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16.11.2019 | Ausgabe 1/2020 Open Access

Journal of Cancer Survivorship 1/2020

Off to a good start after a cancer diagnosis: implementation of a time out consultation in primary care before cancer treatment decision

Journal of Cancer Survivorship > Ausgabe 1/2020
Eveline A. Noteboom, Niek J. de Wit, Ingrid J. E. M. van Asseldonk, Monique C. A. M. Janssen, Wai Yee Lam-Wong, Rob H. P. J. Linssen, Manon J. A. E. Pepels, Natascha A. W. P. Schrama, Mariëlle E. H. Trompper, L. Maaike Veldhuizen, Anne P. Wijtvliet, Ed G. F. Zeldenrust, Ans M. Hendrikx, Wil A. van de Boomen, Dorothé M. Elbersen, Esther M. G. Jacobs, Elsken van der Wall, Charles W. Helsper
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Supportive care for cancer patients may benefit from improving treatment decisions and optimal use of the family physicians’ and specialists’ strengths. To improve shared decision-making (SDM) and facilitate continuity of primary care during treatment, a cancer care path including a “time out consultation” (TOC) in primary care before treatment decision, was implemented. This study assesses the uptake of a TOC and the added value for SDM.


For patients with metastatic lung or gastro-intestinal cancer, a TOC was introduced in their care path in a southern region of The Netherlands, from April until October 2016. Uptake of a TOC was measured to reflect on facilitation of continuity of primary care. The added value for SDM and overall experiences were evaluated with questionnaires and semi-structured interviews among patients, family physicians, and specialists.


Of the 40 patients who were offered a TOC, 31 (78%) had a TOC. Almost all patients, family physicians, and specialists expressed that they experienced added value for SDM. This includes a stimulating effect on reflection on choice (expressed by 83% of patients) and improved preparation for treatment decision (75% of patients). Overall added value of a TOC for SDM, only evaluated among family physicians and specialists, was experienced by 71% and 86% of these physicians, respectively.

Conclusion and Implications for Cancer Survivors

The first experiences with a TOC in primary care before cancer treatment decision suggest that it may help to keep the GP “in the loop” after a cancer diagnosis and that it may contribute to the SDM process, according to patients, family physicians, and specialists.

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