A mixed‐methods examination of communication between oncologists and primary care providers among primary care physicians in underserved communities

Shen, Megan Johnson; Binz-Scharf, Maria Christina; D’Agostino, Thomas A.; Blakeney, Natasha; Weiss, Elisa S.; Michaels, Margo; Patel, Shilpa; McKee, M. Diane; Bylund, Carma L.

doi:10.1002/cncr.29131

Cited by 26 publications

(37 citation statements)

References 24 publications

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“…For example, establishing formalized, explicit policies around triaging high-risk patients for a timely colonoscopy and for chemotherapy infusions and communicating these to all members of the MTS can help in reducing diagnostic and treatment delays. 36,37 …”

Section: Understanding the Multi-team System Through The Casementioning

confidence: 99%

Achieving Coordinated Care for Patients With Complex Cases of Cancer: A Multiteam System Approach

Lee

Clark

Cox

et al. 2016

JOP

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Cancer patients with multiple chronic conditions pose a unique challenge to how primary care and specialty care teams provide well-coordinated, patient-centered care. Effectiveness of these care teams in providing optimal healthcare depends on the extent to which they coordinate their goals and knowledge as components of a multi-team system (MTS). This paper outlines challenges of care coordination in the context of an MTS, illustrated through the care experience of Mr. Fuentes, a patient in Dallas County’s integrated safety-net system, Parkland. As a continuing patient with chronic illnesses, Mr. Fuentes is managed through one of Parkland’s community-oriented primary care clinics. However, a cancer diagnosis triggered additional needs for augmented coordination between his different provider teams. Further research and practice should investigate the relationships of MTS coordination for shared care management, transfer to and from specialty care, treatment compliance, barriers to care, and health outcomes of chronic co-morbid conditions, as well as cancer control and surveillance.

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Section: Understanding the Multi-team System Through The Casementioning

confidence: 99%

Achieving Coordinated Care for Patients With Complex Cases of Cancer: A Multiteam System Approach

Lee

Clark

Cox

et al. 2016

JOP

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“…The results of the questions on post-referral communication have been published elsewhere. 47 For this study, we developed two scale variables about cancer clinical trials. The first measured the physician’s attitudes and beliefs about trials by asking their level of agreement on a 5-point scale (1 Strongly Agree to 5 Strongly Disagree ) for six statements about clinical trials (as shown in Table 1).…”

Section: Methodsmentioning

confidence: 99%

Primary care physicians’ attitudes and beliefs about cancer clinical trials

et al. 2017

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Background/Aims Cancer clinical trials give patients access to state-of-the art treatments and facilitate the translation of findings into mainstream clinical care. However, patients from racial and ethnic minority groups remain underrepresented in clinical trials. Primary care physicians are a trusted source of information for patients, yet their role in decision-making about cancer treatment and referrals to trial participation has received little attention. The aim of this study was to determine physicians’ knowledge, attitudes, and beliefs about cancer clinical trials, their experience with trials, and their interest in appropriate training about trials. Methods 613 physicians in the New York City area primarily serving patients from ethnic and racial minority groups were invited via email to participate in a 20-minute online survey. Physicians were asked about their patient population, trial knowledge and attitudes, interest in training, and personal demographics. Using calculated scale variables, we used descriptive statistical analyses to better understand physicians’ knowledge, attitudes, and beliefs about trials. Results 127 physicians completed the survey. Overall, they had low knowledge about and little experience with trials. However, they generally had positive attitudes toward trials, with 41.4% indicating a strong interest in learning more about their role in trials, and 35.7% indicating that they might be interested. Results suggest that Black and Latino physicians and those with more positive attitudes and beliefs were more likely to be interested in future training opportunities. Conclusions Primary care physicians may be an important group to target in trying to improve cancer clinical trial participation among minority patients. Future work should explore methods of educational intervention for such interested providers.

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“…This has been shown to be the case across different health care systems, such as in the US (Gandhi et al, 2000;Shen et al, 2015), Australia (Jefford et al, 2008;Lizama et al, 2015) and UK (Farquhar et al, 2005). This has been shown to be the case across different health care systems, such as in the US (Gandhi et al, 2000;Shen et al, 2015), Australia (Jefford et al, 2008;Lizama et al, 2015) and UK (Farquhar et al, 2005).…”

Section: Introductionmentioning

confidence: 91%

Physician cooperation in outpatient cancer care. An amplified secondary analysis of qualitative interview data

et al. 2017

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The importance of outpatient cancer care services is increasing due to the growing number of patients having or having had cancer. However, little is known about cooperation among physicians in outpatient settings. To understand what inter- and multidisciplinary care means in community settings, we conducted an amplified secondary analysis that combined qualitative interview data with 42 general practitioners (GPs), 21 oncologists and 21 urologists that mainly worked in medical practices in Germany. We compared their perspectives on cooperation relationships in cancer care. Our results indicate that all participants regarded cooperation as a prerequisite for good cancer care. Oncologists and urologists mainly reported cooperating for tumour-specific treatment tasks, while GPs' reasoning for cooperation was more patient-centred. While oncologists and urologists reported experiencing reciprocal communication with other physicians, GPs had to gather the information they needed. GPs seldom reported engaging in formal cooperation structures, while for specialists, participation in formal spaces of cooperation, such as tumour boards, facilitated a more frequent and informal discussion of patients, for instance on the phone. Further research should focus on ways to foster GPs' integration in cancer care and evaluate if this can be reached by incorporating GPs in formal cooperation structures such as tumour boards.

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A mixed‐methods examination of communication between oncologists and primary care providers among primary care physicians in underserved communities

Cited by 26 publications

References 24 publications

Achieving Coordinated Care for Patients With Complex Cases of Cancer: A Multiteam System Approach

Achieving Coordinated Care for Patients With Complex Cases of Cancer: A Multiteam System Approach

Primary care physicians’ attitudes and beliefs about cancer clinical trials

Physician cooperation in outpatient cancer care. An amplified secondary analysis of qualitative interview data

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