher alignment (p = 0.034). Confidence in managing physical late effects was significantly associated with physician expertise (p < 0.001), hospital type (p = 0.036), and prior training (p < 0.001), while access to consultation varied by expertise and hospital type. Main barriers to late-effect clinics were a lack of one-stop multidisciplinary services (80.7%) and time constraints (78.9%). Conclusions: Gaps in training and confidence persist across specialties and institutions, highlighting the need for national policies that strengthen education, capacity building, multidisciplinary collaboration, and standardized guidelines to ensure equitable late-effect care for pediatric cancer survivors in Thailand.