The willingness of general practitioners to be involved in the follow-up of adult survivors of childhood cancer

Abstract

Background Long-term follow-up of childhood cancer survivors is mainly organised by paediatric oncologists and until now general practitioners (GPs) are rarely involved. To ensure appropriate follow-up for all survivors into adulthood, a combined effort of paediatric oncologists and general practitioners might be the solution. We investigated the willingness of GPs, who had followed a postgraduate course on late effects of cancer treatment, to participate in a shared care model for follow-up of adult childhood cancer survivors as well as what their requirements would be in case of participation. Methods From the Northern Netherlands, 358 GPs participated in a postgraduate course on late effects in paediatric cancer survivors. After the course, they were asked to complete a 10-item questionnaire on motivation to participate in the regular follow-up of adult childhood cancer survivors as well as their conditions to participate. Results The response rate was 65%. Of the responders, 97% were willing to participate in a shared care model for follow-up and 64% felt that it was their responsibility to be in charge of childhood cancer survivors. The main requirements for participation were the availability of guidelines (64%), sufficient information about the patient's medical history (37%), and short communication lines (45%). The main barriers to participate were workload (16%), lack of knowledge (15%), and lack of communication (13%). Conclusion A significant number of GPs are ready to participate in the long-term follow-up of adult childhood cancer survivors if adequate guidelines and medical information is provided and communication lines are clear.

Health-related information needs in a large and diverse sample of adult cancer survivors: implications for cancer care

“…One approach that may help is increased training of primary care physicians (PCPs) on survivorship issues. Primary care is the medical setting most often utilized by survivors once treatment has ended, and there is evidence that PCPs are willing to engage in a "shared care" model with oncologists, but lack of knowledge has been identified as a main barrier to PCPs engaging in survivorship care [46]. Continued research will be necessary to determine whether increasing continuing education will facilitate PCP's understanding of survivor's health-related concerns and decrease the information needs of cancer survivors.…”

Shared care by paediatric oncologists and family doctors for long-term follow-up of adult childhood cancer survivors: a pilot study

“…Models of shared care have been developed for chronic diseases such as diabetes, hypertension, and asthma, 21,22 and there are some examples of shared oncological care for adult patients with cancer. 23,24 Some studies suggest that family doctors are willing to take part in follow-up care of patients with cancer, 9,25 and that hospital follow-up provides no advantages compared with long-term follow-up in primary-care settings. 22,24 "Developing personal relationships", "gaining mutual respect", and "increasing medical knowledge for the benefi t of their patients", seemed to be the most important motivational factors to persuade family doctors to collaborate with specialist services.…”

“…In the Netherlands, survivors usually have family doctors, most of whom are willing to participate in a shared-care programme. 9 In a shared-care programme, family doctors participate in the screening of late eff ects in adult survivors of childhood cancers in consultation with paediatric oncologists of the LTFU clinic. Since the number of survivors of childhood cancers is expected to increase, identifying who should undertake long-term follow-up of such patients after achieving adulthood is important.…”

Personal resources and selected aspects of psychological functioning of ill oncological youths

“…z przeciętnym poziomem samooceny [42], wyższym poziomem kompetencji społecznych [43] oraz równowagą emocjonalną [44]. Można się zatem spodziewać, że młodzież przeżywająca trudną sytuację choroby nowotworowej będzie raczej skłonna usztywniać swoje zachowania zaradcze, co może prowadzić do podejmowania nieefektywnych prób radzenia sobie przez odwracanie uwagi, obwinianie innych i myślenie życzeniowe [45,46]. Znaczna część chorych cechuje się apatią, rezygnacją, biernością, skłonnością do izolowania się oraz brakiem planów i celów życiowych (58% badanych).…”