Adapting patients' oncological treatment through remote participation of general practitioners in multi-disciplinary consultation meetings: A feasibility study

Druel, Vladimir; Gimenez, Laëtitia; Tachousin, Paul; Boussier, Nathalie; Bauvin, Eric; Grosclaude, Pascale; Beyne‐Rauzy, Odile; Rougé‐Bugat, Marie‐Ève

doi:10.1080/13814788.2021.2003775

Cited by 3 publications

(6 citation statements)

References 29 publications

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“…[...] It would certainly be good for the patient if we both say the same thing, right?" [ GP 5,32] "And then it's also good to grab the phone and say [to the oncologist]: let's talk brie y and honestly. [...] This is sometimes also this challenging borderline area, so that we should relate to each other trustfully, that we both mean it well."…”

Section: Resultsmentioning

confidence: 99%

“…To improve interdisciplinary collaboration, studies implementing new strategies have shown some success: e.g. remote participation of GPs in multidisciplinary meetings at the cancer center or integrating GPs with speci c oncological skills in the center before the home return of patients [32,33]. Still, review of the literature shows that the direct oral communication during the active phase of cancer treatment should be further developed [34].…”

Section: Discussionmentioning

confidence: 99%

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Challenges of general practitioner-oncologist interaction in end-of-life communication: a qualitative study

Villalobos

Korezelidou

Unsöld

et al. 2023

Preprint

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Purpose: To explore general practitioners‘ (GP) perspectives on initiation and conduction of end-of-life (EOL) conversations in patients with metastatic lung cancer and how they perceive the interaction with the oncologists of a cancer center. Methods: Qualitative design with in-depth interviews with GPs that refer patients with metastatic lung cancer to a cancer center; thematic analysis following Braun and Clarke. Results: We identified three main themes: timing and conduction of EOL-conversations, factors influencing EOL-conversations, and modes of GP-oncologist interaction. All themes showed important challenges in regard to communication strategies or procedures within the cancer center and between general practitioners and oncologists. Aside from known challenges of EOL-communication, important problems arise from the difficulties in keeping pace with advances in oncology and the increasing prognostic uncertainty. Additionally, the lack of standardized communication in EOL-topics between GPs and oncologists is underlined. Options in the mode of interaction include written information and direct phone calls. Conclusions: Because of the growing complexity in modern oncology, strategies for improvement in EOL-communication and GP-oncologist interaction have to consider information and education about therapeutic advances and prognosis of patients. The written interaction in reports or digital platforms should include information about EOL-communication. As prognostic uncertainty may hinder the adequate provision and conduction of conversations, a trustful personal interaction through direct contact via phone calls between GPs and oncologists should be encouraged.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Challenges of general practitioner-oncologist interaction in end-of-life communication: a qualitative study

Villalobos

Korezelidou

Unsöld

et al. 2023

Preprint

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“…It's so complex, the third antibody or the third checkpoint-inhibitor for lung cancer, I don't know it." [ GP 10,33] Because of the knowledge gap it is di cult for GPs to determine the risk-bene t ratio or to estimate the end of a cancer treatment. The rapid changes in oncological treatment options may even lead to avoidance of talking about prognosis and EOL at all and the risk of supporting unrealistic expectations.…”

Section: ) Timing and Conduction Of Eol-conversationsmentioning

confidence: 99%

“…Normally I follow the hospital's recommendations." [GP 3,33] On the other hand, some situations seem problematic when opinions about treatment goals differ. Some GPs choose patient-empowerment as a strategy.…”

Section: "In Most Conversations I Leave It [The Prognosismentioning

confidence: 99%

Increasing challenges of general practitioner-oncologist interaction in end-of-life communication: a qualitative study

Villalobos

Korezelidou

Unsöld

et al. 2023

Preprint

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Background The timely initiation of end-of-life (EOL) conversations followed by advance care planning (ACP) is considerered best practice for patients with advanced cancer and therefore recommended in oncological guidelines. General practitioners (GPs) play a key role in the coordination of EOL-care and often claim that they have also the reponsibility to initiate the necessary conversations. Nonetheless, the content of these conversations are rarely a subject of communication between GPs and oncology specialists but crucial for timely integration of palliative care. The aim of this study is to explore the GPs‘ perspectives on initiation and conduction of EOL-conversations in patients with metastatic lung cancer and how they perceive the interaction with the oncologists of a cancer center. Methods Qualitative design with in-depth interviews with GPs that refer patients with metastatic lung cancer to a cancer center; thematic analysis following Braun and Clarke. Results We identified three main themes: timing and conduction of EOL-conversations, factors influencing EOL-conversations, and modes of GP-oncologist interaction. All themes showed important and increasing challenges in regard to communication strategies or procedures within the cancer center and between general practitioners and oncologists. Aside from the elucidated challenges of EOL-communication, new problems arise from the difficulties in keeping pace with advances in oncology and the increasing prognostic uncertainty. Additionally, the lack of standardized communication in EOL-topics between GPs and oncologists is underlined. Options in the mode of interaction include written information in reports or digital platforms and direct phone calls. Conclusions Because of the growing complexity in modern oncology, strategies for improvement in GP-oncologist interaction have to consider information about therapeutic advances and prognosis of patients. The increasing prognostic uncertainty hazards the adequate provision and conduction of EOL-conversations and thus, the timely integration of palliative care. As a consequence, a trustful personal interaction that includes direct contact via phone calls between GPs and oncologists should be encouraged.

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“…Implementation methods are diverse: standardized mailing, use of electronic support and relational exchanges between health professionals. The timing of information exchange between health professionals can also vary: during the initial oncology consultation, during the multidisciplinary consultation [12], during the announcement of the diagnosis of cancer [13], for shared decision-making of cancer treatment decisions [6], or at the time of discharge from hospital [14]. The quality of information transmission impacts the quality of care, the satisfaction of patients and GPs, and results in more frequent use of primary care, and a decrease in the number of hospitalizations due to adverse effects of anti-neoplastic treatments [15].…”

Section: Introductionmentioning

confidence: 99%

Experimental system of care coordination for the home return of patients with metastatic cancer: a survey of general practitioners

et al. 2022

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Background To promote improved coordination between general practice and hospital, the French clinical trial CREDO (“Concertation de REtour à DOmicile”) is testing an innovative experimental consultation for patients with metastatic cancer who are returning home. This consultation involves the patient, the patient’s referring GP (GPref) and a GP with specific skills in oncology (GPonc) in a specialized care center. The objective of our study is to explore the satisfaction of GPsref about this consultation, in the phase of interaction between GPonc and GPref. Methods This observational, cross-sectional, multicenter study explored the satisfaction of GPsref who had participated in this type of consultation, via a telephone survey. Results One Hundred GPsref responded to the questionnaire between April and September 2019 (overall response rate: 55%). 84.5% were satisfied with the consultation, and the majority were satisfied with its methods. Half of the GPsref learned new information during the consultation, three-quarters noted an impact on their practice, and 94.4% thought that this type of coordination between the GPref and the oncology specialist could improve general practice - hospital coordination. Conclusions For GPs, the CREDO consultation seems to be practical and effective in improving the coordination between general medicine and hospital. GPs would benefit from such coordination for all patients with cancer, several times during follow-up and at each occurrence of a medically significant event.

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Adapting patients' oncological treatment through remote participation of general practitioners in multi-disciplinary consultation meetings: A feasibility study

Cited by 3 publications

References 29 publications

Challenges of general practitioner-oncologist interaction in end-of-life communication: a qualitative study

Challenges of general practitioner-oncologist interaction in end-of-life communication: a qualitative study

Increasing challenges of general practitioner-oncologist interaction in end-of-life communication: a qualitative study

Experimental system of care coordination for the home return of patients with metastatic cancer: a survey of general practitioners

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