TY - JOUR
T1 - Delivering colon cancer survivorship care in primary care; a qualitative study on the experiences of general practitioners
AU - Vos, Julien A.M.
AU - de Best, Robin
AU - Duineveld, Laura A.M.
AU - van Weert, Henk C.P.M.
AU - van Asselt, Kristel M.
N1 - Funding Information: The I CARE study is funded by the Dutch Cancer Society (KWF Kankerbestrijding/Stichting Alpe d’HuZes, grant BMA 5954). The funder of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of this report. Publisher Copyright: © 2022, The Author(s).
PY - 2022/1/17
Y1 - 2022/1/17
N2 - 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.
AB - 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.
KW - Cancer survivorship care
KW - Colon Cancer
KW - General practitioners
KW - Implementation sciences
KW - Normalisation process theory
KW - Primary health care
KW - Qualitative research
UR - http://www.scopus.com/inward/record.url?scp=85123005390&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12875-021-01610-w
DO - https://doi.org/10.1186/s12875-021-01610-w
M3 - Article
C2 - 35172743
SN - 2731-4553
VL - 23
JO - BMC primary care
JF - BMC primary care
IS - 1
M1 - 13
ER -