Primary Care Physician Perspectives on Caring for Adult Survivors of Hematologic Malignancies and Hematopoietic Cell Transplantation.
Cancer survivor
Care delivery
Late complications
Models of care
Provider education
Journal
Clinical lymphoma, myeloma & leukemia
ISSN: 2152-2669
Titre abrégé: Clin Lymphoma Myeloma Leuk
Pays: United States
ID NLM: 101525386
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
28
07
2019
revised:
16
10
2019
accepted:
05
11
2019
pubmed:
8
12
2019
medline:
13
5
2021
entrez:
8
12
2019
Statut:
ppublish
Résumé
Primary care physicians (PCPs) may face barriers to caring for hematologic malignancy and hematopoietic cell transplantation (HCT) survivors. A Web-based survey consisting of 40 questions and 2 case scenarios was administered to 302 PCPs at 2 large integrated health care systems. The questionnaire assessed perceived barriers to delivery of care to hematologic malignancy/HCT survivors, resources available to care for cancer survivors, practices for care coordination with hematologist-oncologists, and preferred models of care delivery. Overall response rate was 30% (n = 86). PCPs reported several barriers such as lack of resources to facilitate care (69%), lack of awareness of screening/prevention guidelines (55%) and psychosocial needs of survivors (65%), inadequate time (65%), and patient preference to follow up with their oncologists (66%). They expressed confidence in caring for general medical issues (84%) and general cancer screening (73%), but they preferred that oncologists manage cancer-related medical issues (42%) as well as screen for cancer recurrence (52%) and secondary cancers (55%). In multivariable analysis, PCPs who had previously cared for a large number of hematologic malignancy/HCT survivors and those with a longer time since graduation from medical school had greater confidence in managing cancer-related medical issues. PCPs report several barriers in providing care to hematologic malignancy/HCT survivors. Clinical experience with this patient population is associated with greater confidence in providing survivorship care. Several barriers identified by PCPs in providing survivorship care to hematologic malignancy/HCT survivors are potentially addressable by education and clinical decision support tools and guidelines, thereby enhancing the patients' clinical experience and care coordination with hematologist-oncologists.
Sections du résumé
BACKGROUND
Primary care physicians (PCPs) may face barriers to caring for hematologic malignancy and hematopoietic cell transplantation (HCT) survivors.
METHODS
A Web-based survey consisting of 40 questions and 2 case scenarios was administered to 302 PCPs at 2 large integrated health care systems. The questionnaire assessed perceived barriers to delivery of care to hematologic malignancy/HCT survivors, resources available to care for cancer survivors, practices for care coordination with hematologist-oncologists, and preferred models of care delivery.
RESULTS
Overall response rate was 30% (n = 86). PCPs reported several barriers such as lack of resources to facilitate care (69%), lack of awareness of screening/prevention guidelines (55%) and psychosocial needs of survivors (65%), inadequate time (65%), and patient preference to follow up with their oncologists (66%). They expressed confidence in caring for general medical issues (84%) and general cancer screening (73%), but they preferred that oncologists manage cancer-related medical issues (42%) as well as screen for cancer recurrence (52%) and secondary cancers (55%). In multivariable analysis, PCPs who had previously cared for a large number of hematologic malignancy/HCT survivors and those with a longer time since graduation from medical school had greater confidence in managing cancer-related medical issues.
CONCLUSION
PCPs report several barriers in providing care to hematologic malignancy/HCT survivors. Clinical experience with this patient population is associated with greater confidence in providing survivorship care. Several barriers identified by PCPs in providing survivorship care to hematologic malignancy/HCT survivors are potentially addressable by education and clinical decision support tools and guidelines, thereby enhancing the patients' clinical experience and care coordination with hematologist-oncologists.
Identifiants
pubmed: 31810888
pii: S2152-2650(19)32105-6
doi: 10.1016/j.clml.2019.11.008
pmc: PMC7023983
mid: NIHMS1542884
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
70-77Subventions
Organisme : NCI NIH HHS
ID : R01 CA215134
Pays : United States
Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.
Références
Leukemia. 2017 Mar;31(3):728-731
pubmed: 27795559
Cancer Epidemiol Biomarkers Prev. 2007 Apr;16(4):834-9
pubmed: 17416780
J Cancer Surviv. 2014 Dec;8(4):565-70
pubmed: 24820428
Haematologica. 2019 May;104(5):1084-1092
pubmed: 30514795
J Cancer Surviv. 2015 Jun;9(2):180-7
pubmed: 25216608
Biol Blood Marrow Transplant. 2013 Oct;19(10):1498-501
pubmed: 23906634
J Oncol Pract. 2015 Jan;11(1):e19-27
pubmed: 25205779
J Clin Oncol. 2013 Jul 1;31(19):2437-49
pubmed: 23715573
Biol Blood Marrow Transplant. 2019 Mar;25(3):562-569
pubmed: 30315940
Bone Marrow Transplant. 2013 Sep;48(9):1145-51
pubmed: 23292238
Biol Blood Marrow Transplant. 2013 Jul;19(7):1116-23
pubmed: 23660172
J Clin Oncol. 2006 Nov 10;24(32):5117-24
pubmed: 17093273
Biol Blood Marrow Transplant. 2012 Mar;18(3):348-71
pubmed: 22178693
Curr Oncol. 2011 Oct;18(5):e218-26
pubmed: 21980253
CA Cancer J Clin. 2014 Mar-Apr;64(2):83-103
pubmed: 24488779
Blood. 2008 Mar 1;111(5):2516-20
pubmed: 17975015
J Clin Oncol. 2011 Jun 1;29(16):2230-9
pubmed: 21464398
Biol Blood Marrow Transplant. 2017 May;23(5):717-725
pubmed: 27713091
Fam Med. 2013 Jul-Aug;45(7):463-74
pubmed: 23846965
Biol Blood Marrow Transplant. 2015 Jan;21(1):142-50
pubmed: 25445638
Semin Hematol. 2016 Jul;53(3):209-15
pubmed: 27496313
Am Soc Clin Oncol Educ Book. 2016;35:231-9
pubmed: 27249703
Blood Adv. 2017 Aug 22;1(19):1617-1627
pubmed: 29296802
Bone Marrow Transplant. 2013 Jun;48(6):865-71
pubmed: 23222378
J Cancer Surviv. 2013 Sep;7(3):343-54
pubmed: 23526165
J Clin Oncol. 2013 Jun 20;31(18):2322-36
pubmed: 23690429
J Clin Oncol. 2010 Feb 20;28(6):1011-6
pubmed: 20065176