Follow-up of curatively treated cancer in primary care: a qualitative study of the views of Dutch GPs

Geertje B. Liemburg · Joke C. Korevaar · Wouter TG van Zomeren · Annette J. Berendsen · Daan Brandenbarg

13 citations0/0 files storedBritish Journal of General Practice

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Healthcare Systems and Technology Cancer survivorship and care Primary Care and Health Outcomes

Abstract

BACKGROUND: Follow-up for cancer typically occurs in secondary care, and improved survival has increased demands on these services. Other care models may alleviate this burden, such as moving (parts of) follow-up care for curatively treated patients from secondary to primary care (care substitution). AIM: To explore the opinions of GPs regarding the potential benefits, barriers, and requirements of care substitution for breast and colorectal cancer. DESIGN AND SETTING: A qualitative study of the opinions of purposively sampled GPs in Dutch primary care. METHOD: Focus group sessions and individual semi-structured interviews were recorded and transcribed verbatim. Data were analysed by two independent researchers using thematic analysis. RESULTS: = 14) were conducted followed by nine individual interviews. Three main themes were identified: perceived benefits, perceived barriers, and perceived requirements. Perceived benefits included better accessibility and continuity of care, and care closer to patients' homes. Uncertainty about cancer-related competences and practical objections were perceived as barriers. Requirements included close specialist collaboration, support from patients for this change, and stepwise implementation to avoid loss of existing care quality. CONCLUSION: Most GPs reported that they were not in favour of complete care substitution, but that primary care could have greater formal involvement in oncological follow-up if there is close collaboration with secondary care (that is, shared care), support from patients, sufficient resource allocation, stepwise implementation with clear guidelines, and monitoring of quality. Clear and broadly supported protocols need to be developed and tested before implementing follow-up in primary care.

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References

2006Using thematic analysis in psychology 2007Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups 2014Standards for Reporting Qualitative Research 2006Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development 2000Qualitative research in health care: Analysing qualitative data 2016Primary Care Physicians’ Perspectives of Their Role in Cancer Care: A Systematic Review 1999Follow-up of breast cancer in primary care vs specialist care: results of an economic evaluation 2016Coordination of cancer care between family physicians and cancer specialists: Importance of communication.

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