Cancer Survivorship Care Roles for Primary Care Physicians

Crabtree, Benjamin F.; Miller, William L.; Howard, Jenna; Rubinstein, Ellen B.; Tsui, Jennifer; Hudson, Shawna V.; O’Malley, Denalee; Ferrante, Joan M.; Stange, Kurt C.

doi:10.1370/afm.2498

Cited by 35 publications

(42 citation statements)

References 59 publications

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“…Such controversy is considered to reflect poor communication between oncologists and PCPs. Oncologists might be able to leave various tasks of cancer survivor care to PCPs under expert advice and close cooperation 22,23 . Indeed, the PCPs in the present study mentioned the need for certain important bits of information for the initiation of survivor care, as has also been reported in previous studies 14 …”

Section: Discussionsupporting

confidence: 76%

Primary care physicians' perceptions concerning engagement in cancer survivor care

Kimachi

Omae

Kamitani

et al. 2021

J of Gen and Family Med

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Background Given the growing diversity among cancer survivors and the fact that oncologists typically do not perform long‐term care, the expected role of primary care physicians (PCPs) in survivor care is expanding. However, communication and collaboration between oncologists and PCPs are lacking. Therefore, we assessed the perception of cancer survivor care among PCPs. Methods We sent a questionnaire to 767 Japanese Board–certified PCPs, regardless of facility type (clinics and hospitals), inquiring about PCPs' perceptions of their role in survivor care. Additionally, we included vignette‐based scenarios focused on colorectal and prostate cancer survivors to explore factors associated with their clinical decisions. Results We obtained 91 replies (response rate: 11.9%). A total of 75% of PCPs had encountered at least 1 cancer patient in actual practice. Even for patients actively receiving cancer treatment, >70% of PCPs reported that they were willing to engage in comprehensive survivor care, except for the administration of anticancer drugs. Further, 49% of PCPs considered that both PCPs and oncologists were suited to performing regular screening for cancer recurrence in high‐risk patients. Multivariable logistic regression analyses revealed that clinic PCPs were less inclined to conduct screening for recurrence than hospital PCPs in both colorectal (odds ratio, 3.85 [95% confidence interval 1.40–10.6]) and prostate (4.36 [95% confidence interval 1.51–12.6]) cancer scenarios. Conclusions Our findings suggest that Japanese PCPs are willing to engage in survivor care and encourage closer collaboration between oncologists and PCPs. However, oncologists might need to request cooperation, considering the facility type with which PCPs are affiliated.

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Section: Discussionsupporting

confidence: 76%

Primary care physicians' perceptions concerning engagement in cancer survivor care

Kimachi

Omae

Kamitani

et al. 2021

J of Gen and Family Med

View full text Add to dashboard Cite

show abstract

“…Such controversy is considered to re ect poor communication between oncologists and PCPs. However, oncologists might be able to leave various tasks of cancer survivor care to PCPs under expert advice and close cooperation [22,23]. Indeed, the PCPs in the present study mentioned the need for certain important bits of information for the initiation of survivor care, as has also been reported in previous studies [14].…”

Section: Discussionsupporting

confidence: 72%

Primary Care Physicians’ Perceptions Concerning Engagement in Cancer Survivor Care

Kimachi

Omae²,

Kamitani

et al. 2021

Preprint

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PurposeGiven the growing diversity among cancer survivors and the fact that oncologists typically do not perform long-term care, the expected role of primary care physicians (PCPs) in cancer survivor care is expanding. However, communication and collaboration between oncologists and PCPs is lacking. Therefore, we assessed the perception of cancer survivor care among PCPs.MethodsWe surveyed 767 Japanese Board-certified PCPs, regardless of facility type (clinics and hospitals), inquiring about PCPs’ perceptions of their role in survivor care. Additionally, we included vignette-based scenarios focused on colorectal and prostate cancer survivors to explore factors associated with their clinical decisions. Results We obtained 91 replies (response rate: 11.9%). A total of 75% of PCPs had encountered at least 1 cancer patient in actual practice. Even for patients actively receiving cancer treatment, >70% of PCPs reported that they were willing to engage in all aspects of survivor care, except for the administration of anticancer drugs. Further, 49% of PCPs considered that both PCPs and oncologists were suited to performing regular screening for cancer recurrence in high-risk patients. Multivariable logistic regression analyses revealed that clinic PCPs were less inclined to conduct screening for recurrence than hospital PCPs in both colorectal (odds ratio, 3.85 [95% confidence interval 1.40-10.6]) and prostate cancer (4.36 [95% confidence interval 1.51-12.6]) scenarios.ConclusionsOur findings suggest that Japanese PCPs are willing to engage in survivor care and encourage closer collaboration between oncologists and PCPs. However, oncologists might need to request cooperation, considering the facility type with which PCPs are affiliated.

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“…Patients seen at the PCCS clinic are survivors of any cancer type and referred from our cancer center, other specialists, or are self-referred. They are seen either as (1) a consultation to address survivorship needs, with longitudinal primary care provided by a separate primary care provider (PCP) or (2) for establishment of primary care. Visits address any of the following topics: cancer surveillance, cancer screening, treatment-related effects, health promotion, comorbidity management, and palliative care as appropriate.…”

Section: Setting and Participantsmentioning

confidence: 99%

“…While a growing number of survivorship clinics have been designed to better address the needs of the over 16.9 million cancer survivors in the USA, the optimal delivery of survivorship care, particularly within primary care, remains poorly understood. Multiple challenges of providing survivorship care in the primary care context have been identified, including primary care providers (PCPs) being unclear about their role and responsibility in cancer-related care provision, a lack of designating survivorship as a distinct area of care to be addressed, and limitations in health system and information infrastructure for survivorship care [ 2 , 3 ]. Evaluation of previously existing survivorship care models showed heterogeneity in models, with concerns around effective care coordination and adequate provider training [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Optimizing cancer survivorship in primary care: patient experiences from the Johns Hopkins Primary Care for Cancer Survivors clinic

et al. 2022

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Purpose The optimal delivery of survivorship care, particularly within primary care, remains poorly understood. We established the Johns Hopkins Primary Care for Cancer Survivors (PCCS) clinic in 2015 to address care challenges unique to cancer survivors. To better understand the care from the PCCS clinic, we interviewed patients about their perception of care delivery, survivorship care, and care coordination. Methods We conducted semi-structured interviews with adult survivors of any cancer type seen in the PCCS clinic. A priori and in vivo coding of verbatim transcripts was part of the thematic analysis. Results Seventeen cancer survivors were interviewed (ages 37–78). Themes that emerged were (1) optimal care and (2) the PCCS experience. Subthemes respectively included the ideal role of the primary care provider (1), telehealth/COVID-19 challenges and opportunities (1), patient-derived value from the PCCS clinic (2), and improving the PCCS model (2). Overall, PCCS patients expected and experienced high-quality, comprehensive primary care by providers with cancer survivorship expertise. Patients reported telehealth benefits and challenges for survivorship care during the COVID-19 pandemic. Conclusions PCCS patients perceived receiving high-quality primary care and valued being seen in a primary care–based survivorship clinic. The PCCS clinic can serve as a model of primary care–based cancer survivorship. Implications for Cancer Survivors Ideal primary care provider roles and care coordination are important factors for high-quality survivorship care and can be provided by a specialized cancer survivorship clinic in primary care. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-022-01166-3.

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Cancer Survivorship Care Roles for Primary Care Physicians

Cited by 35 publications

References 59 publications

Primary care physicians' perceptions concerning engagement in cancer survivor care

Primary care physicians' perceptions concerning engagement in cancer survivor care

Primary Care Physicians’ Perceptions Concerning Engagement in Cancer Survivor Care

Optimizing cancer survivorship in primary care: patient experiences from the Johns Hopkins Primary Care for Cancer Survivors clinic

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