Patient experiences of GP-led colon cancer survivorship care: a Dutch mixed-methods evaluation

Abstract

Background: Colon cancer survivorship care constitutes both follow-up and aftercare. General practitioner (GP) involvement may help to personalize care. Aim: To address patients’ experiences with GP- versus surgeon-led survivorship care. Design and setting: Stage I-III colon cancer patients were recruited from 8 Dutch hospitals and randomised to receive care by either the GP or surgeon. Method: A mixed-methods approach was used to compare GP- to surgeon-led care, consisting of questionnaire-based data (N=261) and semi-structured interviews (N = 25). After 1 year, the Consumer Quality Index (CQI) was used to measure quality aspects of care. Interviews were performed at various time points (3 to 6 years after surgery) to explore patients’ experiences more in-depth. Results: Overall, patients were satisfied with both GP- and surgeon-led care (ratings 9.6 versus 9.4 out of 10 respectively). No important differences were seen in quality of care as measured by CQI. Interviews revealed that patients often had little expectations of care from either healthcare professional. They described follow-up consultations as short, medically oriented and centered around discussing follow-up test results. Patients also reported little symptoms. Care for patients in the GP-led group was organized in different ways, ranging from solely on patient’s initiative to shared care. Patients sometimes desired a more guiding role from their GP, whereas others preferred to be proactive themselves. Conclusion: Patients experience high quality of colon cancer survivorship care from either GP or surgeon. If the GP is going to be more involved, patients require a clear understanding of roles and responsibilities.

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

“…However, participants still expressed confusion about the follow‐up schedule, and roles and responsibilities of each provider when the model of care was not specialist‐led. Similar experiences have been reported in GP‐led models of follow‐up for CRC survivors 43 . While participants in the shared care arm of the SCORE trial received SCPs to facilitate communication, many could not recall using these and still found that their GPs were unsure of the study protocol, leading to distress that their care needs were not being met.…”

“…Similar experiences have been reported in GP-led models of follow-up for CRC survivors. 43 While participants in the shared care arm of the SCORE trial received SCPs to facilitate communication, many could not recall using these and still found that their GPs were unsure of the study protocol, leading to distress that their care needs were not being met. Better communication tools are needed between hospital-based care providers, GPs, and patients as shared care models have been deemed less acceptable when survivors perceived poor communication between care providers.…”

Patient experiences with patient-led, home-based follow-up after curative treatment for colorectal cancer: a qualitative study

“…There was high between-participant variation in how the responsibility of the different HCPs involved in PHFU was viewed. Unclarity about responsibility is also present in other forms of follow-up; previous studies have concluded that the quality of the perceived follow-up care suffered from this unclarity 20–22. Therefore, it is recommended that it is clearly defined for the patient which HCP has the main responsibility for the PHFU.…”

Detection of colon cancer recurrences during follow-up care by general practitioners vs surgeons

“…For the GP to take over completely, it will require additional time, compensation, and reorganization of the infrastructure ( 30 ). It will also require a clear understanding of the roles and responsibilities in which the patient and GP need to come to an agreement on who will take the lead in organizing follow-up ( 31 ).…”