Factors influencing the translation of shared cancer follow-up care into clinical practice: a systematic review

Abstract

BackgroundThe increasing incidence of cancer, coupled with improved survivorship, has increased demand for cancer follow-up care and the need to find alternative models of care. Shared cancer follow-up care in general practice is a safe option in terms of quality of life and cancer recurrence; however, there are barriers to translating this into practice. This review aimed to identify factors that influence the translation of shared cancer follow-up care into clinical practice.MethodsSystematic review. Seven electronic databases: MEDLINE, Science Citation Index, Academic Search Complete, CINAHL, APA Psychinfo, Health Source: Nursing/Academic Edition and Psychology and Behavioural Sciences Collection, were searched for published papers between January 1999 and December 2021. The narrative review included papers if they were available in full-text, English, peer-reviewed and focused on shared cancer follow-up care.ResultsThirty-eight papers were included in the final review. Five main themes emerged: (1) reciprocal clinical information sharing is needed between oncologists and general practitioners, and needs to be timely and relevant; (2) responsibility of care should be shared with the oncologist overseeing care; (3) general practitioners skills and knowledge to provide cancer follow-up care; (4) need for clinical management guidelines and rapid referral to support general practitioners to provide shared follow-up care and (5) continuity of care and satisfaction of care is vital for shared care.ConclusionThe acceptability of shared cancer follow-up care is increasing. Several barriers still exist to translating this into practice. Work is required to develop a shared-care model that can support general practitioners, while the oncologist can oversee the care and implement two-way communication between general and oncologists’ clinics. The move towards integrating electronic healthcare records and web-based platforms for information exchange provides a promise to the timely exchange of information.PROSPERO registration numberCRD42020191538.

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

“…Concerns about the sustainability of the current oncologist‐led model for cancer follow‐up care have led to the need to explore alternative models of care 27,28 . Despite studies showing acceptance for shared cancer follow‐up care, 35,36 barriers remain to implement the model into clinical practice 24,37,38 . A unique feature of the intervention evaluated in this study was the direct use of health technology to bridge the communication gap between GPs and ROs and specific protocols to support shared cancer follow‐up care.…”

Patterns of follow‐up care in adult blood cancer survivors—Prospective evaluation of health‐related outcomes, resource use, and quality of life

“…4 The most common combined model is the parallel type where follow-up care is provided by oncologists and other health care by general practitioners. 6,7 In the sequential model, often realized in pediatric oncology, cancer survivors are formally transferred from oncologists to primary care providers. 6,7 Another, more complex delivery type is the shared-care model where oncologists and general practitioners have complementary roles in follow-up care.…”

“…6,7 In the sequential model, often realized in pediatric oncology, cancer survivors are formally transferred from oncologists to primary care providers. 6,7 Another, more complex delivery type is the shared-care model where oncologists and general practitioners have complementary roles in follow-up care. [5][6][7] For blood cancer, the fourth most common cancer, 8,9 little is known about follow-up care.…”

“…4 There are different models of follow-up care delivery. [5][6][7] Follow-up can be provided by follow-up clinics, medical specialists, general practitioners, and specialized nurses, alone or in combination. 4 The most common combined model is the parallel type where follow-up care is provided by oncologists and other health care by general practitioners.…”

“…6,7 Another, more complex delivery type is the shared-care model where oncologists and general practitioners have complementary roles in follow-up care. [5][6][7] For blood cancer, the fourth most common cancer, 8,9 little is known about follow-up care. 10 Blood cancer differs from solid tumors by its disseminated nature, an unusually large number of subtypes, 11,12 and a leading role of drug-and cell-based therapies.…”