scholarly journals Primary care-led survivorship care for patients with colon cancer and the use of eHealth: a qualitative study on perspectives of general practitioners

BMJ Open ◽  
2016 ◽  
Vol 6 (4) ◽  
pp. e010777 ◽  
Author(s):  
Laura A M Duineveld ◽  
Thijs Wieldraaijer ◽  
Jan Wind ◽  
Irma M Verdonck-de Leeuw ◽  
Henk C P M van Weert ◽  
...  
Keyword(s):  
Primary Care ◽  
Colon Cancer ◽  
Qualitative Study ◽  
General Practitioners ◽  
Survivorship Care

Improving service delivery to cancer survivors in primary care settings project.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 52-52
Author(s):  
Lewis E. Foxhall
Keyword(s):  
Primary Care ◽  
Colon Cancer ◽  
Cancer Survivors ◽  
Care Management ◽  
Survivorship Care ◽  
Behavioral Counseling ◽  
Colon Cancers ◽  
Screening And Prevention

52 Background: An estimated 14 million cancer survivors live in the U.S., with up to 18 million expected by 2020. Methods: We established a partnership with three Texas family medicine training programs to provide interactive educational sessions focused on survivors’ needs for primary prevention and lifestyle counseling, surveillance and screening, and prevention of psychosocial and long-term effects. Surveys assessing resident and PCP knowledge, self-efficacy, and practices regarding survivorship care management were administered through REDCap in July 2016 and 2017. Results: Baseline response rates were 64% (60/94) and 59% (55/93) at follow-up. Compared to baseline, providers at follow-up were significantly more likely to report being “very confident” in their knowledge about: appropriate surveillance to detect recurrent breast cancer (5% vs 24%; p = 0.01); long-term physical effects of colon cancer and its treatment (8% vs 18%; p = 0.04); potential adverse psychosocial outcomes of colon cancer treatment (24% vs 44%; p = 0.01); appropriate screening for new primary breast (29% vs 61%; p < 0.001) and colon cancers (27% vs 51%; p = 0.01); and preventive lifestyle/behavioral counseling for breast (39% vs 59%; p = 0.03) and colon cancers (37% vs 59%; p = 0.01). Participants were also more likely to “strongly agree” that they have the skills necessary to: provide follow-up care related to the colon cancer and its treatment (10% vs 28%; p = 0.02); initiate appropriate screening for other new primary cancers for breast (28% vs 56%; p < 0.01) and colon cancer survivors (28% vs 58%; p < 0.01); and conduct lifestyle/behavioral counseling to prevent cancer for breast (33% vs 53%; p = 0.03) and colon cancer survivors (34% vs 55%; p = 0.02). Conclusions: Preliminary results suggest our project has improved provider knowledge, self-efficacy, and practices regarding survivorship care management, with the highest levels in areas pertaining to screening and prevention. We aim to continue this trajectory of improvement in subsequent project years and disseminate the project to other primary care training sites in Texas and beyond.

Prescribing of SGLT2 inhibitors in primary care: A qualitative study of General Practitioners and Endocrinologists

2021 ◽  
Vol 180 ◽  
pp. 109036
Author(s):  
Tamara Y. Milder ◽  
Sophie L. Stocker ◽  
Melissa Baysari ◽  
Richard O. Day ◽  
Jerry R. Greenfield
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
General Practitioners ◽  
Sglt2 Inhibitors

scholarly journals Delivering colon cancer survivorship care in primary care; a qualitative study on the experiences of general practitioners

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Julien A. M. Vos ◽  
Robin de Best ◽  
Laura A. M. Duineveld ◽  
Henk C. P. M. van Weert ◽  
Kristel M. van Asselt
Keyword(s):  
Primary Care ◽  
Colon Cancer ◽  
Cancer Survivorship ◽  
Daily Practice ◽  
System Level ◽  
Normalisation Process Theory ◽  
Survivorship Care ◽  
Structured Interviews ◽  
Delivery Of Care ◽  
Roles And Responsibilities

Abstract Background With more patients in need of oncological care, there is a growing interest to transfer survivorship care from specialist to general practitioner (GP). The ongoing I CARE study was initiated in 2015 in the Netherlands to compare (usual) surgeon- to GP-led survivorship care, with or without access to a supporting eHealth application (Oncokompas). Methods Semi-structured interviews were held at two separate points in time (i.e. after 1- and 5-years of care) to explore GPs’ experiences with delivering this survivorship care intervention, and study its implementation into daily practice. Purposive sampling was used to recruit 17 GPs. Normalisation Process Theory (NPT) was used as a conceptual framework. Results Overall, delivering survivorship care was not deemed difficult and dealing with cancer repercussions was already considered part of a GPs’ work. Though GPs readily identified advantages for patients, caregivers and society, differences were seen in GPs’ commitment to the intervention and whether it felt right for them to be involved. Patients’ initiative with respect to planning, absence of symptoms and regular check-ups due to other chronic care were considered to facilitate the delivery of care. Prominent barriers included GPs’ lack of experience and routine, but also lack of clarity regarding roles and responsibilities for organising care. Need for a monitoring system was often mentioned to reduce the risk of non-compliance. GPs were reticent about a possible future transfer of survivorship care towards primary care due to increases in workload and financial constraints. GPs were not aware of their patients’ use of eHealth. Conclusions GPs’ opinions and beliefs about a possible future role in colon cancer survivorship care vary. Though GPs recognize potential benefit, there is no consensus about transferring survivorship care to primary care on a permanent basis. Barriers and facilitators to implementation highlight the importance of both personal and system level factors. Conditions are put forth relating to time, reorganisation of infrastructure, extra personnel and financial compensation. Trial registration Netherlands Trial Register; NTR4860. Registered on the 2nd of October 2014.

scholarly journals A preliminary qualitative study of general practitioners’ views on malnutrition management and oral nutritional supplementation prescription in the community

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Patricia Domínguez Castro ◽  
Sharon Kennelly ◽  
Barbara Clyne ◽  
Gerard Bury ◽  
Catriona Bradley ◽  
...  
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Qualitative Study ◽  
General Practitioners ◽  
Health Care Professionals ◽  
Inappropriate Prescribing ◽  
Community Setting ◽  
Community Dwelling ◽  
Care Community ◽  
Oral Nutritional Supplements

AbstractMalnutrition, arising from a deficiency of energy and protein intake, occurs commonly among community-dwelling individuals. Oral nutritional supplements (ONS) are an effective method of managing malnutrition if prescribed for patients who are malnourished or at risk of malnutrition. However, previous research indicates that inappropriate prescribing of ONS occurs frequently in the community setting (30–70% prevalence). Moreover, it has been previously shown that the management of patients ‘at risk’ of malnutrition in the primary care/community setting in Ireland is sub-optimal, with low awareness of the condition and its management among non-dietetic health care professionals (HCPs). In Ireland, general practitioners (GPs) are the main prescribers of ONS in primary care. They are also on many occasions the first point of contact for individuals in the community who are malnourished or at risk of malnutrition. Therefore, exploring their experiences and perceptions can provide insight into the complexities of managing malnutrition and ONS prescribing in the community. The aim of this qualitative study was to explore GPs’ experiences and opinions on the management of malnutrition and the prescription of ONS in the primary care/community setting in Ireland. Semi-structured interviews were conducted with nine GPs. The interview explored among others the following domains; Barriers and facilitators in the management of malnutrition, ONS prescribing in the primary care/community setting, and future directions in the management of malnutrition and ONS prescribing. Recorded interviews were transcribed and analysed using inductive thematic analysis. Three main themes were identified; i) Malnutrition a secondary concern, encapsulating the idea that malnutrition is not something that GPs screen for in isolation ii) Resources and support for managing malnutrition are needed in the community iii) Reluctance to prescribe ONS. GPs reported not screening for malnutrition, but viewed it as a consequence of other conditions and social factors. According to the GPs, they should not have sole responsibility for malnutrition management and more dietitians and trained community nurses would be desirable to support them to deal with malnutrition in the community. A preference to avoid supplementation and implement dietary changes first was expressed by GPs. As main prescribers, GPs thought that they should receive further independent trainingon the different ONS available in the market as currently they did not feel confident prescribing a range of them. Awareness of ONS cost and its misuse by certain patients were reported as reasons that made GPs reluctant to prescribe them, potentially leading to under prescribing.

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