General Practitioners' Experiences With Implementing Colon or Prostate Cancer Survivorship Care in Primary Care: A Cross-Sectional Survey Nested Within Two Randomized-Controlled Trials.

Abstract

To evaluate general practitioners' (GPs) experiences with providing cancer survivorship care and explore readiness for implementation. This cross-sectional survey study was nested within two randomized-controlled trials conducted in the Netherlands between 2015 and 2023, comparing GP- with specialist-led survivorship care for patients with colon or prostate cancer. An adapted version of the normalisation measure development (NoMAD) survey was distributed among participating GPs. NoMAD assesses the implementation of complex interventions and includes seven items on experiences (score ranges, 0-10) and 19 core items (expressed as % agreement). Higher scores indicate greater normalization, that is, embedding in primary care. In total, 214 GPs participated (response rate, 69%). The overall experience with providing survivorship care was 7.0 ± 1.6 for prostate cancer and 6.4 ± 1.8 for colon cancer. Lowest scores were seen for willingness to provide care (5.9 ± 2.4 and 5.0 ± 2.5, respectively), expected future involvement (6.6 ± 2.0 and 5.6 ± 2.5), and appropriateness of involvement (6.4 ± 2.1 and 5.6 ± 2.7). GPs in both trials agreed (±75%) there was potential value for patients, but not for their own work (±50%). Survivorship care for colon cancer was often perceived as different from usual care (74%). GPs' self-reported knowledge of care was high in the prostate cancer trial (62%), but not in the colon cancer trial (41%). GPs from both trials agreed that they could easily integrate management of physical and psychosocial effects into their work (±70%), but integrating routine check-ups was rated less positively (±55%). Financial compensation was deemed necessary (±80% agreed). Twenty-one percent was willing to provide care for other cancer types. GPs recognize value of providing survivorship care for patients, but experiences differ on the basis of cancer type. Implementation of prostate versus colon cancer survivorship care appears more feasible.