Primary Care Physicians' Views of Routine Follow-Up Care of Cancer Survivors
Primary Care Physicians' Views of Routine Follow-Up Care of Cancer Survivors
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DOI：
10.1200/jco.2008.20.4883
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发表时间：
2009-07-10
影响因子：
45.3
通讯作者：
Verma, Sunil
中科院分区：
文献类型：
--
作者：
Del Giudice, M. Elisabeth;Grunfeld, Eva;Verma, Sunil
目的成年癌症幸存者的常规随访是一个重要的临床和健康服务问题。由于缺乏证据支持肿瘤诊所长期随访治疗的优势，人们对初级保健医生（pcp）提供这种治疗的兴趣越来越大。然而，目前加拿大PCP对这个问题的看法在很大程度上是未知的。方法对加拿大各地按地区和靠近城市中心程度分层的pcp随机抽样进行邮件调查。确定了对成年癌症幸存者的常规随访和促进pcp提供这种护理的方式的看法。结果共有330名pcp应答，调整后应答率为51.7%。在完成积极治疗后，前列腺癌患者的随访时间为2.4 +/- 2.3年，结直肠癌患者的随访时间为2.6 +/- 2.6年，乳腺癌患者的随访时间为2.8 +/- 2.5年，淋巴瘤患者的随访时间为3.2 +/- 2.7年。已经提供这种护理的pcp愿意更快地提供独家护理。pcp认为最有用的模式将帮助他们承担后续癌症护理的独家责任：(1)专家的患者特定信函，(2)印刷指南，(3)快速转诊路线，(4)快速获得怀疑复发的调查。结论：有了适当的信息和支持，pcp报告愿意承担成年癌症幸存者的后续护理的独家责任。从这项调查中获得的见解可能最终有助于指导为这些患者提供最佳护理的策略。
PurposeRoutine follow-up of adult cancer survivors is an important clinical and health service issue. Because of a lack of evidence supporting advantages of long-term follow-up care in oncology clinics, there is increasing interest for the locus of this care to be provided by primary care physicians (PCPs). However, current Canadian PCP views on this issue have been largely unknown.MethodsA mail survey of a random sample of PCPs across Canada, stratified by region and proximity to urban centers, was conducted. Views on routine follow-up of adult cancer survivors and modalities to facilitate PCPs in providing this care were determined.Results A total of 330 PCPs responded (adjusted response rate, 51.7%). After completion of active treatment, PCPs were willing to assume exclusive responsibility for routine follow-up care after 2.4 +/- 2.3 years had elapsed for prostate cancer, 2.6 +/- 2.6 years for colorectal cancer, 2.8 +/- 2.5 years for breast cancer, and 3.2 +/- 2.7 years for lymphoma. PCPs already providing this care were willing to provide exclusive care sooner. The most useful modalities PCPs felt would assist them in assuming exclusive responsibility for follow-up cancer care were (1) a patient-specific letter from the specialist, (2) printed guidelines, (3) expedited routes of rereferral, and (4) expedited access to investigations for suspected recurrence.ConclusionWith appropriate information and support in place, PCPs reported being willing to assume exclusive responsibility for the follow-up care of adult cancer survivors. Insights gained from this survey may ultimately help guide strategies in providing optimal care to these patients.