Abstract
BackgroundPatients who have been treated for colorectal cancer in Australia can consult their general practitioner (GP) for advice about symptoms or side effects at any time following their treatment. However, there is no evidence that such patients are consistently advised by GPs, and patients experience substantial unmet need for reassurance and advice.ObjectiveTo explore the patient management options selected by GPs to treat a set of patients describing their symptoms following treatment for colorectal cancer.MethodsThis was an Internet-based survey. Participants (GPs) viewed 6 video vignettes of actors representing patients who had been treated for colorectal cancer. The actor-patients presented problems that resulted from their treatment. Participants indicated their diagnosis and stated if they would prescribe, refer, or order tests, based on that diagnosis. These responses were then rated against the management decisions for those vignettes as recommended by a team of colorectal cancer experts.ResultsIn total, 52 GPs consented to take part in the study, and 40 (77%) completed the study. Most GPs made a diagnosis of colorectal cancer treatment side effects/symptoms of recurrence that was consistent with the experts’ opinions. However, correct diagnosis was dependent on the type of case viewed. Compared with radiation proctitis, GPs were more likely to recognize peripheral neuropathy (odds ratio, OR, 4.43, 95% CI 1.41-13.96, P=.011) and erectile dysfunction (OR 9.70, 95% CI 2.48-38.03, P=.001), but less likely to identify chemotherapy-induced fatigue (OR 0.19, 95% CI 0.08-0.44). GPs who had more hours of direct patient care (OR 0.38, 95% CI 0.17-0.84, P=.02), were experienced (OR 9.78, 95% CI 1.18-8.84, P=.02), and consulted more patients per week (OR 2.48, 95% CI 1.16-5.30, P=.02) suggested a management plan that was consistent with the expert opinion.ConclusionsIn this pilot study, years of experience and direct patient contact hours had a significant and positive impact on the management of patients. This study also showed promising results indicating that management of the common side effects of colorectal cancer treatment can be delegated to general practice. Such an intervention could support the application of shared models of care. However, a larger study, including the management of side effects in real patients, needs to be conducted before this can be safely recommended.
Highlights
Colorectal cancer is the second most commonly diagnosed adult cancer in Australia [1]
This study showed promising results indicating that management of the common side effects of colorectal cancer treatment can be delegated to general practice
To address the needs of patients treated for colorectal cancer, the general practitioner (GP) needs to be knowledgeable about the recommended treatment for side effects of colorectal cancer treatment and the signs and symptoms that merit referral for further specialist treatment. In this pilot video vignette study, we aim to explore the impact of a variety of clinical and respondent characteristics of GPs’ decisions to treat colorectal cancer patients experiencing treatment side effects or symptoms of recurrence of their cancer
Summary
Colorectal cancer is the second most commonly diagnosed adult cancer in Australia [1]. One in 12 people in Australia will develop colorectal cancer in their lifetime [2]. Most people with colorectal cancer survive more than 5 years and die of unrelated causes [3]. The treatment of colorectal cancer may include surgery, radiotherapy, and chemotherapy. In the months and years following treatment, people may experience a number of troublesome side effects or symptoms and signs related to cancer recurrence. Many patients may experience bowel dysfunction, sexual dysfunction, urinary dysfunction, and fatigue, among other difficulties [4]. Patients who have been treated for colorectal cancer in Australia can consult their general practitioner (GP) for advice about symptoms or side effects at any time following their treatment. There is no evidence that such patients are consistently advised by GPs, and patients experience substantial unmet need for reassurance and advice
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
