Colorectal cancer survivors' experiences and views of shared and telehealth models of survivorship care: A qualitative study

Abstract

ObjectivesThe number of colorectal cancer (CRC) survivors is increasing and current models of survivorship care are unsustainable. There is a drive to implement alternative models of care including shared care between general practitioners (GPs) and hospital‐based providers. The primary objective of this study was to explore perspectives on facilitators and barriers to shared care. The secondary objective was to explore experiences of telehealth‐delivered care.MethodQualitative data were collected via semi‐structured interviews with participants in the Shared Care for Colorectal Cancer Survivors (SCORE) randomised controlled trial. Interviews explored patient experiences of usual and shared survivorship care during the SCORE trial. In response to the COVID pandemic, participant experiences of telehealth appointments were also explored. Interviews were recorded and transcribed for thematic analysis.ResultsTwenty survivors of CRC were interviewed with an even number in the shared and usual care arms; 14 (70%) were male. Facilitators to shared care included: good relationships with GPs; convenience of GPs; good communication between providers; desire to reduce public health system pressures. Barriers included: poor communication between clinicians; inaccessibility of GPs; beliefs about GP capacity; and a preference for follow‐up care with the hospital after positive treatment experiences. Participants also commonly expressed a preference for telehealth‐based follow‐up when there was no need for a clinical examination.ConclusionsThis is one of few studies that have explored patient experiences with shared and telehealth‐based survivorship care. Findings can guide the implementation of these models, particularly around care coordination, communication, preparation, and personalised pathways of care.

Implementation science and psycho‐oncology: Advancing the translation of evidence into practice

“…4 Understanding the context-specific barriers is critical for the selection of strategies that may improve implementation success. 3 In this issue, three papers explore barriers and facilitators across the topics of self-management support programs, 5 colorectal cancer survivors' experiences of shared care and telehealth models 6 and implementation of a national guideline for palliative care. 7 Interestingly, while these studies have been conducted in different contexts-Ireland, Australia and Denmark-there are notable similarities across barriers.…”