Characterizing the relationships between tertiary and community cancer providers: Results from a survey of medical oncologists in Southern California.
Adult
Aged
Aged, 80 and over
Attitude of Health Personnel
California
Cancer Care Facilities
/ organization & administration
Clinical Trials as Topic
Communication
Female
Hospitals, Community
/ organization & administration
Humans
Intersectoral Collaboration
Male
Middle Aged
Neoplasms
/ diagnosis
Oncologists
/ statistics & numerical data
Referral and Consultation
/ organization & administration
Surveys and Questionnaires
/ statistics & numerical data
Tertiary Care Centers
/ organization & administration
Clinical trials
community oncology
referrals
tertiary cancer center
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
12
05
2021
received:
12
04
2021
accepted:
14
06
2021
pubmed:
1
8
2021
medline:
19
2
2022
entrez:
31
7
2021
Statut:
ppublish
Résumé
Tertiary cancer centers offer clinical expertise and multi-modal approaches to treatment alongside the integration of research protocols. Nevertheless, most patients receive their cancer care at community practices. A better understanding of the relationships between tertiary and community practice environments may enhance collaborations and advance patient care. A 31-item survey was distributed to community and tertiary oncologists in Southern California using REDCap. Survey questions assessed the following attributes: demographics and features of clinical practice, referral patterns, availability and knowledge of clinical trials and precision medicine, strategies for knowledge acquisition, and integration of community and tertiary practices. The survey was distributed to 98 oncologists, 85 (87%) of whom completed it. In total, 52 (61%) respondents were community practitioners and 33 (38%) were tertiary oncologists. A majority (56%) of community oncologists defined themselves as general oncologists, whereas almost all (97%) tertiary oncologists reported a subspecialty. Clinical trial availability was the most common reason for patient referrals to tertiary centers (73%). The most frequent barrier to tertiary referral was financial considerations (59%). Clinical trials were offered by 97% of tertiary practitioners compared to 67% of community oncologists (p = 0.001). Most oncologists (82%) reported only a minimal-to-moderate understanding of clinical trials available at regional tertiary centers. Community oncologists refer patients to tertiary centers primarily with the intent of clinical trial enrollment; however, significant gaps exist in their knowledge of trial availability. Our results identify the need for enhanced communication and collaboration between community and tertiary providers to expand patients' access to clinical trials.
Sections du résumé
BACKGROUND
Tertiary cancer centers offer clinical expertise and multi-modal approaches to treatment alongside the integration of research protocols. Nevertheless, most patients receive their cancer care at community practices. A better understanding of the relationships between tertiary and community practice environments may enhance collaborations and advance patient care.
METHODS
A 31-item survey was distributed to community and tertiary oncologists in Southern California using REDCap. Survey questions assessed the following attributes: demographics and features of clinical practice, referral patterns, availability and knowledge of clinical trials and precision medicine, strategies for knowledge acquisition, and integration of community and tertiary practices.
RESULTS
The survey was distributed to 98 oncologists, 85 (87%) of whom completed it. In total, 52 (61%) respondents were community practitioners and 33 (38%) were tertiary oncologists. A majority (56%) of community oncologists defined themselves as general oncologists, whereas almost all (97%) tertiary oncologists reported a subspecialty. Clinical trial availability was the most common reason for patient referrals to tertiary centers (73%). The most frequent barrier to tertiary referral was financial considerations (59%). Clinical trials were offered by 97% of tertiary practitioners compared to 67% of community oncologists (p = 0.001). Most oncologists (82%) reported only a minimal-to-moderate understanding of clinical trials available at regional tertiary centers.
CONCLUSIONS
Community oncologists refer patients to tertiary centers primarily with the intent of clinical trial enrollment; however, significant gaps exist in their knowledge of trial availability. Our results identify the need for enhanced communication and collaboration between community and tertiary providers to expand patients' access to clinical trials.
Identifiants
pubmed: 34331372
doi: 10.1002/cam4.4119
pmc: PMC8366095
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5671-5680Subventions
Organisme : NCI NIH HHS
ID : P30 CA033572
Pays : United States
Informations de copyright
© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
J Clin Med. 2020 Jul 06;9(7):
pubmed: 32640668
J Clin Med. 2020 May 17;9(5):
pubmed: 32429554
J Oncol Pract. 2011 May;7(3):172-7
pubmed: 21886499
J Clin Med. 2020 Sep 15;9(9):
pubmed: 32942638
J Clin Med. 2020 Jun 24;9(6):
pubmed: 32599694
J Clin Med. 2020 Jun 11;9(6):
pubmed: 32545244
JAMA. 2007 Feb 28;297(8):831-41
pubmed: 17327525
Med J Aust. 1998 Jul 20;169(2):73-6
pubmed: 9700340
Cancer. 2006 Jan 15;106(2):426-33
pubmed: 16353206
J Clin Med. 2021 Jan 07;10(2):
pubmed: 33430334
Ann Surg Oncol. 2016 Jul;23(7):2146-52
pubmed: 26790668
Am Soc Clin Oncol Educ Book. 2016;35:185-98
pubmed: 27249699
J Am Med Inform Assoc. 2018 May 1;25(5):458-464
pubmed: 29315417
JAMA Netw Open. 2020 May 1;3(5):e203942
pubmed: 32453382
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
J Clin Oncol. 2002 Apr 15;20(8):2109-17
pubmed: 11956272
JCO Oncol Pract. 2020 Sep;16(9):e849-e858
pubmed: 32240068
Trends Cancer. 2018 Dec;4(12):793-796
pubmed: 30470299
J Clin Med. 2020 Jun 24;9(6):
pubmed: 32599960
J Clin Oncol. 2017 Feb 20;35(6):636-644
pubmed: 27937091
J Surg Oncol. 2019 Jul;120(1):85-92
pubmed: 30650186
JAMA Netw Open. 2019 Sep 4;2(9):e1910593
pubmed: 31483471
Am Soc Clin Oncol Educ Book. 2017;37:160-169
pubmed: 28561651
World J Urol. 2020 May;38(5):1187-1193
pubmed: 31420696
Cancer Med. 2021 Aug;10(16):5671-5680
pubmed: 34331372
J Oncol Pract. 2019 Aug;15(8):e690-e703
pubmed: 31162996
J Clin Epidemiol. 2001 Mar;54(3):217-24
pubmed: 11223318
Cancer. 2015 Nov 1;121(21):3885-93
pubmed: 26218755
J Oncol Pract. 2015 Mar;11(2):e154-62
pubmed: 25549653
J Clin Med. 2020 Jun 02;9(6):
pubmed: 32498251