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24.03.2021 | Review

Outcomes of cancer survivorship education and training for primary care providers: a systematic review

verfasst von: Raymond J. Chan, Oluwaseyifunmi Andi Agbejule, Patsy M. Yates, Jon Emery, Michael Jefford, Bogda Koczwara, Nicolas H. Hart, Megan Crichton, Larissa Nekhlyudov

Erschienen in: Journal of Cancer Survivorship | Ausgabe 2/2022

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Abstract

Purpose

To identify published literature regarding cancer survivorship education programs for primary care providers (PCPs) and assess their outcomes.

Methods

PubMed, Embase, and CINAHL databases were searched between January 2005 and September 2020. The Quality of Cancer Survivorship Care Framework and Kirkpatrick’s 4-level evaluation model were used to summarize program content and outcomes, respectively. Data extraction and critical appraisal were conducted by two authors.

Results

Twenty-one studies were included, describing self-directed online courses (n=4), presentations (n=2), workshops and training sessions (n=6), placement programs (n=3), a live webinar, a fellowship program, a referral program, a survivorship conference, a dual in-person workshop and webinar, and an in-person seminar and online webinar series. Eight studies described the use of a learner framework or theory to guide program development. All 21 programs were generally beneficial to PCP learners (e.g., increased confidence, knowledge, behavior change); however, methodological bias suggests caution in accepting claims. Three studies reported positive outcomes at the patient level (i.e., satisfaction with care) and organizational level (i.e., increased screening referrals, changes to institution practice standards).

Conclusions

A range of cancer survivorship PCP education programs exist. Evidence for clinical effectiveness was rarely reported. Future educational programs should be tailored to PCPs, utilize an evidence-based survivorship framework, and evaluate patient- and system-level outcomes.

Implications for Cancer Survivors

PCPs have an important role in addressing the diverse health care needs of cancer survivors. Improving the content, approach, and evaluation of PCP-focused cancer survivorship education programs could have a positive impact on health outcomes among cancer survivors.

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Ferlay J, Ervik M, Colombet M, Mery L, Pineros M. Global cancer observatory: cancer today. 2019.

Bray F, Jemal A, Grey N, Ferlay J, Forman D. Global cancer transitions according to the Human Development Index (2008-2030): a population-based study. Lancet Oncol. 2012;13(8):790–801.CrossRef

Leach CR, Weaver KE, Aziz NM, Alfano CM, Bellizzi KM, Kent EE, et al. The complex health profile of long-term cancer survivors: prevalence and predictors of comorbid conditions. J Cancer Surviv. 2015;9(2):239–51.PubMedCrossRef

Erikson C, Salsberg E, Forte G, Bruinooge S, Goldstein M. Future supply and demand for oncologists: challenges to assuring access to oncology services. J Oncol Pract. 2007;3(2):79–86.PubMedPubMedCentralCrossRef

Mathew A. Global survey of clinical oncology workforce. J Global Oncol. 2018;4:1–12.

Yang W, Williams JH, Hogan PF, Bruinooge SS, Rodriguez GI, Kosty MP, et al. Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage. J Oncol Pract. 2014;10(1):39–45.PubMedCrossRef

Chaput G, Med CP, Sussman J. Integrating primary care providers through the seasons of survivorship. Curr Oncol (Toronto, Ont). 2019;26(1):48–54.CrossRef

Io M. From cancer patient to cancer survivor: lost in transition. Washington: Institute of Medicine 2005.

Nekhlyudov L, O'Malley DM, Hudson SV. Integrating primary care providers in the care of cancer survivors: gaps in evidence and future opportunities. Lancet Oncol. 2017;18(1):e30–8.PubMedPubMedCentralCrossRef

10.

Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol. 2015;34(6):611–35.PubMedCrossRef

11.

Cohen EE, LaMonte SJ, Erb NL, Beckman KL, Sadeghi N, Hutcheson KA, et al. American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA Cancer J Clin. 2016;66(3):203–39.PubMedCrossRef

12.

Rubin G, Berendsen A, Crawford S, Dommett R, Earle C, Emery J, et al. The expanding role of primary care in cancer control. Lancet Oncol. 2015;16:1231–72.PubMedCrossRef

13.

Maly RC, Liu Y, Diamant AL, Thind A. The impact of primary care physicians on follow-up care of underserved breast cancer survivors. J Am Board Fam Med. 2013;26(6):628–36.PubMedPubMedCentralCrossRef

14.

Lawrence RA, McLoone JK, Wakefield CE, Cohn RJ. Primary care physicians’ perspectives of their role in cancer care: a systematic review. J Gen Intern Med. 2016;31(10):1222–36.PubMedPubMedCentralCrossRef

15.

Ngune I, Jiwa M, McManus A, Hughes J. Do patients with long-term side effects of cancer treatment benefit from general practitioner support? A literature review. Int J Integr Care. 2015;15:e023.PubMedPubMedCentralCrossRef

16.

Grunfeld E, Levine MN, Julian JA, Coyle D, Szechtman B, Mirsky D, et al. Randomized trial of long-term follow-up for early-stage breast cancer: a comparison of family physician versus specialist care. J Clin Oncol. 2006;24(6):848–55.PubMedCrossRef

17.

Cooper JM, Loeb SJ, Smith CA. The primary care nurse practitioner and cancer survivorship care. J Am Acad Nurse Pract. 2010;22(8):394–402.PubMedCrossRef

18.

Vos JAM, Wieldraaijer T, van Weert HCPM, van Asselt KM. Survivorship care for cancer patients in primary versus secondary care: a systematic review. J Cancer Surviv. 2021;15(1):66–76.PubMedCrossRef

19.

Dawes AJ, Hemmelgarn M, Nguyen DK, Sacks GD, Clayton SM, Cope JR, et al. Are primary care providers prepared to care for survivors of breast cancer in the safety net? Cancer. 2015;121(8):1249–56.PubMedCrossRef

20.

Suh E, Daugherty CK, Wroblewski K, Lee H, Kigin ML, Rasinski KA, et al. General internists’ preferences and knowledge about the care of adult survivors of childhood cancer. Ann Intern Med. 2014;160(1):11–7.PubMedPubMedCentralCrossRef

21.

Salz T, Oeffinger KC, Lewis PR, Williams RL, Rhyne RL, Yeazel MW. Primary care providers' needs and preferences for information about colorectal cancer survivorship care. J Am Board Fam Med. 2012;25(5):635–51.PubMedPubMedCentralCrossRef

22.

Sima JL, Perkins SM, Haggstrom DA. Primary care physician perceptions of adult survivors of childhood cancer. J Pediatr Hematol Oncol. 2014;36(2):118–24.PubMedPubMedCentralCrossRef

23.

Bober SL, Recklitis CJ, Campbell EG, Park ER, Kutner JS, Najita JS, et al. Caring for cancer survivors: a survey of primary care physicians. Cancer. 2009;115(18 Suppl):4409–18.PubMedCrossRef

24.

Stephens C, Klemanski D, Lustberg MB, Noonan AM, Brill S, Krok-Schoen JL. Primary care physician’s confidence and coordination regarding the survivorship care for older breast cancer survivors. Support Care Cancer. 2021;29(1):223–30.PubMedCrossRef

25.

Berkowitz C, Allen DH, Tenhover J, Zullig LL, Ragsdale J, Fischer JE, et al. Knowledge and preferences of primary care providers in delivering head and neck cancer survivorship care. J Cancer Educ. 2018;33(6):1323–7.PubMedCrossRef

26.

Nissen MJ, Beran MS, Lee MW, Mehta SR, Pine DA, Swenson KK. Views of primary care providers on follow-up care of cancer patients. Fam Med. 2007;39(7):477–82.PubMed

27.

Price ST, Berini C, Seehusen D, Mims LD: Cancer survivorship training in family medicine residency programs. J Cancer Surviv 2020 https://doi.org/10.1007/s11764-020-00966-9.

28.

Susanibar S, Thrush CR, Khatri N, Hutchins LF. Cancer survivorship training: a pilot study examining the educational gap in primary care medicine residency programs. J Cancer Surviv. 2014;8(4):565–70.PubMedCrossRef

29.

Yip SM, Meyers DE, Sisler J, Wycliffe-Jones K, Kucharski E, Elser C, et al. Oncology education for family medicine residents: a national needs assessment survey. BMC Med Educ. 2020;20(1):283.PubMedPubMedCentralCrossRef

30.

Lee J, Galli J, Siemon J, Huang M, Schlumbrecht M. Assessment of cancer survivorship training and knowledge among resident physicians in obstetrics and gynecology. J Cancer Educ. 2019. https://doi.org/10.1007/s13187-019-01652-w.

31.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol. 2021;134:103–12.PubMedCrossRef

32.

Nekhlyudov L, Mollica MA, Jacobsen PB, Mayer DK, Shulman LN, Geiger AM. Developing a quality of cancer survivorship care framework: implications for clinical care, research, and policy. J Natl Cancer Inst. 2019;111(11):1120–30.PubMedPubMedCentralCrossRef

33.

Shapiro CL, Jacobsen PB, Henderson T, Hurria A, Nekhlyudov L, Ng A, et al. ReCAP: ASCO core curriculum for cancer survivorship education. J Oncol Pract. 2016;12(2):e145–17.CrossRef

34.

UNESCO: International Standard Classification of Education ISCED. In.; 2012.

35.

Barr H, Freeth D, Hammick M, Koppel I, Reeves S: Evaluations of interprofessional education A United Kingdom review for health and social care. 2000.

36.

Study Quality Assessment Tools. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools. Accessed 1 Jan 2021

37.

Hong QN, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, et al. The mixed methods appraisal tool (MMAT) version 2018 for information professionals and researchers. Educ Inf. 2018;34:285–91.

38.

Berrett-Abebe J, Cadet T, Nekhlyudov L, Vitello J, Maramaldi P. Impact of an interprofessional primary care training on fear of cancer recurrence on clinicians' knowledge, self-efficacy, anticipated practice behaviors, and attitudes toward survivorship care. J Cancer Educ. 2019;34(3):505–11.PubMedCrossRef

39.

Buriak SE, Potter J. Impact of an online survivorship primer on clinician knowledge and intended practice changes. J Cancer Educ. 2014;29(1):114–21.PubMedCrossRef

40.

Chaput G, Hendricks K, D'Souza V, Shulha M. Educating primary care providers regarding cancer survivor issues Workshop results. Can Fam Physician. 2018;64(2):S63.

41.

Daly JM, Howald AG, Filchner KA, Miller BJ, Lyons L, Denlinger CS, et al. Enhancing cancer survivorship through improved provider communication, care coordination, and professional education. J Clin Oncol. 2016;34(3):104. https://doi.org/10.1200/jco.2016.34.3_suppl.104.

42.

Donohue S, Haine JE, Li Z, Trowbridge ER, Kamnetz SA, Feldstein DA, et al. The impact of a primary care education program regarding cancer survivorship care plans: results from an engineering, primary care, and oncology collaborative for survivorship health. J Cancer Educ. 2019;34(1):154–60.PubMedPubMedCentralCrossRef

43.

Fulbright JM, Hein W, Stegenga K, Alsman K, Sharma M, Ryan R, et al. Implementing a stepwise educational approach for bridging the gap between specialty and primary care for childhood cancer survivors. J Cancer Surviv. 2020;14:660–5.PubMedCrossRef

44.

Grant M, Economou D, Ferrell B, Uman G. Educating health care professionals to provide institutional changes in cancer survivorship care. J Cancer Educ. 2012;27(2):226–32.PubMedPubMedCentralCrossRef

45.

Harvey A, Zhang Y, Phillips S, Suarez R, Dekle L, Villalobos A, et al. Initial outcomes of an online continuing education series focused on post-treatment cancer survivorship care. J Cancer Educ. 2020;35(1):144–50.PubMedCrossRef

46.

Jacob RA, Hyatt V. A graduate medical education curriculum to introduce the concept of cancer survivorship. MedEdPORTAL. 2018;14:10673.PubMedPubMedCentralCrossRef

47.

Meacham LR, Edwards PJ, Cherven BO, Palgon M, Espinoza S, Hassen-Schilling L, et al. Primary care providers as partners in long-term follow-up of pediatric cancer survivors. J Cancer Surviv. 2012;6(3):270–7.PubMedCrossRef

48.

Merriam SB, DiNardo D. Talking sex with cancer survivors: effects of an educational workshop for primary care providers. J Gen Intern Med. 2018;33(2):353.

49.

Nolan TS, Hatfield R, Browning KK, Kue J, Klemanski DL. Survivorship fellowship: evaluation and evolution of a program for advanced practice providers. Clin J Oncol Nurs. 2019;23(6):575–8.PubMedCrossRef

50.

Perloff T, Dawkins M, Hurd M, Wang J, Hallmeyer S. Planning for survivorship after checkpoint inhibitors: a multidisciplinary education initiative. J Clin Oncol. 2019;37:98.CrossRef

51.

Piper A, Leon L, Kelly H, Bailey A, Wiley G, Lisy K, et al. Clinical placement program in cancer survivorship for primary care providers 2017-2019. J Cancer Surviv. 2020;14(1):14–8.PubMedCrossRef

52.

Risendal B, Westfall JM, Zittleman L, Hodgson C, Garrington T, Sutter C, et al. High Plains Research Network Community Advisory C: Impact of cancer survivorship care training on rural primary care practice teams: a mixed methods approach. J Cancer Educ. 2020. https://doi.org/10.1007/s13187-020-01788-0.

53.

Rushton M, Morash R, Larocque G, Liska C, Stoica L, DeGrasse C, et al. Wellness Beyond Cancer Program: building an effective survivorship program. Curr Oncol. 2015;22(6):e419–34.PubMedPubMedCentralCrossRef

54.

Schilling G, Niebling W, Mack-Hennes A, Arnold D. Cancer survivorship in Germany: education of general practitioners-why and how. Oncol Res Treatment. 2016;39:111.

55.

Schwartz LF, Braddock CH 3rd, Kao RL, Sim MS, Casillas JN. Creation and evaluation of a cancer survivorship curriculum for pediatric resident physicians. J Cancer Surviv. 2018;12(5):651–8.PubMedPubMedCentralCrossRef

56.

Smith K, Emery J, Jefford M, Shibaoka M, Barrett M. Upskilling the primary care workforce in cancer survivorship. Asia Pac J Clin Oncol. 2018;14:180.

57.

Tan W. Cancer survivorship focused education in Filipino nurses in Florida: assessment of understanding and take home-messages/immediate recall. Support Care Cancer. 2017;25(2):S110.

58.

Evans J, Nolte L, Piper A, Simkiss L, Whitfield K, Jefford M. A clinical placement program for primary care professionals at a comprehensive cancer centre. Aust Fam Physician. 2016;45:606–10.PubMed

59.

Buriak SE, Potter J, Bleckley MK. Using a predictive model of clinician intention to improve continuing health professional education on cancer survivorship. J Contin Educ Heal Prof. 2015;35(1):57–64.CrossRef

60.

Price DW, Miller EK, Rahm AK, Brace NE, Larson RS. Assessment of barriers to changing practice as CME outcomes. J Contin Educ Heal Prof. 2010;30(4):237–45.CrossRef

61.

Kelly D, Tangney B. Adapting to intelligence profile in an adaptive educational system. Interact Comput. 2006;18(3):385–409.CrossRef

62.

Young K, Kim J, Yeung G, Sit C, Tobe S. Physician preferences for accredited online continuing medical education. J Contin Educ Heal Prof. 2011;31:241–6.CrossRef

63.

Grudniewicz A, Kealy R, Rodseth RN, Hamid J, Rudoler D, Straus SE. What is the effectiveness of printed educational materials on primary care physician knowledge, behaviour, and patient outcomes: a systematic review and meta-analyses. Implement Sci. 2015;10(1):164.PubMedPubMedCentralCrossRef

64.

Grimshaw JM, Shirran L, Thomas R, Mowatt G, Fraser C, Bero L, et al. Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001;39(8 Suppl 2):II2–II45.PubMed

65.

Eccles M, Grimshaw J, Walker A, Johnston M, Pitts N. Changing the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings. J Clin Epidemiol. 2005;58:107–12.PubMedCrossRef

66.

Klufas A, Shin G, Raphael R, Sarfaty SC, Hirsch AE. A thorough analysis of the current state of cancer education in medical schools and application of experimental teaching techniques and their efficacy. Adv Med Educ Pract. 2020;11:931–46.PubMedPubMedCentralCrossRef

67.

Vaona A, Banzi R, Kwag KH, Rigon G, Cereda D, Pecoraro V, et al. E-learning for health professionals. Cochrane Database Syst Rev. 2018;1(1):CD011736.PubMed

68.

Johnson CE, Lizama N, Garg N, Ghosh M, Emery J, Saunders C. Australian general practitioners’ preferences for managing the care of people diagnosed with cancer. Asia Pac J Clin Oncol. 2014;10(2):e90–8.PubMedCrossRef

69.

Zhang Z, Zhan X, Li Y, Hu R, Yan W. Web-based training for primary healthcare workers in rural China: a qualitative exploration of stakeholders’ perceptions. PLoS One. 2015;10(5):e0125975.PubMedPubMedCentralCrossRef

70.

Rabe A, Sy M, Cheing W, Lucero-Prisno D. COVID-19 and health professions education: a 360° view of the impact of a global health emergency. MedEdPublish. 2020;9(1):148.CrossRef

71.

Kuh GD, Ikenberry SO, Jankowski NA, Cain TR, Ewell PT, Hutchings P, et al. Using evidence of student learning to improve higher education. John Wiley & Sons, Incorporated: New York; 2015.

Titel: Outcomes of cancer survivorship education and training for primary care providers: a systematic review
verfasst von: Raymond J. Chan
Oluwaseyifunmi Andi Agbejule
Patsy M. Yates
Jon Emery
Michael Jefford
Bogda Koczwara
Nicolas H. Hart
Megan Crichton
Larissa Nekhlyudov
Publikationsdatum: 24.03.2021
Verlag: Springer US
Erschienen in: Journal of Cancer Survivorship / Ausgabe 2/2022
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-021-01018-6

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Outcomes of cancer survivorship education and training for primary care providers: a systematic review