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Journal of Cancer Survivorship
Published in: Journal of Cancer Survivorship 6/2016

01-12-2016 | Review

The role of the GP in follow-up cancer care: a systematic literature review

Authors: Judith A. Meiklejohn, Alexander Mimery, Jennifer H. Martin, Ross Bailie, Gail Garvey, Euan T. Walpole, Jon Adams, Daniel Williamson, Patricia C. Valery

Published in: Journal of Cancer Survivorship | Issue 6/2016

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Abstract

Purpose

The purpose of the present study is to explore the role of the general practitioners, family physicians and primary care physicians (GP) in the provision of follow-up cancer care.

Methods

PubMed, MEDLINE and CINAHL were systematically searched for primary research focussing on the role of the GP from the perspective of GPs and patients. Data were extracted using a standardised form and synthesised using a qualitative descriptive approach.

Results

The initial search generated 6487 articles: 25 quantitative and 33 qualitative articles were included. Articles focused on patients’ and GPs’ perspectives of the GP role in follow-up cancer care. Some studies reported on the current role of the GP, barriers and enablers to GP involvement from the perspective of the GP and suggestions for future GP roles. Variations in guidelines and practice of follow-up cancer care in the primary health care sector exist. However, GPs and patients across the included studies supported a greater GP role in follow-up cancer care. This included greater support for care coordination, screening, diagnosis and management of physical and psychological effects of cancer and its treatment, symptom and pain relief, health promotion, palliative care and continuing normal general health care provision.

Conclusion

While there are variations in guidelines and practice of follow-up cancer care in the primary health care sector, GPs and patients across the reviewed studies supported a greater role by the GP.

Implications for Cancer Survivors

Greater GP role in cancer care could improve the quality of patient care for cancer survivors. Better communication between the tertiary sector and GP across the cancer phases would enable clear delineation of roles.
Literature
1.
2.
3.
4.
5.
McCabe MS, Bhatia S, Oeffinger KC, Reaman GH, Tyne C, Wollins DS, et al. American Society of Clinical Oncology statement: achieving high-quality cancer survivorship care. J Clin Oncol. 2013;31(5):631–40.CrossRefPubMedPubMedCentral
6.
de Moor JS, Mariotto AB, Parry C, Alfano CM, Padgett L, Kent EE, et al. Cancer survivors in the United States: prevalence across the survivorship trajectory and implications for care. Cancer Epidemiol Biomarkers Prev. 2013;22(4):561–70.CrossRefPubMedPubMedCentral
7.
Muka T, Imo D, Jaspers L, Colpani V, Chaker L, van der Lee SJ, et al. The global impact of non-communicable diseases on healthcare spending and national income: a systematic review. Eur J Epidemiol. 2015;30(4):251–277.
8.
9.
10.
DeMario MD, Ratain MJ. Oral chemotherapy: rationale and future directions. J Clin Oncol. 1998;16(7):2557.PubMed
11.
Riechelmann RP, Tannock IF, Wang L, Saad ED, Taback NA, Krzyzanowska MK. Potential drug interactions and duplicate prescriptions among cancer patients. J Natl Cancer Inst. 2007;99(8):592–600. doi:10.​1093/​jnci/​djk130.CrossRefPubMed
12.
Augestad KM, Norum J, Dehof S, Aspevik R, Ringberg U, Nestvold T, et al. Cost-effectiveness and quality of life in surgeon versus general practitioner-organised colon cancer surveillance: a randomised controlled trial. BMJ Open 2013;3(4).
13.
Lewis RA, Neal RD, Williams NH, France B, Hendry M, Russell D, et al. Follow-up of cancer in primary care versus secondary care: systematic review. Brit J Gen Pract. 2009;59(564):e234–47. doi:10.​3399/​bjgp09X453567.CrossRef
14.
15.
Emery JD, Shaw K, Williams B, Mazza D, Fallon-Ferguson J, Varlow M, et al. The role of primary care in early detection and follow-up of cancer. Nat Rev Clin Oncol. 2014;11(1):38. doi:10.​1038/​nrclinonc.​2013.​212.
16.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group TP. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement: e1000097. PLoS Med. 2009;6(7). doi:10.​1371/​journal.​pmed.​1000097.
17.
18.
19.
Sisler JJ, Brown JB, Stewart M. Family physicians’ roles in cancer care. Survey of patients on a provincial cancer registry. Can Fam Phys. 2004;50(6):889–96.
20.
Brennan M, Butow P, Spillane AJ, Marven M, Boyle FM. Follow up after breast cancer: views of Australian women. Aust Fam Physician. 2011;40(5):311–6.PubMed
21.
Ben-Ami E, Merom H, Sikron F, Livneh J, Sadetzki S, Wolf I. Involvement of the family physician in the care of chemotherapy-treated patients with cancer: patients’ perspectives. J Oncol Pract / Am Soc Clin Oncol. 2014;10(5):298–305. doi:10.​1200/​JOP.​2013.​001182.CrossRef
22.
Kendall M, Boyd K, Campbell C, Cormie P, Fife S, Thomas K, et al. How do people with cancer wish to be cared for in primary care? Serial discussion groups of patients and carers. Fam Pract. 2006;23(6):644–50. doi:10.​1093/​fampra/​cml035.CrossRefPubMed
23.
Urquhart R, Folkes A, Babineau J, Grunfeld E. Views of breast and colorectal cancer survivors on their routine follow-up care. Curr Oncol (Toronto, Ont). 2012;19(6):294–301. doi:10.​3747/​co.​19.​1051.
24.
O’Brien R, Rose PW, Campbell C, Weller D, Neal RD, Wilkinson C, et al. Experiences of follow-up after treatment in patients with prostate cancer: a qualitative study. BJU Int. 2010;106(7):998.CrossRefPubMed
25.
Halkett GKB, Jiwa M, Lobb EA. Patients’ perspectives on the role of their general practitioner after receiving an advanced cancer diagnosis. Eur J Cancer Care. 2015;24(5):662–72. doi:10.​1111/​ecc.​12224.CrossRef
26.
Suija K, Kordemets T, Annuk K, Kalda R. The role of general practitioners in cancer care: a mixed method design. J Canc Edu Offic J Am Assoc Canc Edu. 2015. doi:10.​1007/​s13187-015-0834-z.
27.
Browne S, Dowie A, Mitchell E, Mitchell L, Wyke S, Ziebland S, et al. Patients’ needs following colorectal cancer diagnosis: where does primary care fit in? Brit J Gen Pract J Roy Coll Gen Pract. 2011;61(592):e692-e9. doi:10.​3399/​bjgp11X606582.
28.
Dalsted RJ, Guassora AD, Thorsen T. Danish general practitioners only play a minor role in the coordination of cancer treatment. Danish Med Bull. 2011;58(1):A4222.
29.
Khan NF, Evans J, Rose PW. A qualitative study of unmet needs and interactions with primary care among cancer survivors. Brit J Cancer. 2011;105 Suppl 1(S1):S46–S51. doi:10.​1038/​bjc.​2011.​422.
30.
31.
Wind J, Duineveld LA, van der Heijden RP, van Asselt KM, Bemelman WA, van Weert HC. Follow-up after colon cancer treatment in the Netherlands; a survey of patients, GPs, and colorectal surgeons. Eur J Sur Oncol J Eur Soc Surg Oncol Brit Assoc Surg Oncol. 2013;39(8):837. doi:10.​1016/​j.​ejso.​2013.​04.​001.
32.
33.
34.
Michiels E, Deschepper R, Van Der Kelen G, Bernheim JL, Mortier F, Vander Stichele R, et al. The role of general practitioners in continuity of care at the end of life: a qualitative study of terminally ill patients and their next of kin. Palliat Med. 2007;21(5):409–15. doi:10.​1177/​0269216307078503​.CrossRefPubMed
35.
Norman A, Sisler J, Hack T, Harlos M. Family physicians and cancer care. Palliative care patients’ perspectives. Can Fam Phys. 2001;47(10):2009–16.
36.
Nazareth I, Jones L, Irving A, Aslett H, Ramsay A, Richardson A, et al. Perceived concepts of continuity of care in people with colorectal and breast cancer—a qualitative case study analysis. Eur J Cancer Care. 2008;17(6):569–77. doi:10.​1111/​j.​1365-2354.​2007.​00891.​x.
37.
38.
Roorda C, de Bock GH, van der Veen WJ, Lindeman A, Jansen L, van der Meer K. Role of the general practitioner during the active breast cancer treatment phase: an analysis of health care use. Support Care Cancer. 2012;20(4):705–14. doi:10.​1007/​s00520-011-1133-9.CrossRefPubMed
39.
40.
Gray RE, Goel V, Fitch MI, Franssen E, Labrecque M. Supportive care provided by physicians and nurses to women with breast cancer: results from a population-based survey. Support Care Cancer. 2002;10(8):647–52. doi:10.​1007/​s00520-002-0370-3.CrossRefPubMed
41.
42.
43.
Aubin M, Vézina L, Verreault R, Fillion L, Hudon É, Lehmann F, et al. Patient, primary care physician and specialist expectations of primary care physician involvement in cancer care. J Gen Intern Med. 2012;27(1):8–15. doi:10.​1007/​s11606-011-1777-7.CrossRefPubMed
44.
Hickner J, Kent S, Naragon P, Hunt L. Physicians’ and patients’ views of cancer care by family physicians: a report from the American Academy of Family Physicians National Research Network. Fam Med. 2007;39(2):126.PubMed
45.
46.
Adams E, Boulton M, Rose P, Lund S, Richardson A, Wilson S, et al. Views of cancer care reviews in primary care: a qualitative study. Brit J Gen Pract J Roy Coll Gen Pract. 2011;61(585):173–82. doi:10.​3399/​bjgp11X567108.CrossRef
47.
48.
49.
50.
Anvik T, Holtedahl KA, Mikalsen H. When patients have cancer, they stop seeing me–the role of the general practitioner in early follow-up of patients with cancer—a qualitative study. BMC Fam Pract. 2006;7(1):19–. doi:10.​1186/​1471-2296-7-19.
51.
Hølge-Hazelton B, Christensen I. In a unique position or squeezed out? The professional roles of general practitioners in cancer care in general and of young adult cancer patients in particular. J Cancer Educ. 2009;24(4):326–30. doi:10.​1080/​0885819090299740​7.CrossRefPubMed
52.
53.
54.
Johansen M-L, Holtedahl KA, Davidsen AS, Rudebeck CE. ‘I deal with the small things’: the doctor–patient relationship and professional identity in GPs’ stories of cancer care. Health. 2012;16(6):569–84.PubMed
55.
56.
57.
Mahboubi A, Lejeune C, Coriat R, Binquet C, Bouvier A-M, Béjean S, et al. Which patients with colorectal cancer are followed up by general practitioners? A population-based study. Eur J Cancer Prev Offic J Eur Cancer Prevent Organ (ECP). 2007;16(6):535–41. doi:10.​1097/​CEJ.​0b013e32801023a2​.CrossRef
58.
Demagny L, Holtedahl K, Bachimont J, Thorsen T, Letourmy A, Bungener M. General practitioners’ role in cancer care: a French-Norwegian study. BMC Res Note. 2009;2(1):200–. doi:10.​1186/​1756-0500-2-200.
59.
Watson E, O’Brien R, Campbell C, Weller D, Neal R, Wilkinson C, et al. Views of health professionals on the role of primary care in the follow-up of men with prostate cancer. Fam Pract. 2011;28(6):647–54. doi:10.​1093/​fampra/​cmr034.CrossRefPubMed
60.
Klabunde CN, Han PKJ, Earle CC, Smith T, Ayanian JZ, Lee R, et al. Physician roles in the cancer-related follow-up care of cancer survivors. Fam Med. 2013;45(7):463.PubMedPubMedCentral
61.
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.CrossRefPubMed
62.
63.
Dahlhaus A, Vanneman N, Guethlin C, Behrend J, Siebenhofer A. German general practitioners’ views on their involvement and role in cancer care: a qualitative study. Fam Pract. 2014;31(2):209.CrossRefPubMed
64.
Sada YH, Street JRL, Singh H, Shada RE, Naik AD. Primary care and communication in shared cancer care: a qualitative study. Am J Manag Care. 2011;17(4):259.PubMedPubMedCentral
65.
66.
Esteva Cantó M, Llobera Cánaves J, Miralles Xamena J, de Lluch Bauzá Amengual M. Management of terminal cancer patients: attitudes and training needs of primary health care doctors and nurses. Support Care Cancer. 2000;8(6):464–71. doi:10.​1007/​s005200000157.CrossRefPubMed
67.
68.
69.
Lizama N, Johnson CE, Ghosh M, Garg N, Emery JD, Saunders C. Keeping primary care “in the loop”: general practitioners want better communication with specialists and hospitals when caring for people diagnosed with cancer. Asia Pac J Clin Oncol. 2015;11(2):152–9. doi:10.​1111/​ajco.​12327.CrossRefPubMed
70.
71.
72.
Kantsiper M, McDonald EL, Geller G, Shockney L, Snyder C, Wolff AC. Transitioning to breast cancer survivorship: perspectives of patients, cancer specialists, and primary care providers. J Gen Int Med. 2009;24 Suppl 2(S2):S459–66. doi:10.​1007/​s11606-009-1000-2.
73.
Cheung WY, Aziz N, Noone A-M, Rowland JH, Potosky AL, Ayanian JZ, et al. Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists. J Cancer Surviv. 2013;7(3):343–54. doi:10.​1007/​s11764-013-0281-y.CrossRefPubMed
74.
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. doi:10.​1111/​ajco.​12047.CrossRefPubMed
75.
76.
Anell A, Willis M. International comparison of health care systems using resource profiles. Bull World Health Organ. 2000;78(6):770–8.PubMedPubMedCentral
77.
Aubin M, Giguère A, Martin M, Verreault R, Fitch MI, Kazanjian A, et al. Interventions to improve continuity of care in the follow-up of patients with cancer. Cochrane Datab Syst Rev. 2012;7:CD007672.
78.
Howell D, Hack TF, Oliver TK, Chulak T, Mayo S, Aubin M, et al. Models of care for post-treatment follow-up of adult cancer survivors: a systematic review and quality appraisal of the evidence. J Cancer Surviv. 2012;6(4):359–71. doi:10.​1007/​s11764-012-0232-z.CrossRefPubMed
79.
Jefford M, Baravelli C, Dudgeon P, Dabscheck A, Evans M, Moloney M, et al. Tailored chemotherapy information faxed to general practitioners improves confidence in managing adverse effects and satisfaction with shared care: results from a randomized controlled trial. J Clin Oncol. 2008;26(14):2272–7. doi:10.​1200/​JCO.​2007.​14.​7710.CrossRefPubMed
80.
Birgitta Johansson GBKHBGP-oS, Medicinska och farmaceutiska v, Uppsala u, Vårdvetenskap, Medicinska f, Institutionen för folkhälso- och v, et al. The role of the general practitioner in cancer care and the effect of an extended information routine. Scand J Prima health Care. 2000;18(3):143–8. doi:10.​1080/​028134300453331.
81.
82.
Boekhout AH, Maunsell E, Pond GR, Julian JA, Coyle D, Levine MN, et al. A survivorship care plan for breast cancer survivors: extended results of a randomized clinical trial. J Cancer Surviv. 2015;9(4):683–91. doi:10.​1007/​s11764-015-0443-1.CrossRefPubMed
83.
84.
Nicolaije KAH, Ezendam NPM, Vos MC, Pijnenborg JMA, Boll D, Boss EA, et al. Impact of an automatically generated cancer survivorship care plan on patient-reported outcomes in routine clinical practice: longitudinal outcomes of a pragmatic, cluster randomized trial. J Clin Oncol Offic J Am Soc Clin Oncol. 2015;33(31):3550–9. doi:10.​1200/​JCO.​2014.​60.​3399.CrossRef
85.
Grunfeld E, Mant D, Yudkin P, Adewuyi-Dalton R, Cole D, Stewart J, et al. Routine follow up of breast cancer in primary care: randomised trial. BMJ Brit Med J. 1996;313(7058):665–9.CrossRefPubMed
86.
87.
Cascinu S, Falconi M, Valentini V, Jelic S, Group EGW, On behalf of the EGWG. Pancreatic cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annal Oncol: Offic J Eur Soc Med Oncol / ESMO. 2010;21 Suppl 5(Supplement 5):v55–v8. doi:10.​1093/​annonc/​mdq165.
88.
Colombo N, Preti E, Landoni F, Carinelli S, Colombo A, Marini C, et al. Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annal Oncol Offic J Eur Soc Med Oncol / ESMO. 2013;24 Suppl 6:vi33.
89.
Senkus E, Kyriakides S, Penault-Llorca F, Poortmans P, Thompson A, Zackrisson S, et al. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annal Oncol Offic J Eur Soc Med Oncol / ESMO. 2013;24 Suppl 6:vi7.
90.
Waddell T, Verheij M, Allum W, Cunningham D, Cervantes A, Arnold D, et al. Gastric cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annal Oncol Offic J Eur Soc Med Oncol / ESMO. 2013;24 Suppl 6:vi57.
91.
Crinò L, Weder W, van Meerbeeck J, Felip E, Group EGW, On behalf of the EGWG. Early stage and locally advanced (non-metastatic) non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annal Oncol Offic J Eur Soc Med Oncol / ESMO. 2010;21 Suppl 5(Supplement 5):v103–v15. doi:10.​1093/​annonc/​mdq207.
92.
Cardoso F, Harbeck N, Fallowfield L, Kyriakides S, Senkus E, Group EGW, et al. Locally recurrent or metastatic breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annal Oncol Offic J Eur Soc Med Oncol / ESMO. 2012;23 Suppl 7(suppl 7):vii11–vii9. doi:10.​1093/​annonc/​mds232.
93.
Resnick MJ, Lacchetti C, Bergman J, Hauke RJ, Hoffman KE, Kungel TM, et al. Prostate cancer survivorship care guideline: American Society of Clinical Oncology Clinical Practice Guideline endorsement. J Clin Oncol Offic J Am Soc Clin Oncol. 2015;33(9):1078–85. doi:10.​1200/​JCO.​2014.​60.​2557.CrossRef
94.
Australia C. Follow-up care for women with early breast cancer: a guide for general practitioners 2010. Canberra: Australian Government; 2010.
95.
96.
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. doi:10.​1007/​s11764-014-0403-1.CrossRefPubMed
Metadata
Title
The role of the GP in follow-up cancer care: a systematic literature review
Authors
Judith A. Meiklejohn
Alexander Mimery
Jennifer H. Martin
Ross Bailie
Gail Garvey
Euan T. Walpole
Jon Adams
Daniel Williamson
Patricia C. Valery
Publication date
01-12-2016
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 6/2016
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-016-0545-4

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