A Shared Cancer Follow-Up Model of Care Between General Practitioners and Radiation Oncologists for Patients With Breast, Prostate, and Colorectal Cancer: Protocol for a Mixed Methods Implementation Study

Sandell, Tiffany; Schütze, Heike; Miller, Andrew

doi:10.2196/21752

Cited by 6 publications

(3 citation statements)

References 36 publications

(38 reference statements)

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“…Furthermore, using these items within the system algorithm appeared to work well, and further work should validate their use in this context. Areas of improvement indicated by the feedback questionnaires included accessibility of general practitioner bloods, which illustrates further work is required to facilitate integration and communication of follow-up between primary and secondary care [ 44 ]. Furthermore, the high rate of completions that generated alerts to the clinicians (62.8%, see Additional file 10 for detail of symptom and non-symptom alerts), may suggest that refinement of the criteria is required to make this feasible for clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Electronic patient-reported monitoring of symptoms during follow-up of ovarian cancer patients: a feasibility study

et al. 2022

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Background Ovarian cancer patients require monitoring for relapse. Innovative follow-up methods are increasingly being explored. An electronic patient-reported outcome (ePRO) follow-up pathway was developed for women treated for ovarian cancer. This feasibility study explored patient acceptability and compliance. Methods A single-arm non-blinded prospective feasibility study was undertaken at two hospitals. Participants were women who had completed treatment for ovarian cancer whose clinician was happy for them to be monitored remotely. Automated 3-monthly reminders were sent to participants to complete an ePRO questionnaire and obtain blood tests. Participants were reviewed over the phone by their clinical nurse specialist instead of attending clinic-based follow-up. The primary outcome was compliance (expected ePRO completions/blood tests) across the 12-month study period. Secondary outcomes were recruitment, attrition, resource use, symptom severity/alerts and patient acceptability. Results Twenty-four women consented (50% consent rate), and 13 remained on study at 12 months. Seven women relapsed, 3 chose to withdraw, and 1 withdrew for other clinical reasons. ePRO compliance was high and consistent at 75-82%, although the two hospitals differed. Adherence to the clinical protocol was evident for blood tests and contacts with staff (fewer visits, more phonecalls compared to an earlier audit). End-of-study feedback indicated high patient satisfaction. Conclusions Remote ePRO follow-up for ovarian cancer is feasible and acceptable to patients who are able and willing to participate. However, the low recruitment rate (ineligible + declined) indicate it is not suitable/acceptable to all patients immediately post-treatment. Further large-scale research and implementation work is required, especially in a post-COVID era. Trial registration ClinicalTrials.gov ID: NCT02847715 (first registered 19/05/2016).

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Section: Discussionmentioning

confidence: 99%

Electronic patient-reported monitoring of symptoms during follow-up of ovarian cancer patients: a feasibility study

et al. 2022

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“…The study design was qualitative, with a critical realism lens. This intervention is part of a larger study described elsewhere 30 . The study was conducted at two hospital cancer centres, one regional, Illawarra Cancer Care Centre, and one rural, Shoalhaven Cancer Care Centre, in New South Wales, Australia.…”

Section: Methodsmentioning

confidence: 99%

Acceptability of a shared cancer follow‐up model of care between general practitioners and radiation oncologists: A qualitative evaluation

Sandell

Schütze

Miller

2023

Health Expectations

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IntroductionFacilitators to implement shared cancer follow‐up care into clinical practice include mechanisms to allow the oncologist to continue overseeing the care of their patient, two‐way information sharing and clear follow‐up protocols for general practitioners (GPs). This paper aimed to evaluate patients, GPs and radiation oncologists (ROs) acceptance of a shared care intervention.MethodsSemi‐structured interviews were conducted pre‐ and post intervention with patients that were 3 years post radiotherapy treatment for breast, colorectal or prostate cancer, their RO, and their GP. Inductive and deductive thematical analysis was employed.ResultsThirty‐two participants were interviewed (19 patients, 9 GPs, and 4 ROs). Pre intervention, there was support for GPs to play a greater role in cancer follow‐up care, however, patients were concerned about the GPs cancer‐specific skills. Patients, GPs and ROs were concerned about increasing the GPs workload. Post intervention, participants were satisfied that the GPs had specific skills and that the impact on GP workload was comparable to writing a referral. However, GPs expressed concern about remuneration. GPs and ROs felt the model provided patient choice and were suitable for low‐risk, stable patients around 2–3 years post treatment. Patients emphasised that they trusted their RO to advise them on the most appropriate follow‐up model suited to their individual situation. The overall acceptance of shared care depended on successful health technology to connect the GP and RO. There were no differences in patient acceptance between rural, regional, and cancer types. ROs presented differences in acceptance for the different cancer types, with breast cancer strongly supported.ConclusionPatients, GPs and ROs felt this shared cancer follow‐up model of care was acceptable, but only if the RO remained directly involved and the health technology worked. There is a need to review funding and advocate for health technology advances to support integration.Patient or Public ContributionPatients treated with curative radiotherapy for breast, colorectal and prostate cancer, their RO and their GPs were actively involved in this study by giving their consent to be interviewed.

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“…Ethics approval was received from the Joint University of Wollongong and the Illawarra Shoalhaven Local Health District Human Research Ethics Committee (2020/ETH00301). A detailed protocol is available [27]; the trial was registered with the Australian New Zealand Clinical Trials Registry on 20 October 2020, ACTRN12620001083987.…”

Section: Methodsmentioning

confidence: 99%

Concordance between General Practitioners and Radiation Oncologists for Cancer Follow-Up Care

Sandell

Miller

Schütze

2022

IJERPH

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(1) Background: Patients treated with radiotherapy require follow-up care to detect and treat acute and late side effects, and to monitor for recurrence. The increasing demand for follow-up care poses a challenge for specialists and general practitioners. There is a perception that general practitioners do not have the specialised knowledge of treatment side effects and how to manage these. Knowing the concordance between general practitioner and oncologist clinical assessments can improve confidence in healthcare professionals. This study aimed to measure the level of agreement between general practitioners and radiation oncologists using a standardised clinical assessment; (2) Methods: a cross-sectional clinical practice study; sample aim of 20 breast, prostate or colorectal patients, three years post-radiotherapy treatment; their general practitioner and radiation oncologist; (3) Results: There was acceptable percent agreement (>75%) and a moderate to almost perfect agreement (Fleiss kappa) for all variables between the 15 general practitioner-radiation oncologist dyads; (4) Conclusions: The general practitioner and radiation oncologist concordance of a clinical follow-up assessment for radiation oncology patients is an important finding. These results can reassure both general practitioners and oncologists that general practitioners can provide cancer follow-up care. However, further studies are warranted to confirm the findings and improve reassurance for health professionals.

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A Shared Cancer Follow-Up Model of Care Between General Practitioners and Radiation Oncologists for Patients With Breast, Prostate, and Colorectal Cancer: Protocol for a Mixed Methods Implementation Study

Cited by 6 publications

References 36 publications

Electronic patient-reported monitoring of symptoms during follow-up of ovarian cancer patients: a feasibility study

Electronic patient-reported monitoring of symptoms during follow-up of ovarian cancer patients: a feasibility study

Acceptability of a shared cancer follow‐up model of care between general practitioners and radiation oncologists: A qualitative evaluation

Concordance between General Practitioners and Radiation Oncologists for Cancer Follow-Up Care

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