Objectives Inherent treatment complexities for patients with both cancer and multiple chronic conditions (MCC) make these patients likely candidates for shared care between primary care providers (PCPs) and oncologists. However, providers' views on the optimal model for care coordination between PCPs and oncologists in the context of both cancer and MCC are unclear. Thus, the purpose of this systematic review is to evaluate the perceptions of PCPs and oncologists regarding barriers and facilitators to care coordination during the care of patients with cancer and MCC, and their opinions on what is needed to improve current care coordination strategies. Methods We systematically searched PubMed, CINAHL and PsycINFO for articles pertaining to PCPs' and oncologists' perspectives, experiences and needs regarding care coordination during the cancer care continuum, in the context of patients with cancer and MCC. Key findings A total of 22 articles were retained. From qualitative synthesis, three themes emerged regarding PCPs' and oncologists' perceived barriers to cancer care coordination: (1) limited findings of physicians' experiences in MCC care; (2) lack of defined provider roles in cancer care; and (3) lack of comprehensive information sharing, efficient communication methods and clear shared-care plans during care for cancer patients with MCC.Conclusions Results provide insights into providers' needs for navigating the complexities of cancer care coordination. Future studies should consider further investigating the needs of patients and multiple provider types for optimizing care coordination throughout the cancer care continuum.Provider perspective on oncology care coordination Natalie S. Hohmann et al.
ObjectivesCoordination of medication prescribing is important in the care of patients with multiple chronic conditions (MCC) given the involvement of multiple providers and multiple medications used to manage MCC. The objective of this study was to identify physician and practice factors associated with physicians’ coordination of prescribing for complex patients with MCC.MethodsOur cross-sectional study used a 33-item anonymous, online survey to assess physicians’ coordination practices while prescribing for patients with MCC. We sampled primary care physicians (PCPs), psychiatrists, and oncologists across the United States. Coordination of medication prescribing was measured on a 7-point Likert-type scale. χ2, Fisher exact test, and binomial logistic regression, adjusted for factors and covariates, were used to determine differences in coordination of prescribing. Average marginal effects were calculated for factors.ResultsA total of 50 PCPs, 50 psychiatrists, and 50 oncologists participated. Most psychiatrists (56%) and oncologists (52%) reported frequently coordinating prescribing with other physicians, whereas less than half of the PCPs (42%) reported frequently coordinating prescribing. Female physicians were 25% points more likely to report coordinating prescribing than male physicians (P = 0.0186), and physicians not using electronic medical records were 30% points more likely to report coordinating prescribing than physicians using electronic medical records (P = 0.0230). Four additional factors were associated with lower likelihood of coordinating prescribing.ConclusionsPhysician and practice factors may influence differences in coordination of medication prescribing, despite physician specialty. These factors can provide a foundation for developing interventions to improve coordination of prescribing practices for MCC.
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