scholarly journals Rural Primary Care Providers’ Perceptions of Their Role in the Breast Cancer Care Continuum

2010 ◽  
Vol 26 (2) ◽  
pp. 189-195 ◽  
Author(s):  
Kathleen M. Rayman ◽  
Joellen Edwards
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Breast Cancer Care ◽  
Care Continuum ◽  
Rural Primary Care ◽  
Cancer Care Continuum

scholarly journals Involvement of Primary Care Physicians in the Decision Making and Care of Patients With Breast Cancer

2016 ◽  
Vol 34 (33) ◽  
pp. 3969-3975 ◽  
Author(s):  
Lauren P. Wallner ◽  
Paul Abrahamse ◽  
Jaspreet K. Uppal ◽  
Christopher R. Friese ◽  
Ann S. Hamilton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Decision Making ◽  
Cancer Care ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Treatment Decisions ◽  
Care Providers ◽  
Breast Cancer Care ◽  
Patient Reported

Purpose Collaborative care between cancer specialists and primary care providers (PCPs) may improve the delivery of high-quality cancer care. Yet, patient perspectives about how involved the PCPs were in their breast cancer care and treatment decisions remain unknown. Patients and Methods A weighted random sample of women newly diagnosed with breast cancer in 2013 to 2014, as reported to the SEER registries in Los Angeles, California, and Georgia, were sent a survey approximately 6 months after diagnosis (N = 2,279, 71% response rate). The distributions of patient-perceived PCP quality (six questions about PCP access and awareness of values) and the following three measures of patient-reported PCP involvement were assessed: how informed the respondent felt her PCP was about her breast cancer (engagement); how often the respondent talked with her PCP (communication); and how often the respondent felt the PCP participated in treatment decisions (participation). Adjusted mean scores of patient-reported satisfaction with and deliberation about the surgical treatment decision were then compared across levels of PCP engagement, communication, and participation using multivariable linear regression. Results The majority of women in this sample perceived high PCP quality (63.6%), high PCP breast cancer engagement (66.2%), and high PCP communication (69.1%). More than a third of women (35.4%) reported that their PCP participated in their treatment decisions. Higher PCP engagement was associated with higher decision satisfaction when compared with low PCP engagement (adjusted P = .003). Conclusion Patient perceptions of PCP quality and PCP involvement in breast cancer care during treatment are high for most women, and PCPs often participate in breast cancer treatment decisions. However, PCP involvement did not lead to meaningful improvements in patients’ appraisals of their decision making.

Identifying challenges to breast cancer care coordination at urban community-based primary care clinics.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 83-83
Author(s):  
Tamara Hamlish ◽  
Zakiya N Moton ◽  
Zuoli Zhang ◽  
Dana Sohmer ◽  
Olufunmilayo I. Olopade ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Care Coordination ◽  
Cancer Care ◽  
Medical Records ◽  
Primary Care Providers ◽  
Primary Care Visit ◽  
Patient Centered ◽  
Care Continuum ◽  
Cancer Specialists

83 Background: Primary care providers (PCPs) are well positioned to play a significant role in improving cancer care in the U.S. and achieving the Institute of Medicine (IOM) recommendation for patient-centered, coordinated, comprehensive cancer care across the care continuum. This is particularly important in underserved communities where fragmented care contributes to widening disparities in cancer mortality. However, PCPs can face considerable challenges delivering cancer care. This research examines challenges to breast cancer survivorship (BCS) care coordination at federally qualified health centers (FQHCs). Methods: We conducted a chart review at five Chicago FQHCs to assess BCS-related follow-up care provided by PCPs. We reviewed patient electronic medical records for documentation of breast cancer-related health information by the PCP and for documentation from cancer specialists, including consultant notes, pathology reports, and treatment histories. Based on BC ICD -9 codes we identified 109 patients who had a BC diagnosis within five years and a primary care visit at one of the five FQHCS within 2 years. Results: The patient population was primarily comprised of African Americans (81%), with 16% Hispanic, and 4% Asian or non-Hispanic White. Mean age at diagnosis was 55 years with 30% diagnosed < 50 years. Medicaid (59%) was the most common health insurance. More than half of the patients had ≥1 chronic disease. Critical clinical BC information was missing from patient medical records, including BC pathology (65%), mammogram (60%), last clinical breast examination (49%), and cancer specialist notes (45%). Documentation of family history and genetic counseling were missing from 76% and 98% of the records, respectively. Conclusions: Our data indicate that PCPs at FQHCs currently have a limited role in delivering IOM recommended patient-centered, coordinated, comprehensive cancer care across the care continuum. The research results underscore a need for improvement in two key areas: 1) support for PCPs to build capacity in BCS care and 2) enhanced communication and care coordination between cancer specialists and PCPS in order to make PCPs an active part of the BCS care team.

Breast Cancer Follow-Up: Strategies for Successful Collaboration between Cancer Care Specialists and Primary Care Providers

2010 ◽  
Vol 6 (6) ◽  
pp. 452-463
Author(s):  
Mary Ann Zalewski ◽  
Susan Beikman ◽  
Shannon Ferrari ◽  
Kathleen Slavish ◽  
Margaret Rosenzweig
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Successful Collaboration

scholarly journals Development of a Modular Mobile Health App for Personalized Rehabilitation in the Breast Cancer Care Continuum (Preprint)

2020 ◽  
Author(s):  
Ji Young Lim ◽  
Jong Kwang Kim ◽  
Yoon Kim ◽  
So-Yeon Ahn ◽  
Jonghan Yu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mobile Health ◽  
Cancer Care ◽  
Medical Information ◽  
Mobile App ◽  
Self Management ◽  
User Evaluation ◽  
Breast Cancer Care ◽  
Care Continuum ◽  
Cancer Care Continuum

BACKGROUND Although many mobile health (mHealth) apps as a support tool for self-management of breast cancer have evolved, limited studies have developed a comprehensive app and described the algorithms for personalized rehabilitation in the breast cancer care continuum. OBJECTIVE This study aimed to develop a comprehensive mobile app and an algorithm that adjust personalized content to facilitate self-management throughout the breast cancer care continuum. METHODS The development process of the modular app included the following six steps: (1) organizing expert teams, (2) defining evidence-based fundamental content and modules, (3) classifying user cases according to surgery type and treatment, (4) describing algorithms of the key modules for personalized content, (5) constructing the app platform and connectivity to digital health care devices, and (6) conducting a user evaluation of the key modules using needs and satisfaction questionnaires after app testing. RESULTS The expert teams developed algorithms and the mHealth app to dynamically adjust the content for individual patients throughout the breast cancer care continuum. The review of the related literature, and guidelines and the development of the app took 18 months. User evaluation outcomes were positive, with needs and satisfaction questionnaire scores of 4.4 and 4.1 of 5, respectively. The ranking results demonstrated that personalized exercise was the most needed feature with the highest satisfaction score. CONCLUSIONS The strength of this study was the development of a comprehensive mHealth app and algorithms for adjusting content based on user medical information for personalized rehabilitation during the breast cancer care continuum and obtaining positive user evaluation results.

scholarly journals CanIMPACT: Understanding complexities, variation, and disparities in the breast cancer care continuum in Five Canadian provinces using administrative data

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Patti Groome ◽  
Marcy Winget ◽  
Li Jiang ◽  
Kathleen Decker ◽  
Cynthia Kendell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Data Processing ◽  
Cancer Care ◽  
Local Context ◽  
Longitudinal Analyses ◽  
Breast Cancer Care ◽  
Common Data Elements ◽  
Care Continuum ◽  
Cancer Care Continuum ◽  
Canadian Provinces

ABSTRACT ObjectiveCanIMPACT is a multi-province Canadian research team funded to understand the interplay between primary and oncology breast cancer care. A first step was to describe current practice and inter/intra-provincial care variation across the care continuum using provincial administrative health data. Here we describe the inter-provincial process and analysis plans. ApproachOur multi-disciplinary team includes five Canadian provinces: British Columbia, Alberta, Manitoba, Ontario and Nova Scotia. Cohorts consist of all breast cancers diagnosed from 2007 to at least 2011 in each of the five provinces. Common databases include cancer registries, census area-level income and rurality, outpatient physician claims, ambulatory care and inpatient hospitalizations. Other databases with laboratory, pharmacy, emergency services, and immigration data were available in some provinces. Common data elements across provincial datasets were identified, and a standardized methodology was developed. ResultsCommon data processing and analysis plans were finalized over 24 months; provinces refined details as per local context while maximizing methodological comparability. Basic descriptive analyses plus 18 phase-specific and 3 longitudinal analyses have been planned. Six plans for the diagnostic phase focus on identifying modifiable disparities in access and outcomes; 8 plans for the treatment phase focus on variation in chemotherapy treatment patterns, quality/safety, and utilization of primary care services; 4 plans for the survivorship phase focus on adherence to guidelines for follow-up breast cancer care, other chronic diseases and preventive care; 3 longitudinal analyses assess factors related to changes in utilization of chronic disease services over the cancer care continuum. ConclusionsWe have shown it is feasible to develop and standardize data processing and analyses across multiple provinces to address important cancer care questions across the continuum. This work will inform comparisons and improvements in Canadian cancer care. This effort has also helped increase research capacity in health services research.

Primary care provider engagement about breast cancer care during treatment: Results from the iCanCare Study.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 101-101
Author(s):  
Lauren P. Wallner ◽  
Paul Abrahamse ◽  
Christopher Ryan Friese ◽  
Steven J. Katz ◽  
Sarah T. Hawley
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Los Angeles ◽  
Collaborative Care ◽  
Cancer Care ◽  
Primary Care Providers ◽  
Current Response ◽  
Care Providers ◽  
Breast Cancer Patients ◽  
High Quality

101 Background: Collaborative care between cancer specialists and primary care providers (PCP) ensures high quality cancer care. Yet, little is known about patient’s perspectives about the level of PCP engagement in and communication about breast cancer (BC) care during treatment. Methods: A weighted random sample of newly diagnosed breast cancer patients in the Georgia and Los Angeles SEER registries were surveyed approximately 6 months after diagnosis (expected final N = 2600, 70% current response rate). PCP BC engagement and communication were defined using 2 outcome measures (categorized as less (never/rarely) vs. more (sometimes/often/always)): how informed the respondent’s PCP was about BC treatment and how often respondents talked with their PCP about their BC care visits. Overall PCP quality was assessed by averaging patient responses (5 categories, never to always) to 5 questions: ease of access to PCP (3 questions) and PCP’s awareness of patient values (2 questions) and categorized as high ( ≥ 4), moderate (3) and low ( < 3). The associations between patient factors and PCP quality with BC engagement and communication were evaluated using multivariable logistic regression. Results: In a preliminary sample (N = 2054), the majority of women reported high PCP quality (63%), high PCP BC engagement (65%) and communication (68%). (Table) Women who reported less PCP BC engagement were more likely to report low PCP quality (OR: 15.7, 95%CI: 9.5, 25.9;) and chemotherapy use (OR: 1.3, 95%CI: 1.1, 1.6), adjusting for age, race, insurance, comorbidities and PCP continuity. The results were similar for PCP communication. Conclusions: Patient perceptions of PCP quality, engagement and communication during BC treatment are high for most women with BC. However, there remains opportunity for improvement in both, as many women report poor engagement and communication despite perceiving high quality primary care. Targeting these patients and their clinicians may be particularly effective in interventions to improve collaborative care in cancer. [Table: see text]

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