The role of the GP in follow-up cancer care: a systematic literature review

Meiklejohn, Judith; Mimery, Alexander; Martin, Jennifer; Bailie, Ross; Garvey, Gail; Walpole, Euan; Adams, Jon; Williamson, Daniel; Valery, Patricia C.

doi:10.1007/s11764-016-0545-4

Cited by 91 publications

(85 citation statements)

References 90 publications

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“…Of the participating clinicians, over 80% correctly identified PSA testing frequency as annually or more frequently following RP. These findings are in accordance with a recent systemic review, which suggested that a greater GP role in cancer care could improve the quality of patient care for cancer survivors 12, 19. Lewis et al 19 suggested that hospital follow-up might prompt unnecessary tests, raise anxiety, provide false reassurance, and delay the patient's return to full function.…”

Section: Discussionsupporting

confidence: 81%

“…In current practice, the PSA serum marker is a simple method of detecting disease recurrence after RP. International guidelines agree on the essential role of routine PSA testing in prostate cancer follow-up 8, 12. Typically, following prostatectomy, an undetectable PSA level of < 0.2 is expected, in keeping with total eradication of prostate tissue, and thus cure.…”

Section: Discussionmentioning

confidence: 99%

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Primary care follow-up of radical prostatectomy patients: A regional New Zealand experience

Yassaie

McLaughlin

Perera

et al. 2016

Prostate International

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BackgroundContemporary recommendations regarding the duration of follow-up after radical prostatectomy (RP) are highly heterogeneous. Protocol-based follow-up schemes have been implemented to facilitate the expeditious identification of patients with recurrence. The aim of this study is to assess the reliability and comfort of general practitioners (GPs) in follow-up of RP.MethodsFollowing institutional ethical approval, we performed a retrospective review in patients undergoing follow-up after RP between January 2004 and December 2010. Patient factors, disease variables, and follow-up prostate specific antigen (PSA) compliance was collected. “Noncompliant” follow-up care was defined as: patients that had not received a PSA for a 14 month period within 5 years of prostatectomy. Patient and disease-based risk factors for noncompliant follow-up were assessed. GPs were also surveyed in their follow-up practice of RP patients, to assess their familiarity in caring for these patients.ResultsIn total, 65 cases were identified that met the inclusion criteria. At 60 months of follow-up, 66% (43/65) of patients had a compliant follow-up regime. For patients with noncompliant follow-up at 60 months, median time of compliance did not differ significantly when assessing preoperative PSA, Gleason sum, extraprostatic extension, or surgical margin status. Of the GPs surveyed, 68% of GPs felt comfortable in follow-up of RP patients. Some 62% of GPs would expect the PSA to be < 0.1 and 25% of GPs would measure the PSA annually.ConclusionOur study identified that follow-up by GPs after RP is insufficient. Accordingly, there is a requirement for formal educational programs if primary care is to take a greater role in follow-up of these patients.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Primary care follow-up of radical prostatectomy patients: A regional New Zealand experience

Yassaie

McLaughlin

Perera

et al. 2016

Prostate International

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“…Key barriers to the provision of care include inadequate information from secondary care and a lack of knowledge around cancer side effects and follow-up requirements. 7 In recognition of the above, the Royal College of General Practitioners (RCGP) chose 'Consequences of Cancer' as one of its 2015-2016 'Spotlight' projects. Led by Macmillan Cancer Support, a leading UK cancer support charity, the project builds on work carried out by Macmillan and partners as part of the National Cancer Survivorship Initiative.…”

Section: Implications For Primary Carementioning

confidence: 99%

Managing the consequences of cancer in primary care

et al. 2016

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“…Delayed communication and inaccurate information transfer between healthcare professionals may have serious implications for continuity of care and patient safety. [8][9][10][11][12][13] High quality PHC is particularly important for groups who experience disproportionate barriers to access to care; such as ethnic minorities, 14 patients who live in rural 15 and more deprived areas 14,16 and indigenous populations. 7,8 In high-income countries with universal healthcare systems, there is increasing acceptance of the role of GP in cancer care.…”

Section: Introductionmentioning

confidence: 99%

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

Valery

Bernardes

Witt

et al. 2020

Internal Medicine Journal

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Background Cancer care involves many different healthcare providers. Delayed or inaccurate communication between specialists and general practitioners (GP) may negatively affect care. Aim To describe the pattern and variation of communication between primary healthcare (PHC) services and hospitals and specialists in relation to the patient's cancer care. Methods A retrospective audit of clinical records of Indigenous Australians diagnosed with cancer during 2010–2016 identified through 10 PHC services in Queensland is described. Poisson regression was used to model the dichotomous outcome availability of hospital discharge summary versus not. Results A total of 138 patient records was audited; 115 of those patients visited the PHC service for cancer‐related care after cancer diagnosis; 40.0% visited the service before a discharge summary was available, and 36.5% of the patients had no discharge summary in their medical notes. While most discharge summaries noted important information about the patient's cancer, 42.4% lacked details regarding the discharge medications regimen. Conclusions Deficits in communication and information transfer between specialists and GP may adversely affect patient care. Indigenous Australians are a relatively disadvantaged group that experience poor health outcomes and relatively poor access to care. The low proportion of discharge summaries noting discharge medication regimen is of concern among Indigenous Australians with cancer who have high comorbidity burden and low health literacy. Our findings provide an insight into some of the factors associated with quality of cancer care, and may provide guidance for focus areas for further research and improvement efforts.

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The role of the GP in follow-up cancer care: a systematic literature review

Abstract: Greater GP role in cancer care could improve the quality of patient care for cancer survivors. Better communication between the tertiary sector and GP across the cancer phases would enable clear delineation of roles.

Cited by 91 publications

References 90 publications

Primary care follow-up of radical prostatectomy patients: A regional New Zealand experience

Primary care follow-up of radical prostatectomy patients: A regional New Zealand experience

Managing the consequences of cancer in primary care

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

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