Improving primary care involvement in cancer care

Today Dr. Ietje Perfors defended her thesis Improving primary care involvement in cancer care.

Perfors shows in her thesis that Dutch cancer patients call for more general practitioner (GP) involvement shortly after cancer diagnosis and report a need for shared decision making (SDM) support with the GP. Currently, this need is inadequately met.

The researchgroup designed and evaluated the GRIP intervention which consisted of two components.

  1. A time Out consultation (TOC) with SDM before treatment decision in hospital with patient’s GP and
  2. Structural guidance during and after treatment by the GP and the homecare oncology nurse (HON).

The concept of a TOC seemed well accepted (>80% visited their GP when offered). Yet, adequate timing of a TOC proved challenging, as the majority of patients had their TOC after the treatment decision in the hospital was already made. This resulted in lower experienced SDM in the intervention arm. The second part of the GRIP intervention; the HON, also seemed well accepted, but the design seemed suboptimal. Other findings include; slightly more GP contacts and use of the emergency department and lower GP satisfaction in the intervention arm. In short; potential and need for primary care involvement seems obvious, but the design, evaluation and implementation of new interventions remains challenging. Continuous development of interventions to support primary care involvement in cancer care remains needed.

Nederlandse Federatie van Kankerpatiëntenorganisaties (NFK) is co-initiator of the GRIP study