Primary care physicians’ knowledge and confidence in providing cancer survivorship care: a systematic review

Abstract

Purpose To systematically review existing literature on knowledge and confidence of primary care physicians (PCPs) in cancer survivorship care. Methods PubMed, Ovid MEDLINE, CINAHL, Embase, and PsycINFO were searched from inception to July 2022 for quantitative and qualitative studies. Two reviewers independently assessed studies for eligibility and quality. Outcomes were characterized by domains of quality cancer survivorship care. Results Thirty-three papers were included, representing 28 unique studies; 22 cross-sectional surveys, 8 qualitative, and 3 mixed-methods studies. Most studies were conducted in North America (n = 23) and Europe (n = 8). For surveys, sample sizes ranged between 29 and 1124 PCPs. Knowledge and confidence in management of physical (n = 19) and psychosocial effects (n = 12), and surveillance for recurrences (n = 14) were described most often. Generally, a greater proportion of PCPs reported confidence in managing psychosocial effects (24–47% of PCPs, n= 5 studies) than physical effects (10–37%, n = 8). PCPs generally thought they had the necessary knowledge to detect recurrences (62–78%, n = 5), but reported limited confidence to do so (6–40%, n = 5). There was a commonly perceived need for education on long-term and late physical effects (n = 6), and cancer surveillance guidelines (n = 9). Conclusions PCPs’ knowledge and confidence in cancer survivorship care varies across care domains. Suboptimal outcomes were identified in managing physical effects and recurrences after cancer. Implications for Cancer Survivors These results provide insights into the potential role of PCPs in cancer survivorship care, medical education, and development of targeted interventions.

Health Care Transitions Among Adolescents and Young Adults With Cancer

“…Notably, much of the literature on transition in AYA survivors, and associated barriers, has emerged from studies of childhood and adolescent cancer survivors entering adulthood. 35,63,66,82-90 Beyond single-center, disease-specific reports, 91,92 and the documented discomfort of adult PCPs in following long-term survivors, 93-95 there are very limited data available on transition of young adult survivors who move directly from acute oncologic care to longitudinal care by the primary care provider. Additional work is needed to elucidate successful approaches to transition, as well as unique barriers that need to be overcome, in this population.…”

Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: SIO-ASCO Guideline Summary and Q&A

“…to manage the emotional well-being of individuals with cancer (oncology, primary care, or both? ), 19,20 national quality oncology care standards emphasize the need for cancer practices to routinely screen for emotional well-being and refer patients for evidence-based care as needed. [21][22][23] Cancer centers are strongly encouraged to refer patients experiencing anxiety and depression to evidence-based integrative interventions, but they do not necessarily need to provide these therapies on-site.…”

“…While debate continues regarding “whose job is it?” to manage the emotional well-being of individuals with cancer (oncology, primary care, or both? ), 19,20 national quality oncology care standards emphasize the need for cancer practices to routinely screen for emotional well-being and refer patients for evidence-based care as needed. 21-23…”

Emotional Meanings of Clinical Practice with Head and Neck Cancer Patients: a qualitative study with Brazilian professionals

“…Therefore, the relationship between health professionals and patients involves emotions and feelings that, depending on the disease and the patient pro le, can have a negative emotional impact on both. This way, health professionals experience an emotional burden with several patients, each with their unique way of handling the disease [4]. In the case of professionals who treat patients with Head and Neck Cancer (HNC), these are recurring experiences.…”

“…In this context, to suppress distress resulting from the patient's situation of fragility and vulnerability, health professionals end up facing some emotional disorganization when treating patients with HNC [4].…”