Views of family physicians about survivorship care plans to provide breast cancer follow-up care

 Blogger's Note/Opinion: this is not the first research paper on this issue with the conclusions being basically the same (eg. communication...); given the complexities of genetics today this paper is limited in its scope

open access - breast cancer follow-up care Current Oncology

 Cancer Rehabilitation and Survivorship

Views of family physicians about survivorship care plans to provide breast cancer follow-up care: exploration of results from a randomized controlled trial

Background

The U.S. Institute of Medicine recommends that cancer patients receive survivorship care plans, but evaluations to date have found little evidence of the effectiveness of such plans. We conducted a qualitative follow-on study to a randomized controlled trial (rct) to understand the experiences of family physicians using survivorship care plans to support the follow-up of breast cancer patients.

Methods

A subset of family physicians whose patients were enrolled in the parent rct in Ontario and Nova Scotia were eligible for this study. In interviews, the physicians discussed survivorship care plans (intervention) or usual discharge letters (control), and their confidence in providing follow-up cancer care.

Results

Of 123 eligible family physicians, 18 (10 intervention, 8 control) were interviewed (Halifax, Hamilton, Toronto). In general, physicians receiving a survivorship care plan found only the 1-page care record to be useful. Physicians who received only a discharge letter had variable views about the letter’s usefulness; several indicated that it lacked information about potential cancer- or treatment-related problems. Most physicians were comfortable providing care 3–5 years after diagnosis, but desired timely and informative communication with oncologists.

Conclusions

Although family physicians did not find extensive survivorship care plans useful, discharge letters might not be sufficiently comprehensive for follow-up breast cancer care. Effective strategies for two-way communication between family physicians and oncologists are still lacking.

 

INTRODUCTION

The safety of follow-up breast cancer care delivered exclusively by family physicians (fps) has been established in two randomized trials1,2.
Family physicians have expressed comfort with taking on more responsibility for cancer survivors, but they desire additional tools such as patient-specific standardized letters and guidelines for follow-up care, expedited routes for re-referral, and expedited access to investigations for suspected recurrence3.

The report From Cancer Patient to Cancer Survivor: Lost in Transition4 from the U.S. Institute of Medicine called for health care practitioners to provide patients with a survivorship care plan (scp) or a comprehensive care summary and follow-up plan that is effectively explained. Cancer scps have been endorsed as the “new way of doing business” once primary treatment is complete4 and are regarded as powerful tools for coordination of care at the end of adjuvant cancer treatment5......