Role of oncologists and primary care physicians in providing follow-up care to non-Hodgkin lymphoma survivors within 5 years of diagnosis: a population-based study
Role of oncologists and primary care physicians in providing follow-up care to non-Hodgkin lymphoma survivors within 5 years of diagnosis: a population-based study
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DOI：
10.1007/s00520-013-2113-z
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发表时间：
2014-06-01
影响因子：
3.1
通讯作者：
Rowland, Julia H.
中科院分区：
文献类型：
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作者：
Forsythe, Laura P.;Arora, Neeraj K.;Rowland, Julia H.
随着非霍奇金淋巴瘤（NHL）幸存者的不断增长，他们的身体和心理治疗负担越来越重，再加上医疗专业人员的预计短缺，有必要重新设计癌症随访护理。本研究检查了随访护理模式，与随访护理相关的因素，和对NHL幸存者随访治疗的态度。我们使用来自洛杉矶县监测流行病学和最终结果登记处的基于人群的样本，调查了诊断后2至5年的侵袭性NHL幸存者（N = 363）。大多数幸存者（82%）接受了癌症相关随访，在过去的一年里，一位肿瘤学家。复发史、合并症多、症状多、生存者-肿瘤医生关系短与肿瘤医生的高频率护理相关[（过去一年中每千日元5次就诊的部分），p < 0.05]。许多幸存者（71%）在肿瘤学家的跟踪下也看到了初级保健提供者（PCP），47%的人也看到了PCP和其他专家。除了肿瘤科医生外，与PCP相关的因素包括更多的症状，更多的健康信息需求，无复发史，感知的癌症随访护理质量良好，以及较少的肿瘤科医生就诊（p < 0.05）。幸存者普遍报告高保证，低负面预期，后续care.The高比例的NHL幸存者接受多个医生的护理，以及相当大的比例（类似于30%）谁最近没有看到一个PCP，表明跨专业的协调护理是至关重要的，以确保全面的，非重复的护理。了解与癌症相关随访相关的因素是实现更有效、高效、以患者为中心的护理的第一步。
The growing population of non-Hodgkin lymphoma (NHL) survivors living longer with high physical and psychological treatment burden, in combination with the projected shortage of medical professionals, necessitates redesigning cancer follow-up care. This study examined follow-up care patterns, factors associated with follow-up care, and attitudes towards follow-up care among NHL survivors.We surveyed survivors of aggressive NHL 2 to 5 years post-diagnosis (N = 363) using a population-based sample from the Los Angeles County Surveillance Epidemiology and End Results registry.Most survivors (82 %) received cancer-related follow-up care in the past year from an oncologist. History of recurrence, more comorbidities, more symptoms, and a shorter survivor-oncologist relationship were associated with high-frequency care with the oncologist [(a parts per thousand yen5 visits in the past year), p < 0.05]. Many survivors followed up by oncologists (71 %) also saw a primary care provider (PCP) and 47 % also saw both a PCP and other specialists. Factors associated with seeing a PCP in addition to an oncologist included more symptoms, more health information needs, no history of recurrence, perceived excellent quality of cancer follow-up care, and fewer visits with the oncologist (p < 0.05). Survivors generally reported high reassurance from, and low negative anticipation towards, follow-up care.The high proportion of NHL survivors receiving care from multiple physicians, and the sizable proportion (similar to 30 %) who have not recently seen a PCP, suggests that coordinating care across specialties is critical to ensure comprehensive, non-duplicative care. Understanding factors associated with cancer-related follow-up is a first step towards more effective, efficient, patient-centered care.