Understanding the Attitudes and Beliefs of Oncologists Regarding the Transitioning and Sharing of Survivorship Care

Abstract

Transitioning survivorship care from oncologists to primary care physicians (PCPs) is a reasonable alternative to oncologist-led care. This study assessed oncologists’ attitudes and beliefs regarding sharing/transitioning survivorship care. A prospective survey of oncologists within a regional cancer program assessing self-reported barriers and facilitators to sharing/transitioning survivorship care was disseminated. In total, 63% (n = 39) of surveyed oncologists responded. Patient preference (89%) and anxiety (84%) are key to transition of care decisions; reduced remuneration (95%) and fewer longitudinal relationships (63%) do not contribute. Oncologists agreed that more patients could be shared/transitioned. Barriers include treatment-related toxicities (82% agree), tumor-specific factors (60–90% agree) and perception of PCP willingness to participate in survivorship care (47% agree). Oncologists appear willing to share/transition more survivors to PCPs, though barriers exist that warrant further study. Understanding these issues is critical to developing policies supporting comprehensive survivorship care models that address both cancer and non-cancer health needs. The demonstrated feasibility of this project warrants a larger-scale survey of oncologists with respect to the transition of survivorship care to PCPs, to further inform effective interventions to support high-quality survivorship care.

Factors influencing the translation of shared cancer follow-up care into clinical practice: a systematic review

“… 29–32 34 41 42 Shared cancer follow-up care relies on the two-way transfer of information between all health professionals involved in patient care, 32 as oncologists need to receive important clinical outcome data about the patient from the general practitioner. 43 Five papers highlighted the need to further develop health information technology to assist the two-way information sharing process and improve the timeliness and quality of information between general practitioners and oncologists. 31 37 40 44 45 There is a need for shared information systems that are connected between the oncologist and the general practitioner to support care, and fast-track options to the hospital system when patients are unwell.…”

“… 29 31 32 35 40 41 43 44 50 52 56 59 61 62 The lack of clear guidelines was a barrier to transitioning to a shared care follow-up model between oncologists and general practitioners. 43 However, general practitioners were more willing to take a greater role in follow-up care if they were provided appropriate follow-up clinical management guidelines 35 62 and more guidance about follow-up screening and side effects of cancer treatment. 59 Specific follow-up guidelines, 61 specifically templates, 59 could be in the form of a printable checklist or using validated instruments 29 and would reassure general practitioners that they were addressing aspects critical for the particular patients’ care.…”

“…Seven papers discussed issues with one-way information sharing: written information from the oncologist to the general practitioner 29–32 34 41 42. Shared cancer follow-up care relies on the two-way transfer of information between all health professionals involved in patient care,32 as oncologists need to receive important clinical outcome data about the patient from the general practitioner 43. Five papers highlighted the need to further develop health information technology to assist the two-way information sharing process and improve the timeliness and quality of information between general practitioners and oncologists 31 37 40 44 45.…”

“…Twenty-two papers discuss responsibility for follow-up care 4 35 36 38 41–43 46–59. There was a preference from patients, general practitioners and oncologists, for oncologists to maintain overall responsibility for cancer follow-up care 42 43 46 48 55 56.…”

“…Twenty-two papers discuss responsibility for follow-up care 4 35 36 38 41–43 46–59. There was a preference from patients, general practitioners and oncologists, for oncologists to maintain overall responsibility for cancer follow-up care 42 43 46 48 55 56. Oncologists were more likely to prefer an oncologist-led model instead of a shared-care or general practitioner-led model, as oncologists felt that they had the specialised knowledge for follow-up care,48 and general practitioners did not 42 48 55.…”