Family Physician Involvement in Cancer Care Follow-up: The Experience of a Cohort of Patients With Lung Cancer

Abstract

PURPOSE There has been little research describing the involvement of family physicians in the follow-up of patients with cancer, especially during the primary treatment phase. We undertook a prospective longitudinal study of patients with lung cancer to assess their family physician's involvement in their follow-up at the different phases of cancer. METHODSIn 5 hospitals in the province of Quebec, Canada, patients with a recent diagnosis of lung cancer were surveyed every 3 to 6 months, whether they had metastasis or not, for a maximum of 18 months, to assess aspects of their family physician's involvement in cancer care. RESULTSOf the 395 participating patients, 92% had a regular family physician but only 60% had been referred to a specialist by him/her or a colleague for the diagnosis of their lung cancer. A majority of patients identifi ed the oncology team or oncologists as mainly responsible for their cancer care throughout their cancer journey, except at the advanced phase, where a majority attributed this role to their family physician. At baseline, only 16% of patients perceived a shared care pattern between their family physician and oncologists, but this proportion increased with cancer progression. Most patients would have liked their family physician to be more involved in all aspects of cancer care.CONCLUSIONS Although patients perceive that the oncology team is the main party responsible for the follow-up of their lung cancer, they also wish their family physicians to be involved. Better communication and collaboration between family physicians and the oncology team are needed to facilitate shared care in cancer follow-up.

The Family Physician's Perceived Role in Preventing and Guiding Hospital Admissions at the End of Life: A Focus Group Study

“…2,7 It could be suggested, therefore, that adopting a system by which the usual family physician refers patients for most specialized services would be a good starting point to reduce the number of end-of-life hospital admissions. Family physicians would be included earlier in the end-of-life trajectory, thereby improving their role as care planners and their ability to provide continuity of care, 42 as well as further strengthen their position as end-of-life care providers.…”

Barriers to Breast and Colorectal Cancer Survivorship Care: Perceptions of Primary Care Physicians and Medical Oncologists in the United States

“…13 Patients may be satisfied with their care even if they perceive much greater participation by their PCP than the modest participation that may actually occur. 14 Receipt of general noncancer preventive care is one benefit of concurrent follow-up by both MOs and PCPs compared with patients followed by oncologists alone. 15 Other commonly cited noncancer-specific barriers to care, such as patient noncompliance, insurance restrictions impeding receipt of appropriate care, and language barriers, may also adversely affect patient receipt of appropriate survivorship care.…”

Adult Cancer Survivors Discuss Follow-up in Primary Care: 'Not What I Want, But Maybe What I Need'

“…[20][21][22][23][24][25] Although some research suggests that patients are interested in having their primary care physicians be familiar with issues relevant to cancer survivorship, [26][27][28] there is little research that examines patients' preferences for extended follow-up care. 21,26,27 The current study therefore focused on long-term survivors of localized breast and prostate cancer and explored their preferences regarding the role of the primary care physician in their extended cancer follow-up care. The overarching goal was to identify the preferences of a rapidly growing patient population characterized by the challenges of future health problems related to their previous cancer therapy and for whom many years of follow-up care can be expected.…”

“…3,[36][37][38] Most studies of cancer survivors' follow-up care use quantitative methods and large cohorts to assess survivor attitudes and health behaviors. 21,24,26,27,[38][39][40] …”