What is the evidence behind cancer care reviews, a primary care cancer support tool? A scoping review

Gopal, Dipesh P; Ahmad, Tahania; Efstathiou, Nikolaos; Guo, Ping; Taylor, Stephanie

doi:10.1007/s11764-022-01251-7

Cited by 5 publications

(3 citation statements)

References 55 publications

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“…These comorbidities can also be embedded in cancer care reviews in the UK, which have been reported to lack patient-centredness [62]…”

Section: Discussionmentioning

confidence: 99%

Prevalence of multimorbidity in survivors of 28 cancer sites: an English nationwide cross-sectional study

Ahmad

2024

Am J Cancer Res

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Multimorbidity, the presence of a chronic condition in addition to cancer, is of particular importance to cancer survivors. It has an impact on the progression, stage at diagnosis, prognosis, and treatment of cancer patients. Evidence is scarce on the prevalence of specific comorbidities in survivors of different cancers to inform prevention and management of multimorbidity. The objective of this study is to address this evidence gap by using large scale electronic health data from multiple linked UK healthcare databases to examine the prevalence of multimorbidity in 28 cancer sites. For this population-based cross-sectional study, we linked primary and secondary healthcare data from the UK Clinical Research Practice Datalink (CPRD) GOLD dataset and Hospital Episode Statistics (HES). We identified survivors of 28 common cancers aged 18 years or older at diagnosis who survived 2 years of cancer and compared their multimorbidity with matched controls without a history of cancer. To compare prevalence of individual comorbidity, multivariable logistic regression models, adjusted for confounding factors were used. Between January 1, 2010 and December 31, 2020, we identified 347,028 cancer survivors and 804,299 controls matched on age, sex and general practice. Cancer survivors had a higher prevalence of multimorbidity compared to non-cancer controls across all the cancer sites. Hypertension (56.2%), painful conditions (39.8%), osteoarthritis (38.0%), depression (31.8%) and constipation (31.4%) were the five most frequent chronic conditions reported. Compared to the controls, higher odds of constipation were found in survivors of 25 of the 28 cancer sites and higher odds of anaemia were found in 23 cancer sites. Prevalence of constipation, anaemia and painful conditions were higher after cancer diagnosis compared to before diagnosis. Since these comorbidities are not uniformly assessed as part of any of the comorbidity scales, they tend to be underreported among cancer survivors. The elevated risk of certain comorbidities in cancer survivors suggests the potential for preventative efforts in this population to lower disease burden and improve quality of life. Long-term conditions should not be viewed as the inevitable result of cancer diagnosis and treatment. We need to consider integrated management of chronic conditions tailored to specific cancers to improve cancer survivorship.

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“…These comorbidities can also be embedded in cancer care reviews in the UK, which have been reported to lack patient-centredness [62]…”

Section: Discussionmentioning

confidence: 99%

Prevalence of multimorbidity in survivors of 28 cancer sites: an English nationwide cross-sectional study

Ahmad

2024

Am J Cancer Res

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“…Since this trial started, research into HNA has grown considerably. 25 A systematic review in 2019 found mixed outcomes from the included trials, with some finding improvement in quality of life but most not. A similar picture emerged from a 2022 scoping review of ‘Cancer Care Reviews’ that included HNAs.…”

Section: Discussionmentioning

confidence: 99%

Holistic needs assessment in outpatient cancer care: a randomised controlled trial

et al. 2023

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DesignAnalyst blinded, parallel, multi-centre, randomised controlled trial (RCT).ParticipantsPeople with confirmed diagnoses of cancer (head and neck, skin or colorectal) attending follow-up consultation 3 months post-treatment between 2015 and 2020.InterventionHolistic needs assessment (HNA) or care as usual during consultation.ObjectiveTo establish whether incorporating HNA into consultations would increase patient participation, shared decision making and postconsultation self-efficacy.Outcome measuresPatient participation in the consultations examined was measured using (a) dialogue ratio (DR) and (b) the proportion of consultation initiated by patient. Shared decision making was measured with CollaboRATE and self-efficacy with Lorig Scale. Consultations were audio recorded and timed.RandomisationBlock randomisation.BlindingAudio recording analyst was blinded to study group.Results147 patients were randomised: 74 control versus 73 intervention.OutcomeNo statistically significant differences were found between groups for DR, patient initiative, self-efficacy or shared decision making. Consultations were on average 1 min 46 s longer in the HNA group (respectively, 17 m 25 s vs 15 min 39 s).ConclusionHNA did not change the amount of conversation initiated by the patient or the level of dialogue within the consultation. HNA did not change patient sense of collaboration or feelings of self-efficacy afterwards. HNA group raised more concerns and proportionally more emotional concerns, although their consultations took longer than treatment as usual.Implications for practiceThis is the first RCT to test HNA in medically led outpatient settings. Results showed no difference in the way the consultations were structured or received. There is wider evidence to support the roll out of HNA as part of a proactive, multidisciplinary process, but this study did not support medical colleagues facilitating it.Trial registration numberNCT02274701.

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“…The general practitioner (GP) has a central role in the different phases of cancer patient management [1][2][3][4], including in early treatment phases [5,6]. However, exchanges between general practice and hospital remain fragmented [7].…”

Section: Introductionmentioning

confidence: 99%

Experimental system of care coordination for the home return of patients with metastatic cancer: a survey of general practitioners

et al. 2022

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Background To promote improved coordination between general practice and hospital, the French clinical trial CREDO (“Concertation de REtour à DOmicile”) is testing an innovative experimental consultation for patients with metastatic cancer who are returning home. This consultation involves the patient, the patient’s referring GP (GPref) and a GP with specific skills in oncology (GPonc) in a specialized care center. The objective of our study is to explore the satisfaction of GPsref about this consultation, in the phase of interaction between GPonc and GPref. Methods This observational, cross-sectional, multicenter study explored the satisfaction of GPsref who had participated in this type of consultation, via a telephone survey. Results One Hundred GPsref responded to the questionnaire between April and September 2019 (overall response rate: 55%). 84.5% were satisfied with the consultation, and the majority were satisfied with its methods. Half of the GPsref learned new information during the consultation, three-quarters noted an impact on their practice, and 94.4% thought that this type of coordination between the GPref and the oncology specialist could improve general practice - hospital coordination. Conclusions For GPs, the CREDO consultation seems to be practical and effective in improving the coordination between general medicine and hospital. GPs would benefit from such coordination for all patients with cancer, several times during follow-up and at each occurrence of a medically significant event.

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What is the evidence behind cancer care reviews, a primary care cancer support tool? A scoping review

Cited by 5 publications

References 55 publications

Prevalence of multimorbidity in survivors of 28 cancer sites: an English nationwide cross-sectional study

Prevalence of multimorbidity in survivors of 28 cancer sites: an English nationwide cross-sectional study

Holistic needs assessment in outpatient cancer care: a randomised controlled trial

Experimental system of care coordination for the home return of patients with metastatic cancer: a survey of general practitioners

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