The Effectiveness of Shared Care in Cancer Survivors—A Systematic
                        Review

Yan, Zhao; Brettle, Alison; Qiu, Ling

doi:10.5334/ijic.3954

Cited by 57 publications

(83 citation statements)

References 37 publications

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“…4 The findings of this study confirmed the advantage of involving oncologists and primary care physicians in patient care, which has been associated with positive outcomes during survivorship. 29 However, even in the publicly funded poorly understood, and implementation of efforts remains fragmented. 31 We suggest that such a model be tailored to address barriers, including funding constraints, staffing shortages, and lack of shared information systems between different health care sectors.…”

Section: Jama Network Open | Health Policymentioning

confidence: 99%

Evaluation of Factors Associated With Unmet Needs in Adult Cancer Survivors in Canada

et al. 2020

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IMPORTANCE Understanding the challenges faced by an increasing number of cancer survivors can guide the development and implementation of effective survivorship care models. OBJECTIVE To identify the physical, emotional, and practical concerns and associated unmet needs reported by cancer survivors. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional survey study obtained data from the Experiences of Cancer Patients in Transitions Study of the Canadian Partnership Against Cancer, in collaboration with cancer agencies in the 10 Canadian provinces, that was disseminated in 2016. This analysis included only adult survivors aged 30 years or older who underwent chemotherapy, radiation therapy, surgical treatment, or a combination of these therapies for breast, prostate, colorectal, melanoma, or hematological cancer within the past 1 to 3 years. Data synthesis and quality assessment were conducted in 2017. Data analysis was completed in July 2019. MAIN OUTCOMES AND MEASURES The outcomes were the (1) quantification of the magnitude and multiplicity of the physical, emotional, and practical concerns of adult survivors of breast, colorectal, prostate, melanoma, or hematological cancer; (2) exploration of the magnitude of associated unmet needs; and (3) identification of patient-, treatment-, and cancer-specific factors associated with the reporting of unmet needs. RESULTS Overall, 10 717 adult respondents were included (5660 [53%] female and 6367 [60%] aged Ն65 years). The median number of concerns per respondent was 6 (interquartile range [IQR], 3-10). Among respondents with concerns, help was sought for a median of 2 (IQR, 0-4) concerns. Unmet needs were reported for a median of 4 (IQR, 2-7) concerns. Emotional concerns were reported by 8330 respondents (78%), physical concerns by 9236 respondents (86%), and practical concerns by 4668 respondents (44%). At least 1 unmet need was reported by 7033 survivors (84%) with emotional concerns, 7475 (81%) with physical concerns, and 3459 (74%) with practical concerns. Age, sex, annual income, marital status, geographic location, language, and treatment type

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Section: Jama Network Open | Health Policymentioning

confidence: 99%

Evaluation of Factors Associated With Unmet Needs in Adult Cancer Survivors in Canada

et al. 2020

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“…Overall, shared-care is highly acceptable, resulting in better patient compliance and satisfaction. In terms of effectiveness, shared-care has been shown to be similar to usual care ( 37 , 38 ). The current findings and recommendations of this study have implications for the integration of a shared-care model into routine primary care practice.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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Background Breast cancer is prevalent and has high cure rates. The resultant increase in numbers of breast cancer survivors (BCS) may overwhelm the current oncology workforce in years to come. We postulate that primary care physicians (PCPs) could play an expanded role in comanaging survivors, provided they are given the appropriate tools and training to do so. Objective To explore the perspectives of PCPs towards managing BCS in a community-based shared-care programme with oncologists. Methods Eleven focus groups and six in-depth interviews were conducted with seventy PCPs recruited by purposive sampling. All sessions were audio-recorded, transcribed verbatim and coded by three independent investigators. Thematic data analysis was performed and the coding process facilitated by NVivo 12. Results Majority of PCPs reported currently limited roles in managing acute and non-cancer issues, optimizing comorbidities and preventive care. PCPs aspired to expand their role to include cancer surveillance, risk assessment and addressing unmet psychosocial needs. PCPs preferred to harmonize cancer survivorship management of their primary care patients who are also BCS, with defined role distinct from oncologists. Training to understand the care protocol, enhancement of communication skills, confidence and trust were deemed necessary. PCPs proposed selection criteria of BCS and adequacy of their medical information; increased consultation time; contact details and timely access to oncologists (if needed) in the shared-care programme. Conclusions PCPs were willing to share the care of BCS with oncologists but recommended role definition, training, clinical protocol, resources and access to oncologist’s consultation to optimize the programme implementation.

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“…Recent systematic reviews have found equivalent quality of life, mental health and clinical outcomes for cancer survivors who follow-up in primary care and specialists services [ 8 ], with lower costs associated with shared care models [ 9 ]. It is also the preferred model of survivorship care by cancer survivors, general practitioners and specialists [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing suitability for long-term colorectal cancer shared care: a scenario-based qualitative study

et al. 2020

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Background Shared care is the preferred model for long-term survivorship care by cancer survivors, general practitioners and specialists. However, survivorship care remains specialist-led. A risk-stratified approach has been proposed to select suitable patients for long-term shared care after survivors have completed adjuvant cancer treatment. This study aims to use patient scenarios to explore views on patient suitability for long-term colorectal cancer shared care across the risk spectrum from survivors, general practitioners and specialists. Methods Participants completed a brief questionnaire assessing demographics and clinical issues before a semi-structured in-depth interview. The interviews focused on the participant’s view on suitability for long term cancer shared care, challenges and facilitators in delivering it and resources that would be helpful. We conducted thematic analysis using an inductive approach to discover new concepts and themes. Results Interviews were conducted with 10 cancer survivors, 6 general practitioners and 9 cancer specialists. The main themes that emerged were patient-centredness, team resilience underlined by mutual trust and stronger system supports by way of cancer-specific training, survivorship care protocols, shared information systems, care coordination and navigational supports. Conclusions Decisions on the appropriateness of this model for patients need to be made collaboratively with cancer survivors, considering their trust and relationship with their general practitioners and the support they need. Further research on improving mutual trust and operationalising support systems would assist in the integration of shared survivorship care.

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The Effectiveness of Shared Care in Cancer Survivors—A Systematic Review

Cited by 57 publications

References 37 publications

Evaluation of Factors Associated With Unmet Needs in Adult Cancer Survivors in Canada

Evaluation of Factors Associated With Unmet Needs in Adult Cancer Survivors in Canada

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

Assessing suitability for long-term colorectal cancer shared care: a scenario-based qualitative study

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