scholarly journals Understanding the Attitudes and Beliefs of Oncologists Regarding the Transitioning and Sharing of Survivorship Care

2021 ◽  
Vol 28 (6) ◽  
pp. 5452-5465
Author(s):  
Courtney H. Coschi ◽  
Daryl Bainbridge ◽  
Jonathan Sussman
Keyword(s):  
Primary Care Physicians ◽  
Health Needs ◽  
Attitudes And Beliefs ◽  
Willingness To Participate ◽  
Survivorship Care ◽  
Prospective Survey ◽  
Effective Interventions ◽  
Care Models ◽  
Specific Factors ◽  
Longitudinal Relationships

Transitioning survivorship care from oncologists to primary care physicians (PCPs) is a reasonable alternative to oncologist-led care. This study assessed oncologists’ attitudes and beliefs regarding sharing/transitioning survivorship care. A prospective survey of oncologists within a regional cancer program assessing self-reported barriers and facilitators to sharing/transitioning survivorship care was disseminated. In total, 63% (n = 39) of surveyed oncologists responded. Patient preference (89%) and anxiety (84%) are key to transition of care decisions; reduced remuneration (95%) and fewer longitudinal relationships (63%) do not contribute. Oncologists agreed that more patients could be shared/transitioned. Barriers include treatment-related toxicities (82% agree), tumor-specific factors (60–90% agree) and perception of PCP willingness to participate in survivorship care (47% agree). Oncologists appear willing to share/transition more survivors to PCPs, though barriers exist that warrant further study. Understanding these issues is critical to developing policies supporting comprehensive survivorship care models that address both cancer and non-cancer health needs. The demonstrated feasibility of this project warrants a larger-scale survey of oncologists with respect to the transition of survivorship care to PCPs, to further inform effective interventions to support high-quality survivorship care.

Survivorship model of care at a large National Cancer Institute.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 37-37
Author(s):  
Smitha Pabbathi ◽  
Mary Ann Morgan
Keyword(s):  
Primary Care Physicians ◽  
Full Time ◽  
Survivorship Care ◽  
Advantages And Disadvantages ◽  
Steady Growth ◽  
Care Models ◽  
Seer Data ◽  
Part Time ◽  
Breast And Prostate Cancer ◽  
Age Range

37 Background: There is a lack of existing evidence on survivorship care models and their advantages and disadvantages when it comes to improving health outcomes. We describe the evolution of a Survivorship Care model at a large NCI designated Cancer Institute. Our model is closest to ASCO’s description of General Survivorship Clinic/Shared Care. The Clinic is led by a full time nurse practitioner and two part time internists. Initial start-up expenses were provided by Foundation funds Methods: Aggregate data was requested from Information Shared Services. Data was extracted from both Billing from Transmed-HRI and the Cancer Registry from the time period of May 2011 to August 2015 to identify patients who have been followed in the long-term Survivorship clinic. Results: Our program initially focused on breast and prostate cancer populations based on SEER data of cancer survivors and risk-stratification. Twelve other cancer types are now referred resulting in steady growth. A review of our patient population revealed 924 unique patients of which 619 were female and 305 male. Fifty-nine patients fell in the age range 20-44, 445 in the age range 45-65, and 420 > 65 age. Over fifty percent of our patients are from the Breast Program; the next largest population is Genito-Urinary and third largest group is Digestive. The patients racially identified as white are 89%, 6.3% black, 2.7% as other, 2% unknown. This is consistent with the center population. Eighty patients had recurrences or new primaries. Conclusions: The number of referrals has grown every year and the majority of patients continue to be followed annually. Patients do not feel lost in transition because we have a team based approach as the parent program exists within the institution. Our model not only allows our oncologists to focus on new patients and those with recurrent or metastatic disease but it can help bridge survivorship care from the oncologist to primary care physicians in the community. This type of clinic will also facilitate evaluation and treatment of late effects such as anthracyclines and pelvic radiation across diseases for management of symptoms.

scholarly journals Gastrointestinal Disease–Specific Survivorship Care: A New Personalized Model Integrating Onco-Wellness

2021 ◽  
Vol 28 ◽  
pp. 107327482110060
Author(s):  
Tai Hutchinson ◽  
Sarah Hoffe ◽  
Sabrina Saeed ◽  
Sonya A. Pflanzer ◽  
Jason B. Fleming ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Active Treatment ◽  
Primary Care Physicians ◽  
Gastrointestinal Disease ◽  
Care Plan ◽  
Survivorship Care ◽  
Psychosocial Needs ◽  
Care Continuum ◽  
Gi Cancer ◽  
Care Models

Although the number of gastrointestinal (GI) cancer survivors is projected to increase in the coming years, there are currently no survivorship care models that address the specific and growing needs of this population. Current survivorship care models were evaluated to assess their suitability for GI cancer survivors. A survivorship care model based on foundational wellness principles is under development to address the specific needs of GI cancer survivors. This model delivers a cohesive and collaborative care continuum for survivors of different GI malignancies. Oncology providers in GI departments and internal medicine providers in survivorship programs are positioned to provide a comprehensive approach for the care of patients treated with curative intent. Survivorship care is introduced at the conclusion of active treatment in the form of an Onco-wellness consultation, an in-person or telemedicine comprehensive care plan creation and review by our Survivorship Program. Personalized care plan including long term and late effects of treatment, nutrition, physical activity and rehabilitation recommendations, prevention of secondary malignancies and psychosocial needs are reviewed. As patients transition from active treatment to survivorship within the GI Program, the GI Advance Practice Professionals (APPs) are well-positioned to deliver comprehensive survivorship care specific to the GI patient’s needs while integrating recommendations and principles from the Onco-wellness consultation. With projected shortages of both oncology and primary care physicians, such an APP-based model has the potential to bridge gaps in the survivorship care continuum and mutually benefit patients and physicians.

Delivery of Survivorship Care by Primary Care Physicians: The Perspective of Breast Cancer Patients

2009 ◽  
Vol 27 (6) ◽  
pp. 933-938 ◽  
Author(s):  
Jun J. Mao ◽  
Marjorie A. Bowman ◽  
Carrie T. Stricker ◽  
Angela DeMichele ◽  
Linda Jacobs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Primary Care Physicians ◽  
Multivariate Regression ◽  
Care Delivery ◽  
Postmenopausal Breast Cancer ◽  
The United States ◽  
Cancer Therapies ◽  
Survivorship Care ◽  
General Care

Purpose Most of the 182,460 women diagnosed with breast cancer in the United States this year will become long-term survivors. Helping these women transition from active treatment to survivorship is a challenge that involves both oncologists and primary care physicians (PCPs). This study aims to describe postmenopausal breast cancer survivors' (BCS) perceptions of PCP-related survivorship care. Patients and Methods We conducted a cross-sectional survey of 300 BCSs seen in an outpatient breast oncology clinic at a large university hospital. The primary outcome measure was a seven-item self-reported measure on perceived survivorship care (Cronbach's α = .89). Multivariate regression analyses were used to identify factors associated with perceived care delivery. Results Overall, BCSs rated PCP-related survivorship care as 65 out of 100 (standard deviation = 17). The areas of PCP-related care most strongly endorsed were general care (78%), psychosocial support (73%), and health promotion (73%). Fewer BCSs perceived their PCPs as knowledgeable about cancer follow-up (50%), late effects of cancer therapies (59%), or treating symptoms related to cancer or cancer therapies (41%). Only 28% felt that their PCPs and oncologists communicated well. In a multivariate regression analysis, nonwhite race and level of trust in the PCP were significantly associated with higher perceived level of PCP-related survivorship care (P = .001 for both). Conclusion Although BCSs perceived high quality of general care provided by their PCPs, they were not as confident with their PCPs' ability to deliver cancer-specific survivorship care. Interventions need to be tested to improve oncology-primary care communication and PCP knowledge of cancer-specific survivorship care.

Introducing physician associates

2017 ◽  
Vol 10 (12) ◽  
pp. 746-753
Author(s):  
Susan Denton ◽  
Krishni Manorajan ◽  
Pahim Miah
Keyword(s):  
Medical Profession ◽  
Healthcare Delivery ◽  
Health Needs ◽  
Delivery Of Healthcare ◽  
The Public ◽  
Health Delivery ◽  
Care Models ◽  
The Uk ◽  
Multi Disciplinary Team

Physician associate (PA) is a new profession that has the potential to change healthcare delivery in the UK. However, it is poorly understood by both the medical profession and the public. Evolving health needs, patient expectations, treatment and delivery of healthcare have led to proposed new care models that require a different skill mix to underpin health delivery. We explore the role of PAs, who as part of a multi-disciplinary team while being supervised by doctors, can help support a sustainable future for primary care.

Novel approaches to support breast cancer survivorship care models

The Breast ◽  
2017 ◽  
Vol 36 ◽  
pp. 1-13 ◽  
Author(s):  
Kelly C. Gast ◽  
Summer V. Allen ◽  
Kathryn J. Ruddy ◽  
Tufia C. Haddad
Keyword(s):  
Breast Cancer ◽  
Cancer Survivorship ◽  
Survivorship Care ◽  
Breast Cancer Survivorship ◽  
Care Models ◽  
Novel Approaches

Delivery of survivorship care from rural primary care and oncology practices.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 85-85
Author(s):  
Jennifer R. Klemp ◽  
Becky N. Lowry ◽  
Judy A Johnston ◽  
Kyla Alsman ◽  
Danielle Peereboom ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Cancer Center ◽  
Successful Implementation ◽  
Evidence Based ◽  
Survivorship Care ◽  
Rural Primary Care ◽  
Education Of Patients ◽  
Office Management ◽  
Primary Care Practices

85 Background: While evidence-based guidelines for survivorship care exist, implementation in oncology and primary care practices has fallen short. There is little evidence of the barriers preventing successful implementation in rural primary care and oncology practices. We sought to assess knowledge gaps and barriers to successful implementation of evidence-based survivorship care guidelines in rural Kansas practices. Methods: Midwest Cancer Alliance, outreach arm of the University of Kansas Cancer Center, and Kansas Patients and Providers Engaged in Prevention Research, completed interviews in rural primary care and oncology practices. Results: Primary Care (n=7) and Oncology Practices (n=4): Interviews with primary care physicians, medical oncologists, advanced practice providers, nurses, tumor registrar, outreach coordinator, and office management & staff. Conclusions: Rural primary care and oncology practices experienced barriers to delivering survivorship care including: educational gaps, communication of history, treatment, and recommendations, EHR integration, and lack of resources. Next steps focus on a unified approach to state-wide survivorship education of patients, primary care and oncology practices. [Table: see text]

The optimal living and survivorship program: Piloting a novel survivorship care model.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 40-40
Author(s):  
Stacie Corcoran ◽  
John Russell ◽  
Jill Clayton ◽  
Bridget Kelly ◽  
Andrea Smith ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Unmet Need ◽  
Multidisciplinary Care ◽  
Post Treatment ◽  
Survivorship Care ◽  
Care Model ◽  
Supportive Services ◽  
Care Models ◽  
After Cancer

40 Background: Multiple agencies define cancer survivorship as beginning at the time of diagnosis. However, traditional care models deliver “survivorship care” months or years after diagnosis, which can cause care disruption and “transition anxiety”. We hypothesized that an approach centered around wellbeing could be applied across the cancer continuum (starting at diagnosis) and serve as a novel survivorship care model. Methods: We developed the Optimal Living and Survivorship Program with 3 key components: 1) a centralized model that provides multidisciplinary care; 2) an individualized Wellness Plan (WP); and 3) enrollment at the time of diagnosis to mitigate post-treatment transition. Participants complete a digital wellness questionnaire (WQ) prior to the 1st medical oncology consult, receive a validated algorithm-based WP, and meet with a Wellness Advanced Practice Provider (WAPP). The WP consists of individualized education and referrals (e.g., nutrition, exercise, financial counseling). The WAPP will assume post-treatment (“survivorship”) care. We piloted this approach in patients diagnosed with breast cancer beginning in 11/19. The primary outcome is feasibility defined by completion of the WQ. Secondary outcomes include participation in the WAPP visits, attendance at appointments, and quality of life (QOL). Results: Due to COVID-19, the pilot was paused in 2/20. Data collected from 11/19 through 2/20 reveal a total of 67 eligible patients with newly diagnosed breast cancer were approached, with 65 enrolled. All participants completed the WQ and all received a WP with supportive referrals and educational resources. All participants engaged with WP recommendations. Participants were screened at high risk for an average of 3.8 unmet needs, and 98% were at high risk for 2 or more needs at time of diagnosis. Exercise was the highest unmet need (83%). There was 76% adherence with referral to the program’s Exercise Physiologist. Other areas of needs were nutrition (59%) and sleep quality (51%). WAPP tele-visits began in 6/20; visit completion rates will be presented. Qualitative data regarding patient experience and QOL will be obtained via interviews and feedback will be categorized in thematic domains. Conclusions: Most patients enrolled in the program, completed a WQ and engaged with the WP. Our findings suggest that this early intro to survivorship is feasible. Earlier engagement and incorporation of wellness and supportive services from time of diagnosis may improve our ability to address multifactorial needs during and after cancer therapy.

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