Correspondence between primary and secondary care about patients with cancer: A qualitative mixed-methods analysis

Abstract

Cancer care is complex and involves many different healthcare providers, especially during diagnosis and initial treatment, and it has been reported that both general practitioners and oncology specialists experience difficulties with interdisciplinary communication. The aim of this qualitative study was to explore information sharing between primary and secondary care for patients with lung, breast or colorectal cancer. A qualitative content analysis of 50 medical files (419 documents) was performed, which identified 70 correspondence-related items. Six main topics were identified in most referral letters from primary to secondary care, but it was particularly notable that highly relevant information regarding the past medical history was often mixed with less relevant information. To lesser extents, the same held true for the medication list and presenting history. In the letters from specialists, nine topics were identified in most letters. Although information about actual treatment was always present, only limited detail, if any, was given about the intent of the treatment (curative or palliative) or the treatment alternatives. Interviews with nine healthcare providers confirmed these issues. These findings indicate that neither the initial referral nor the specialist correspondence is tailored to the needs of the recipient.

Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

“…Compared to a previous study which recruited 248 indigenous cancer patients from hospitals in Queensland, 49 18,19,49 the higher proportion of medical charts at PHC services with missing cancer stage is of concern and it may be attributed to poor communication between hospitals and PHC services. [53][54][55] In a qualitative content analysis of the letters from specialists to GP from 50 patients with lung, breast or colorectal cancer in the Netherlands, while information about cancer treatment was always present, only limited detail was noted about the intent of the treatment (curative vs palliative), treatment alternatives, or about how the patient had reacted to the information received. In other disease groups, both the quality and the availability of HDS in the PHC setting varied.…”

“…Comparable data about the quality of HDS in cancer population, and data on tracking HDS from the hospital to the PHC setting, are scarce. 55 A Canadian study reported substantial communication challenges between health professionals involved in cancer care (e.g. In a review of 55 studies, including mixed disease populations and countries, HDS often lacked important information (e.g.…”

“…[53][54][55] In a qualitative content analysis of the letters from specialists to GP from 50 patients with lung, breast or colorectal cancer in the Netherlands, while information about cancer treatment was always present, only limited detail was noted about the intent of the treatment (curative vs palliative), treatment alternatives, or about how the patient had reacted to the information received. 55 A Canadian study reported substantial communication challenges between health professionals involved in cancer care (e.g. delays in medical transcription, difficulties accessing patient information, lack of rapport between GP and cancer specialists.…”

Breast cancer specialists' perspective on their role in their patients' return to work: A qualitative study

“…The present findings also point to a lack of communication between BC specialists and other professionals, such as GP, OP and social workers, regarding BC survivors' RTW. This is doubtless multifactorial, involving a lack of time on all sides and insufficient training, habits, and value attached to multidisciplinary teamwork beyond cancer treatment (47). While the communication among healthcare professionals for cancer survivor follow-up, as well as the role of communication between occupational health, employers and colleagues to managing RTW has been identified as key in the cancer survivor in the literature (28,37,48,49), the communication between BC specialists and other professionals regarding RTW has not received much attention.…”

Maak van je verwijsbrief geen troebele SOEP

“…Wij brachten daarom in kaart welke informatie in Nederland wordt uitgewisseld tussen huisartsen en medisch specialisten over patiënten met borst-, long-en darmkanker vanaf verwijzing tot aan het eind van de initiële behandelfase. 7 Hiervoor analyseerden we in een kwalitatief onderzoek 419 documenten uit 50 patiëntendossiers uit drie verschillende ziekenhuizen in Noord-Nederland. Daarnaast interviewden we vier huisartsen, vier medisch specialisten en een verpleegkundig specialist over onderlinge communicatie.…”