Impact of shared care program in follow‐up of childhood cancer survivors: An intervention study

Abstract

In this shared care program, survivors overcame distrust in their GP's knowledge and entered the FU program after their GPs had been involved in patient-centered education. Personalized and incentive-based guidance was very useful in helping survivors to adhere to FU. Support of a dedicated long-term FU team was very useful. A nationwide organization, consideration of special needs in subgroups of survivors and sustained funding are needed to adjust the program in the very long term.

The Role of Primary Care Physicians in Childhood Cancer Survivorship Care: Multiperspective Interviews

“…Increased PCP involvement may also reduce delayed visits among survivors "saving" health concerns for their annual or sometimes bi‐annual clinic visit at the hospital, which can lead to poorer prognoses for otherwise preventable or easily treatable conditions. Encouraging PCP involvement by the oncologist or tertiary hospital multidisciplinary team may improve survivors’ confidence and reduce potential anxiety induced by transition to adult (often primary) care, when many survivors become disengaged from any follow‐up . Disengagement results in missed opportunities to monitor for, and possibly prevent, treatment‐related complications.…”

“…A significant minority of PCPs are unwilling to accept exclusive responsibility for cancer survivors, either adult or children . Rather, PCPs prefer a shared care follow‐up model, which evidence suggests helps survivors overcome distrust in providers . Further clarification of primary and tertiary providers’ responsibilities is needed, and may improve the confidence of all parties and the quality of care delivered by reducing overlap or missed opportunities for surveillance .…”

Multidisciplinary Late Effects Clinics for Childhood Cancer Survivors in Germany - a Two-Center Study

“…Several models of care for LTFU of these patients have been proposed including shared care LTFU programs as a collaboration between general practitioners (GPs) and cancer centers, GP-led models as well as clinic-based models of LTFU by a multidisciplinary team [6,[17][18][19]. Patients' satisfaction with LTFU was mostly dependent on coordination and communication between the involved specialists as well as their expertise concerning late effects and LTFU [18,20].…”

Intervention‐focused research for childhood cancer survivors: “It takes a village…”

“…begins, in small part, to address this concern by incorporating the primary care general practitioners (GPs) into both their study and clinical intervention teams. 1 Past work in survivorship care research has described a clear message from primary care providers in the United States and Canada regarding the provision of LTFU care for CCS. In a random sample of 2,000 surveyed U.S. internists, 1,110 responding participants reported involvement in the care of CCS but many would prefer to follow these patients in collaboration with a cancer center.…”

“…In this issue of Pediatric Blood & Cancer , the work of Ducassou et al. begins, in small part, to address this concern by incorporating the primary care general practitioners (GPs) into both their study and clinical intervention teams . Their model of care appears to be developed with clear and sound rationale and delivers comprehensive LTFU care while bringing survivorship teams together with GPs.…”