Primary Care Providers' Needs and Preferences for Information about Colorectal Cancer Survivorship Care

the Memorial Sloan-Kettering Cancer Center
The Journal of the American Board of Family Medicine (Impact Factor: 1.98). 09/2012; 25(5):635-51. DOI: 10.3122/jabfm.2012.05.120083
Source: PubMed


The Institute of Medicine (IOM) proposed that cancer survivors and their primary care providers (PCPs) should receive survivorship care plans to inform ongoing care. We aimed to determine PCPs' preferences for the content of survivorship care plans for colorectal cancer (CRC) survivors.
PCPs in 3 practice-based research networks completed a survey regarding 45 topics of CRC information based on the IOM's survivorship care plan framework.
One hundred fifty-six PCPs completed the survey. For 35 topics (78%), at least half of respondents felt the topic was very important. Most PCPs reported receiving too little information about problems with chemotherapy (68%) or radiation (60%) and whether the oncologist intended to monitor for other cancers (71%). PCPs widely agreed that they do not have enough information about increased risk of second CRCs, other cancers, and other diseases (78%); long-term effects of chemotherapy (73%) and radiation (67%); and genetic counseling (83%).
PCPs endorse the IOM's survivorship care plan framework as relevant and often report needing more information. Survivorship care plans may provide important information to PCPs by communicating patients' cancer histories and making recommendations regarding which aspects of care should be provided by the oncologist or the PCP.

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    • "In studies describing PCP perceptions of survivorship care, it was noted that PCPs report a general discomfort when caring for cancer survivors and felt SCP that included a concise diagnosis and treatment summary, guidelines, and recommendations for survivorship care, treatment complications, and patient-specific recommendations for managing late effects would be of benefit (Salz et al., 2012a). Oncologists also reported that they would be uncomfortable providing survivorship care and that SCP would be helpful (Forsythe et al., 2012; Klabunde et al., 2013). "

    Full-text · Article · Feb 2015
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    ABSTRACT: This seventh annual practice-based research theme issue of the Journal of the American Board of Family Medicine highlights primary care research conducted in practice-based research networks (PBRNs). The issue includes discussion of (1) theoretical and methodological research, (2) health care research (studies addressing primary care processes), (3) clinical research (studies addressing the impact of primary care on patients), and (4) health systems research (studies of health system issues impacting primary care including the quality improvement process). We had a noticeable increase in submissions from PBRN collaborations, that is, studies that involved multiple networks. As PBRNs cooperate to recruit larger and more diverse patient samples, greater generalizability and applicability of findings lead to improved primary care processes.
    No preview · Article · Sep 2012 · The Journal of the American Board of Family Medicine
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    ABSTRACT: Purpose of study Knowledge about information sharing among primary care clinicians, oncologists, and their cancer patients is critical given its importance in facilitating the delivery of quality care to the increasing number of cancer survivors. The purpose of our study was to provide a better understanding of the nature of interactions among primary care clinicians, patients, and oncologists throughout the cancer care continuum to better understand the transition to survivorship. Method Twenty-one qualitative in-depth interviews were conducted with 11 primary care physicians and 10 nurse practitioners. Themes were identified using content analysis. Results The following themes emerged from the data including: (1) a visit is worth a thousand written reports—primary care clinicians described the importance of patient visits during cancer treatment; (2) community vs. cancer center oncologists—primary care clinicians described differences in information sharing with community oncologists as compared with those in academic centers; (3) correcting for information deficits—primary care clinicians, unable to obtain regular progress reports directly from oncologists, developed indirect strategies to obtain information; (4) the deficiencies in post-treatment follow-up care plans; and (5) the panacea of electronic medical records and survivor care plans. Conclusions The themes that emerged from this work describe in detail the absence of systematic information sharing among primary care clinicians, patients, and oncologists that is needed to support quality survivorship care in the primary care setting. The descriptions by primary care clinicians contribute to a deeper understanding of the daily challenges that both interfere and/or support primary care clinicians in their care of survivors of cancer. Implications for cancer survivors Managing the complex care of cancer survivors often requires the expertise of a number of skilled providers. Information sharing among these individuals is one of the most fundamental aspects of ensuring effective transitions in care. Our results indicate that systematic information sharing among providers caring for cancer survivors is lacking. Identifying strategies to enhance information sharing among and between providers is essential to facilitating the delivery of high-quality survivor care.
    No preview · Article · Nov 2012 · Journal of Cancer Survivorship
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