A randomised controlled trial to improve the role of the general practitioner in cancer rehabilitation: effect on patients’ satisfaction with their general practitioners

Abstract

ObjectiveTo test whether a complex intervention facilitating early cancer rehabilitation by involvement of the general practitioner (GP) soon after diagnosis improves patients’ satisfaction with their GPs.DesignA cluster randomised controlled trial. All general practices in Denmark were randomised to an intervention or a control group before the start of the study. Patients included those with cancer who were subsequently allocated to either group based on the randomisation status of their GP.ParticipantsAdult patients with cancer treated for incident cancer at the public regional hospital (Vejle Hospital, Denmark) were included between May 2008 and February 2009. A total of 955 patients registered with 323 practices were included, of which 486 patients were allocated to the intervention group and 469 to the control group.InterventionThe intervention included a patient interview assessing the need for rehabilitation, improved information from the hospital to GPs including information on the patients’ current needs along with information about needs of patients with cancer in general. Further, GPs were encouraged to proactively contact the patients and facilitate the patients’ rehabilitation course.Outcome measures6 months after inclusion of the patient, patient satisfaction with their GP during the last 12 months in five different dimensions of GP care was assessed using the Danish version of the EuroPEP (European Patients Evaluate General Practice Care) questionnaire (DanPEP). 14 months after inclusion, patient satisfaction with the GP regarding the cancer course and GP's satisfaction with own contribution to the patients’ rehabilitation course were assessed using ad hoc questions specifically designed for this study.ResultsNo overall effect of the intervention was observed. Subgroup analysis of the patients with breast cancer showed statistically significant improvement of satisfaction with the GP in two of the five DanPEP dimensions.ConclusionsThis complex intervention aiming at improving GPs’ services in cancer rehabilitation had no impact on patient satisfaction.Trial registrationClinicalTrials.gov, registration ID number NCT01021371

French women's representations and experiences of the post‐treatment management of breast cancer and their perception of the general practitioner's role in follow‐up care: A qualitative study

“…Innovative, shared follow‐up schemes allow a two‐way exchange of information and create ties between GPs and specialist centres . These initiatives may foster greater patient trust; however, in a recent controlled trial of an attempt to increase the involvement of GPs in cancer rehabilitation, this aim was not achieved . Further studies must determine how GPs can be involved in the management of cancer treatment and post‐treatment care.…”

Interventions to improve care coordination between primary healthcare and oncology care providers: a systematic review

“…Five systematic reviews, 17–21 six RCTs 22–27 and 11 non-randomised studies 28–38 comprised the review. The six RCTs and 11 non-randomised studies were not already included in the five systematic reviews.…”

“…Six RCTs were included in the review, one each from Canada, 23 Australia, 24 the UK 25 and the USA, 26 and two from Denmark. 22 27 Studies were designed for all cancers, 22 haematological, breast, ovarian and colorectal cancers, 24 breast, colorectal and lung cancers, 25 26 breast cancer only 23 and colorectal cancer only. 27 Two RCTs examined interventions that targeted transition from diagnosis through to treatment, 26 27 one study targeted only treatment, 24 two studies targeted transition from treatment through to survivorship 22 25 and one study targeted survivorship specifically.…”

What role does the general practitioner in France play among cancer patients during the initial treatment phase with intravenous chemotherapy? A qualitative study

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“…Most studies of GPs are based on data gathered either from GPs themselves using qualitative research techniques [2][3][4] or from patients via quantitative techniques. [5][6][7][8][9] Six qualitative studies in which patients were interviewed, stressed the importance of GPs in the early follow-up phase, particularly for emotional support and medical management. [10][11][12][13][14][15] To a very significant extent, these issues are specific to the healthcare system in the country in which they occur.…”