Practitioners’ perspectives on community-based breast cancer survivorship care in Singapore: A focus group study

Abstract

With the long-term goal of optimising the delivery of breast cancer survivorship care in Singapore, we conducted a qualitative study to gather in-depth descriptions from community practitioners (general practitioners and community pharmacists) about their perceptions of community-based cancer survivorship care in Singapore. Sixteen participants (11 general practitioners and five community pharmacists) participated in four structured focus group discussions between August and November 2016. The focus group discussions were analysed using deductive content analysis. The majority of community practitioners do not encounter breast cancer survivors in their clinical practices. Perceived barriers to community-based survivorship care include patients' lack of confidence in primary care, financial constraints and lack of empanelment. Most community practitioners concur that the success of community-based survivorship care largely depends on the co-operation and participation of survivors. Survivorship management via standardised care pathways is not fully advocated by practitioners. Survivorship care plans are identified as useful, but they should also incorporate a non-cancer-related medical history and medication list. Community practitioners in Singapore are eager to participate in the delivery of cancer survivorship care. Future studies should develop a community-based care model that involves community practitioners and evaluate the cost-effectiveness of such a care model. The current model of cancer survivorship in Singapore is not sustainable. Differences in healthcare ecosystems, cultures and resources available in an Asian context should be taken into consideration before designing a community-based cancer survivorship program in Singapore.

Development and pilot testing of a decision aid for navigating breast cancer survivorship care

“…First, we performed extensive literature review to develop the DA content. We we reviewed decisional needs from BCS’ and primary care HCPs’ perspectives based on two local qualitative studies [ 26 , 27 ]. Catering to reported informational needs, we designed the DA to address the following content areas: principles of cancer survivorship, roles of participating HCPs, clinical evidence of care models, care coordination strategies, and cost considerations.…”

Cancer Survivorship – More Than Just Surviving Cancer

“…In addition, the lack of empanelment could complicate the shared care model as multiple primary care practitioners may be involved which calls for greater coordination of care. 9 Considering these challenges, it would thus be critical to achieving the relevant changes in mindset from both the patients and primary care practitioners in which the value of shared care is clearly appreciated by all parties. In addition, it will be crucial to design the appropriate pricing and reimbursement structure to see through the successful uptake of such a shared care model.…”

Roles and recommendations from primary care physicians towards managing low-risk breast cancer survivors in a shared-care model with specialists in Singapore—a qualitative study

“…We previously conducted a pilot focus group study on private PCPs’ perspectives on community-based cancer survivorship care in Singapore and found that majority of private PCPs encounter very few cancer survivors in their practice ( 12 ). They reported barriers like patients’ lack of confidence in primary care, financial constraints, limited time and lack of empanelment.…”