Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists

2013 ◽  
Vol 7 (3) ◽  
pp. 343-354 ◽  
Author(s):  
Winson Y. Cheung ◽  
Noreen Aziz ◽  
Anne-Michelle Noone ◽  
Julia H. Rowland ◽  
Arnold L. Potosky ◽  
...  
2012 ◽  
Vol 25 (5) ◽  
pp. 635-651 ◽  
Author(s):  
T. Salz ◽  
K. C. Oeffinger ◽  
P. R. Lewis ◽  
R. L. Williams ◽  
R. L. Rhyne ◽  
...  

2021 ◽  
Vol 28 (5) ◽  
pp. 3408-3419
Author(s):  
Dominique Tremblay ◽  
Nassera Touati ◽  
Karine Bilodeau ◽  
Catherine Prady ◽  
Susan Usher ◽  
...  

Risk-stratified pathways of survivorship care seek to optimize coordination between cancer specialists and primary care physicians based on the whole person needs of the individual. While the principle is supported by leading cancer institutions, translating knowledge to practice confronts a lack of clarity about the meaning of risk stratification, uncertainties around the expectations the model holds for different actors, and health system structures that impede communication and coordination across the care continuum. These barriers must be better understood and addressed to pave the way for future implementation. Recognizing that an innovation is more likely to be adopted when user experience is incorporated into the planning process, a deliberative consultation was held as a preliminary step to developing a pilot project of risk-stratified pathways for patients transitioning from specialized oncology teams to primary care providers. This article presents findings from the deliberative consultation that sought to understand the perspectives of cancer specialists, primary care physicians, oncology nurses, allied professionals, cancer survivors and researchers regarding the following questions: what does a risk stratified model of cancer survivorship care mean to care providers and users? What are the prerequisites for translating risk stratification into practice? What challenges are involved in establishing these prerequisites? The multi-stakeholder consultation provides empirical data to guide actions that support the development of risk-stratified pathways to coordinate survivorship care.


Cureus ◽  
2020 ◽  
Author(s):  
Sukesh Manthri ◽  
Stephen A Geraci ◽  
Kanishka Chakraborty

2019 ◽  
Vol 35 (6) ◽  
pp. 1219-1226 ◽  
Author(s):  
Emily M. Geramita ◽  
Ira R. Parker ◽  
Jill W. Brufsky ◽  
Brenda Diergaarde ◽  
G. J. van Londen

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 84-84
Author(s):  
Joy M. Fulbright ◽  
Wendy McClellan ◽  
Gary C. Doolittle ◽  
Hope Krebill ◽  
Robin Ryan ◽  
...  

84 Background: Children's Mercy (CM) established a cancer survivorship clinic that cares for approximately 180 survivors a year. A third of the survivors are 18 years or older requiring transition to adult care. The importance of transitioning childhood cancer survivors from pediatric oncology care to adult primary care has been acknowledged in literature, but obstacles remain. Barriers include patient and provider anxiety, difficulty navigating the complex health care system and lack of knowledge regarding late effects. CM and The University of Kansas Cancer Center (KUCC) collaborated to decrease barriers to transition for childhood cancer survivors. Methods: The work group met for 2 years to develop the clinic at KUCC. Models and delivery of survivorship care, including the breast cancer survivorship clinic at KUCC, were reviewed. A shared nurse navigator was identified as an essential component to a seamless transition. Philanthropic support was obtained and job description was developed. Contracts were negotiated to allow the navigator to be present at both institutions. Results: The Survivorship Transition Clinic (STC) at KUCC launched July 2014, with a navigator supporting patients at CM as they begin their transition. The same navigator then meets with the patient at KUCC STC as they initiate care. The navigator provides treatment summaries, patient education and navigates the referral services for survivors. Since clinic launch, 16 survivors out of 16 have successfully transitioned from pediatric to adult survivorship care. Positive feedback was received from patient satisfaction surveys that were administered. A common theme showed a relief from anxiety due to having a contact person to facilitate communication among providers in a complex healthcare system. Conclusions: The nurse navigator has minimized anxiety about transition for patients and parents as she establishes a relationship with patients at CM, and then is able to provide continuity as they transition to the STC at KUMC. The navigator also improves communication between pediatric providers, adult primary care providers and sub-specialists caring for the patients. Overall, our transition process has been effective and is now serving as a model across both institutions.


2020 ◽  
Vol 105 (9) ◽  
pp. e3300-e3306 ◽  
Author(s):  
Archana Radhakrishnan ◽  
David Reyes-Gastelum ◽  
Brittany Gay ◽  
Sarah T Hawley ◽  
Ann S Hamilton ◽  
...  

Abstract Context While prior research has examined how primary care providers (PCPs) can care for breast and colon cancer survivors, little is known about their role in thyroid cancer survivorship. Objective To understand PCP involvement and confidence in thyroid cancer survivorship care. Design/Setting/Participants We surveyed PCPs identified by thyroid cancer patients from the Georgia and LA SEER registries (n = 162, response rate 56%). PCPs reported their involvement in long-term surveillance and confidence in handling survivorship care (role of random thyroglobulin levels and neck ultrasound, and when to end long-term surveillance and refer back to the specialist). We examined: 1) PCP-reported factors associated with involvement using multivariable analyses; and 2) bivariate associations between involvement and confidence in handling survivorship care. Main Outcome Measures PCP involvement (involved vs not involved) and confidence (high vs low). Results Many PCPs (76%) reported being involved in long-term surveillance. Involvement was greater among PCPs who noted clinical guidelines as the most influential source in guiding treatment (OR 4.29; 95% CI, 1.56-11.82). PCPs reporting high confidence in handling survivorship varied by aspects of care: refer patient to specialist (39%), role of neck ultrasound (36%) and random thyroglobulin levels (27%), and end long-term surveillance (14%). PCPs reporting involvement were more likely to report high confidence in discussing the role of random thyroglobulin levels (33.3% vs 7.9% not involved; P < 0.01). Conclusions While PCPs reported being involved in long-term surveillance, gaps remain in their confidence in handling survivorship care. Thyroid cancer survivorship guidelines that delineate PCP roles present one opportunity to increase confidence about their participation.


Author(s):  
P. Robinson ◽  
K. Rychlik ◽  
P. Mumby ◽  
S. Lo ◽  
K. Albain ◽  
...  

2017 ◽  
Vol 33 (6) ◽  
pp. 1323-1327 ◽  
Author(s):  
Callie Berkowitz ◽  
Deborah H. Allen ◽  
Jennifer Tenhover ◽  
Leah L. Zullig ◽  
John Ragsdale ◽  
...  

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14028-e14028
Author(s):  
Archana Radhakrishnan ◽  
David Reyes-Gastelum ◽  
Sarah T. Hawley ◽  
Ann S. Hamilton ◽  
Kevin C. Ward ◽  
...  

e14028 Background: While prior research has examined how primary care providers (PCPs) can help care for breast and colon cancer survivors, little is known about the role of PCPs in thyroid cancer survivorship. We surveyed PCPs to understand their involvement and confidence in providing several aspects of thyroid cancer survivorship care. Methods: Thyroid cancer patients (N = 2632) diagnosed in 2014-2015 and identified from the Georgia and LA SEER registries, were surveyed, and identified their PCPs, who then were also surveyed (N = 162, 56% response rate). PCPs were asked to report their: 1) involvement in thyroid cancer long-term surveillance (not involved: never/rarely vs. involved: sometimes/often/almost always involved); and 2) confidence in handling four aspects of thyroid cancer survivorship care (low: not at all/a little/somewhat vs. high: quite/very confident). We examined PCP factors (individual, practice, attitudes and beliefs) associated with PCP involvement in long-term surveillance using multivariable logistic regression. We then examined associations between PCP involvement in long-term surveillance and PCP confidence in handling the four aspects of thyroid cancer survivorship care using Chi-squared tests. Results: The majority of PCPs (76%) reported involvement in long-term surveillance. Adjusted odds of PCPs reporting involvement was greater among PCPs who somewhat/strongly believed that PCPs have the skills necessary to provide survivorship care (OR 4.33; 95% CI 1.38-15.37), and PCPs who noted clinical guidelines as being the most influential in guiding treatment (OR 4.48; 95% CI 1.67-13.07). PCP reports of high confidence in handling the four aspects of survivorship care were consistently less than 50%: when to refer patient to specialist (40%), role of neck ultrasound (36%), role of random thyroglobulin levels (27%), and when to end long-term surveillance (14%). PCPs who reported involvement in long-term surveillance were more likely to report high confidence in discussing the role of random thyroglobulin levels (33.3% vs. 7.9% for those not involved, p < 0.01) but not the other aspects of survivorship care. Conclusions: Though many PCPs reported they were involved in thyroid cancer long-term surveillance, gaps remain in their confidence in handling several aspects of thyroid cancer survivorship care. Guidelines were noted as important in influencing management; therefore, developing guidelines that specifically delineate PCP roles in thyroid cancer survivorship may present one opportunity to increase PCPs’ confidence about their participation.


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