Timely cancer diagnosis and management as a chronic condition: opportunities for primary care

Jiwa, Moyez; Saunders, Christobel; Thompson, Sandra; Rosenwax, Lorna; Sargant, Scott; Khong, Eric; Halkett, Georgia; Sutherland, Gloria; Ee, Hooi C.; Packer, Tanya; Merriman, Gareth; Arnet, Hayley

doi:10.5694/j.1326-5377.2008.tb01921.x

Cited by 32 publications

(30 citation statements)

References 25 publications

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“…Standard information supplied by the specialist is often insufficient or too late. The coordination of patient care and communication between GPs and cancer specialists was found to improve when GPs are able to consult the electronic medical record of the specialist [30,31]. Furthermore, the development of guidelines, describing tasks and coordination in follow-up care for both specialists and GPs is of utmost importance [21].…”

Section: Discussionmentioning

confidence: 99%

Excess of health care use in general practice and of comorbid chronic conditions in cancer patients compared to controls

2012

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Background The number of cancer patients and the number of patients surviving initial treatments is expected to rise. Traditionally, follow-up monitoring takes place in secondary care. The contribution of general practice is less visible and not clearly defined. This study aimed to compare healthcare use in general practice of patients with cancer during the follow-up phase compared with patients without cancer. We also examined the influence of comorbid conditions on healthcare utilisation by these patients in general practice. Methods We compared health care use of N=8,703 cancer patients with an age and gender-matched control group of patients without cancer from the same practice. Data originate from the Netherlands Information Network of General Practice (LINH), a representative network consisting of 92 general practices with 350,000 enlisted patients. Health care utilisation was assessed using data on contacts with general practice, prescription and referral rates recorded between 1/1/2001 and 31/12/2007. The existence of additional comorbid chronic conditions (ICPC coded) was taken into account. Results Compared to matched controls, cancer patients had more contacts with their GP-practice (19.5 vs. 11.9, p<.01), more consultations with the GP (3.5 vs. 2.7, p<.01), more home visits (1.6 vs. 0.4, p<.01) and they got more medicines prescribed (18.7 vs. 11.6, p<.01) during the follow-up phase. Cancer patients more often had a chronic condition than their matched controls (52% vs. 44%, p<.01). Having a chronic condition increased health care use for both patients with and without cancer. Cancer patients with a comorbid condition had the highest health care use. Conclusion We found that cancer patients in the follow-up phase consulted general practice more often and suffered more often from comorbid chronic conditions, compared to patients without cancer. It is expected that the number of cancer patients will rise in the years to come and that primary health care professionals will be more involved in follow-up care. Care for comorbid chronic conditions, communication between specialists and GPs, and coordination of tasks then need special attention.

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Section: Discussionmentioning

confidence: 99%

Excess of health care use in general practice and of comorbid chronic conditions in cancer patients compared to controls

2012

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“…24,56,57 The use of electronic records, 54,58 GP participating in multidisciplinary team meetings, 59 the use of patient journey mapping tools, 60 and of Patient Navigators and/or Cancer Care Coordinators 54,61 have been put forward as practical strategies to improve communication between GP and hospital-based services and assist patients to transition better from hospital to community health services. Deficits in communication and information transfer between hospitalbased specialists and GP may adversely affect patient care.…”

Section: Resultsmentioning

confidence: 99%

Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

Valery

Bernardes

Witt

et al. 2020

Internal Medicine Journal

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Background Cancer care involves many different healthcare providers. Delayed or inaccurate communication between specialists and general practitioners (GP) may negatively affect care. Aim To describe the pattern and variation of communication between primary healthcare (PHC) services and hospitals and specialists in relation to the patient's cancer care. Methods A retrospective audit of clinical records of Indigenous Australians diagnosed with cancer during 2010–2016 identified through 10 PHC services in Queensland is described. Poisson regression was used to model the dichotomous outcome availability of hospital discharge summary versus not. Results A total of 138 patient records was audited; 115 of those patients visited the PHC service for cancer‐related care after cancer diagnosis; 40.0% visited the service before a discharge summary was available, and 36.5% of the patients had no discharge summary in their medical notes. While most discharge summaries noted important information about the patient's cancer, 42.4% lacked details regarding the discharge medications regimen. Conclusions Deficits in communication and information transfer between specialists and GP may adversely affect patient care. Indigenous Australians are a relatively disadvantaged group that experience poor health outcomes and relatively poor access to care. The low proportion of discharge summaries noting discharge medication regimen is of concern among Indigenous Australians with cancer who have high comorbidity burden and low health literacy. Our findings provide an insight into some of the factors associated with quality of cancer care, and may provide guidance for focus areas for further research and improvement efforts.

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“…33 Women were offered the opportunity to have their needs assessed by a multidisciplinary team of allied health practitioners in the community. 32 Of the 74 women who were invited to participate, 21 were recruited and 19 completed the study.…”

Section: New Models Of Carementioning

confidence: 99%

The health of women treated for breast cancer: A challenge in primary care

Jiwa¹

2012

AMJ

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316 REVIEWPlease cite this paper as: Jiwa M, Chan A, Lotriet J and Razmi S. The health of women treated for breast cancer: A challenge in primary care. AMJ 2012, 5, 6, 316--321. http//dx. AbstractAt least one in a hundred consultations in general practice in Australia involves women being treated for breast cancer. The challenges presented during these consultations test the quality of primary care. Firstly, women are reported to prefer to discuss their breast cancer--related problems with a specialist even though research suggests that patients generally prefer to consult with a general practitioner (GP). The extent to which these patients will have maintained or return to their previous level of functioning will be a reflection on the quality of primary care, as some breast cancer--related health issues may persist beyond the time period when they are undergoing specialist review. Further, psychosocial matters, sexuality and relationships may require repeated review and perhaps consultations involving family members and would therefore be better addressed by a GP. An increasingly urgent need exists to review how best to support people who are successfully treated for life limiting illnesses, such as breast cancer. Key WordsBreast cancer, primary care, cancer morbidity Breast cancer Breast cancer is the second most common cancer in women. Treatment is generally effective, and most women are still alive five years from diagnosis. In Australia 143,967 women had been treated for breast cancer between 1981 and 2006. 1 Since then, another estimated 12,000 cases have been treated annually, suggesting that by 2012 there are likely to be more than 200,000 woman living in Australia who have been treated for breast cancer.2 In this country there is an estimated one hundred million consultations with GPs every year, 22.4% with women aged 44--74 years.

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Timely cancer diagnosis and management as a chronic condition: opportunities for primary care

Cited by 32 publications

References 25 publications

Excess of health care use in general practice and of comorbid chronic conditions in cancer patients compared to controls

Excess of health care use in general practice and of comorbid chronic conditions in cancer patients compared to controls

Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?

The health of women treated for breast cancer: A challenge in primary care

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