Improving communication between the general practitioner and the oncologist: a key role in coordinating care for patients suffering from cancer

Vladimir Druel,Nathalie Boussier,Marie-Eve Rougé Bugat,Laetitia Gimenez,Kim Paricaud,Pascale Grosclaude,Jean-Pierre Delord

doi:10.1186/s12885-020-06993-0

Abstract

BackgroundPatients suffering from cancers are increasingly numerous in general practice consultations. The General Practitioner (GP) should be at the heart of the management of patients. Several studies have examined the perceptions of GPs confronted with the patient suffering from cancer and the relationships of GPs with oncologists, but few studies have focused on the patients’ perspective. We studied the three-way relationship between the oncologist, the GP, and the patient, from the patient’s point of view.MethodsA questionnaire validated by a group consisting of GPs, oncologists, nurses, an epidemiologist and quality analyst, was administered over a three-week period to patients suffering from cancer receiving chemotherapy in a day hospital.ResultsThe analysis was based on 403 questionnaires. Patients had confidence in the GP’s knowledge of oncology in 88% of cases; 49% consulted their GP for pain, 15% for cancer-related advice, and 44% in emergencies. Perceived good GP/oncologist communication led patients to turn increasingly to their GP for cancer-related consultations (RR = 1.14; p = 0.01) and gave patients confidence in the GP’s ability to manage cancer-related problems (RR = 1.30; p < 0.01). Mention by the oncologist of the GP’s role increased the consultations for complications (RR = 1.82; p < 0.01) as well as recourse to the GP in an emergency (RR = 1.35; p < 0.01).ConclusionPatients suffering from cancer considered that the GP was competent, but did not often consult their GP for cancer-related problems. There is a discrepancy between patients’ beliefs and their behaviour. When the oncologist spoke to patients of the GP’s role, patients had recourse to their GP more often. Systematically integrating a GP consultation to conclude cancer diagnosis disclosure, could improve management and care coordination.

Highlights

Patients suffering from cancers are increasingly numerous in general practice consultations
We found that increasing communication between different practitioners, in a way that is perceptible to the patient, reduces the use of emergency departments and increases the use of General Practitioner (GP) in primary care
Our work underlines the need for communication between all those involved [20, 43], as well as the fact that this communication must be visible and made explicit to the patient. It probably increases confidence because we showed that when the patient believes that there is good communication between the GP and the oncologist, the number of patients consulting for a cancer-related problem increases, whether in an emergency or not

Summary

Introduction

Patients suffering from cancers are increasingly numerous in general practice consultations. The General Practitioner (GP) should be at the heart of the management of patients. Several studies have examined the perceptions of GPs confronted with the patient suffering from cancer and the relationships of GPs with oncologists, but few studies have focused on the patients’ perspective. More and more patients consulting their general practitioner (GP) have, or have had, cancer [5]. The GP has a central role in the care of patients with cancer [6]. For greater equity in the management of patients suffering from cancer, a French National Cancer Plan has been implemented [10] to standardize its management. The plan proposes that the GP should be at the center of the care of patients suffering from cancer

Methods

Results

Discussion

Conclusion