Skip to main content
Erschienen in: Supportive Care in Cancer 10/2020

03.02.2020 | Original Article

Knowledge and self-efficacy for caring for breast and colon cancer survivors among safety net primary care providers

verfasst von: Niharika Dixit, Nancy Burke, Gladys Rodriguez, Urmimala Sarkar, Barbara Cicerelli, Joanna Denise DeVore, Anna María Nápoles

Erschienen in: Supportive Care in Cancer | Ausgabe 10/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

Primary care providers (PCPs) are critical to the provision of comprehensive care for cancer survivors, yet there is very little data on the practices and quality of survivorship care occurring in safety net primary care settings. This study aimed to assess the knowledge and attitudes of PCPs and preferences for care models for breast and colon cancer survivors in a safety net health network.

Methods

A modified National Cancer Institute Survey of Physician Attitudes Regarding the Care of Cancer Survivors was sent electronically to 220 PCPs in 12 primary care clinics in the San Francisco Health Network affiliated with Zuckerberg San Francisco General Hospital and Trauma Center.

Results

The response rate was 50% (110/220). About half of PCPs strongly/somewhat agreed (vs. strongly/somewhat disagreed) that PCPs have the knowledge needed to provide follow-up care related to breast (50%) and colon cancer (54%). Most providers (93%) correctly reported recommended frequency of mammography, however, frequency of blood tests and other imaging surveillance were not as well recognized for breast or colon cancer. Recognition of long-term side effects of chemotherapy drugs ranged from 12% for oxaliplatin to 44% for doxorubicin. Only 33% of providers reported receiving any survivorship training. The most preferred model for survivorship care was shared care model (40%).

Conclusions

Safety net PCPs prefer a shared care model for care of cancer survivors but are limited by lack of training, poor communication, and poor delineation of roles. Patient-centered survivorship care can be improved through effective oncologist-PCP-patient partnerships and coordination.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Bluethmann SM, Mariotto AB, Rowland JH (2016) Anticipating the “Silver Tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomark Prev 25(7):1029–1036CrossRef Bluethmann SM, Mariotto AB, Rowland JH (2016) Anticipating the “Silver Tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomark Prev 25(7):1029–1036CrossRef
2.
Zurück zum Zitat Walsh K (2016) Addressing psychosocial issues in cancer survivorship: past, present and future. Future Oncol 12(24):2823–2834CrossRef Walsh K (2016) Addressing psychosocial issues in cancer survivorship: past, present and future. Future Oncol 12(24):2823–2834CrossRef
3.
Zurück zum Zitat Oancea SC, Cheruvu VK (2016) Psychological distress among adult cancer survivors: importance of survivorship care plan. Support Care Cancer 24(11):4523–4531CrossRef Oancea SC, Cheruvu VK (2016) Psychological distress among adult cancer survivors: importance of survivorship care plan. Support Care Cancer 24(11):4523–4531CrossRef
4.
Zurück zum Zitat Nekhlyudov L, Walker R, Ziebell R et al (2016) Cancer survivors’ experiences with insurance, finances, and employment: results from a multisite study. J Cancer Surviv 10:1104–1111 Nekhlyudov L, Walker R, Ziebell R et al (2016) Cancer survivors’ experiences with insurance, finances, and employment: results from a multisite study. J Cancer Surviv 10:1104–1111
5.
Zurück zum Zitat McTiernan A, Irwin M, Vongruenigen V (2010) Weight, physical activity, diet, and prognosis in breast and gynecologic cancers. J Clin Oncol 28:4074–4080CrossRef McTiernan A, Irwin M, Vongruenigen V (2010) Weight, physical activity, diet, and prognosis in breast and gynecologic cancers. J Clin Oncol 28:4074–4080CrossRef
6.
Zurück zum Zitat Institute oM, National RC (2006) In: Hewitt M, Greenfield S, Stovall E (eds) From cancer patient to cancer survivor: lost in transition. The National Academies Press, Washington, DC Institute oM, National RC (2006) In: Hewitt M, Greenfield S, Stovall E (eds) From cancer patient to cancer survivor: lost in transition. The National Academies Press, Washington, DC
7.
Zurück zum Zitat Halpern MT, Viswanathan M, Evans TS, Birken SA, Basch E, Mayer DK (2015) Models of cancer survivorship care: overview and summary of current evidence. J Oncol Pract 11(1):19CrossRef Halpern MT, Viswanathan M, Evans TS, Birken SA, Basch E, Mayer DK (2015) Models of cancer survivorship care: overview and summary of current evidence. J Oncol Pract 11(1):19CrossRef
8.
Zurück zum Zitat Mead H, Pratt-Chapman M, Gianattasio K, Cleary S, Gerstein M (2017) Identifying models of cancer survivorship care. JCO. 35(5):1CrossRef Mead H, Pratt-Chapman M, Gianattasio K, Cleary S, Gerstein M (2017) Identifying models of cancer survivorship care. JCO. 35(5):1CrossRef
9.
Zurück zum Zitat Bodenheimer T, Lorig K, Holman H, Grumbach K (2002) Patient self-management of chronic disease in primary care. JAMA. 288(19):2469–2475CrossRef Bodenheimer T, Lorig K, Holman H, Grumbach K (2002) Patient self-management of chronic disease in primary care. JAMA. 288(19):2469–2475CrossRef
10.
Zurück zum Zitat Bazzell JL, Spurlock A, McBride M (2015) Matching the unmet needs of cancer survivors to resources using a shared care model. J Cancer Educ 30(2):312–318CrossRef Bazzell JL, Spurlock A, McBride M (2015) Matching the unmet needs of cancer survivors to resources using a shared care model. J Cancer Educ 30(2):312–318CrossRef
11.
Zurück zum Zitat Hortobagyi GN (2007) American Society of Clinical Oncology. A shortage of oncologists? The American Society of Clinical Oncology workforce study. J Clin Oncol 25(12):1468–1469CrossRef Hortobagyi GN (2007) American Society of Clinical Oncology. A shortage of oncologists? The American Society of Clinical Oncology workforce study. J Clin Oncol 25(12):1468–1469CrossRef
12.
Zurück zum Zitat Yang W, Williams JH, Hogan PF, Bruinooge SS, Rodriguez GI, Kosty MP et al (2014) Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage. J Oncol Pract 10(1):39–45CrossRef Yang W, Williams JH, Hogan PF, Bruinooge SS, Rodriguez GI, Kosty MP et al (2014) Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage. J Oncol Pract 10(1):39–45CrossRef
13.
Zurück zum Zitat Hudson SV (2013) Continuous primary care is central to comprehensive cancer care: are we ready to meet growing needs? J Am Board Fam Med 26(6):623–625CrossRef Hudson SV (2013) Continuous primary care is central to comprehensive cancer care: are we ready to meet growing needs? J Am Board Fam Med 26(6):623–625CrossRef
14.
Zurück zum Zitat Dawes AJ, Hemmelgarn M, Nguyen DK, Sacks GD, Clayton SM, Cope JR et al (2015) Are primary care providers prepared to care for survivors of breast cancer in the safety net? Cancer. 121(8):1249–1256CrossRef Dawes AJ, Hemmelgarn M, Nguyen DK, Sacks GD, Clayton SM, Cope JR et al (2015) Are primary care providers prepared to care for survivors of breast cancer in the safety net? Cancer. 121(8):1249–1256CrossRef
15.
Zurück zum Zitat Klabunde CN, Han PK, Earle CC, Smith T, Ayanian JZ, Lee R et al (2013) Physician roles in the cancer-related follow-up care of cancer survivors. Fam Med 45(7):463–474PubMedPubMedCentral Klabunde CN, Han PK, Earle CC, Smith T, Ayanian JZ, Lee R et al (2013) Physician roles in the cancer-related follow-up care of cancer survivors. Fam Med 45(7):463–474PubMedPubMedCentral
16.
Zurück zum Zitat Nekhlyudov L, Aziz NM, Lerro C, Virgo KS (2014) Oncologists’ and primary care physicians’ awareness of late and long-term effects of chemotherapy: implications for care of the growing population of survivors. J Oncol Pract 10(2):29CrossRef Nekhlyudov L, Aziz NM, Lerro C, Virgo KS (2014) Oncologists’ and primary care physicians’ awareness of late and long-term effects of chemotherapy: implications for care of the growing population of survivors. J Oncol Pract 10(2):29CrossRef
17.
Zurück zum Zitat Burke NJ, Napoles TM, Banks PJ, Orenstein FS, Luce JA, Joseph G (2016) Survivorship care plan information needs: perspectives of safety-net breast cancer patients. PLoS One 11(12):e0168383CrossRef Burke NJ, Napoles TM, Banks PJ, Orenstein FS, Luce JA, Joseph G (2016) Survivorship care plan information needs: perspectives of safety-net breast cancer patients. PLoS One 11(12):e0168383CrossRef
18.
Zurück zum Zitat Potosky AL, Han PK, Rowland J, Klabunde CN, Smith T, Aziz N et al (2011) Differences between primary care physicians’ and oncologists’ knowledge, attitudes and practices regarding the care of cancer survivors. J Gen Intern Med 26(12):1403–1410CrossRef Potosky AL, Han PK, Rowland J, Klabunde CN, Smith T, Aziz N et al (2011) Differences between primary care physicians’ and oncologists’ knowledge, attitudes and practices regarding the care of cancer survivors. J Gen Intern Med 26(12):1403–1410CrossRef
19.
Zurück zum Zitat Cheung WY, Aziz N, Noone AM, Rowland JH, Potosky AL, Ayanian JZ et al (2013) Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists. J Cancer Surviv 7(3):343–354CrossRef Cheung WY, Aziz N, Noone AM, Rowland JH, Potosky AL, Ayanian JZ et al (2013) Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists. J Cancer Surviv 7(3):343–354CrossRef
20.
Zurück zum Zitat Research electronic data capture (REDCap) – A metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform [Internet]; 2009 [updated Apr; cited Jan 3, 2019]. Available from: https://refworks.proquest.com/tools/. Research electronic data capture (REDCap) – A metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform [Internet]; 2009 [updated Apr; cited Jan 3, 2019]. Available from: https://​refworks.​proquest.​com/​tools/​.
23.
Zurück zum Zitat Virgo KS, Lerro CC, Klabunde CN, Earle C, Ganz PA (2013) Barriers to breast and colorectal cancer survivorship care: perceptions of primary care physicians and medical oncologists in the United States. J Clin Oncol 31(18):2322–2336CrossRef Virgo KS, Lerro CC, Klabunde CN, Earle C, Ganz PA (2013) Barriers to breast and colorectal cancer survivorship care: perceptions of primary care physicians and medical oncologists in the United States. J Clin Oncol 31(18):2322–2336CrossRef
24.
Zurück zum Zitat Grunfeld E, Julian JA, Pond G, Maunsell E, Coyle D, Folkes A et al (2011) Evaluating survivorship care plans: results of a randomized, clinical trial of patients with breast cancer. J Clin Oncol 29(36):4755–4762CrossRef Grunfeld E, Julian JA, Pond G, Maunsell E, Coyle D, Folkes A et al (2011) Evaluating survivorship care plans: results of a randomized, clinical trial of patients with breast cancer. J Clin Oncol 29(36):4755–4762CrossRef
25.
Zurück zum Zitat O’Brien MA, Grunfeld E, Sussman J, Porter G, Mobilio MH (2015) Views of family physicians about survivorship care plans to provide breast cancer follow-up care: exploration of results from a randomized controlled trial. Curr Oncol 22(4):252–259CrossRef O’Brien MA, Grunfeld E, Sussman J, Porter G, Mobilio MH (2015) Views of family physicians about survivorship care plans to provide breast cancer follow-up care: exploration of results from a randomized controlled trial. Curr Oncol 22(4):252–259CrossRef
26.
Zurück zum Zitat Jacobsen PB, DeRosa AP, Henderson TO, Mayer DK, Moskowitz CS, Paskett ED et al (2018) Systematic review of the impact of cancer survivorship care plans on health outcomes and health care delivery. J Clin Oncol 36(20):2088–2100CrossRef Jacobsen PB, DeRosa AP, Henderson TO, Mayer DK, Moskowitz CS, Paskett ED et al (2018) Systematic review of the impact of cancer survivorship care plans on health outcomes and health care delivery. J Clin Oncol 36(20):2088–2100CrossRef
27.
Zurück zum Zitat National Cancer Policy Forum, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. No title. 2018. National Cancer Policy Forum, Board on Health Care Services, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. No title. 2018.
28.
Zurück zum Zitat Jortberg BT, Fernald DH, Hessler DM, Dickinson LM, Wearner R, Connelly L et al (2019) Practice characteristics associated with better implementation of patient self-management support. J Am Board Fam Med 32(3):329–340CrossRef Jortberg BT, Fernald DH, Hessler DM, Dickinson LM, Wearner R, Connelly L et al (2019) Practice characteristics associated with better implementation of patient self-management support. J Am Board Fam Med 32(3):329–340CrossRef
29.
Zurück zum Zitat Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. JCO. 27(17):2758–2765CrossRef Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA (2009) Future of cancer incidence in the United States: burdens upon an aging, changing nation. JCO. 27(17):2758–2765CrossRef
Metadaten
Titel
Knowledge and self-efficacy for caring for breast and colon cancer survivors among safety net primary care providers
verfasst von
Niharika Dixit
Nancy Burke
Gladys Rodriguez
Urmimala Sarkar
Barbara Cicerelli
Joanna Denise DeVore
Anna María Nápoles
Publikationsdatum
03.02.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 10/2020
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-019-05277-z

Weitere Artikel der Ausgabe 10/2020

Supportive Care in Cancer 10/2020 Zur Ausgabe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

Das sind die führenden Symptome junger Darmkrebspatienten

Darmkrebserkrankungen in jüngeren Jahren sind ein zunehmendes Problem, das häufig längere Zeit übersehen wird, gerade weil die Patienten noch nicht alt sind. Welche Anzeichen Ärzte stutzig machen sollten, hat eine Metaanalyse herausgearbeitet.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.