Abstract
PurposeThe cancer survivor population is projected to increase to 22.2 million by 2030, requiring improved collaboration between oncology and primary care practices (PCP). PCPs may feel ill-equipped to provide cancer survivorship care to patients without input from cancer specialists. Compared with nonrural cancer survivors, rural cancer survivors report experiencing worse treatment-related symptoms. The goal of this study was to gain a better understanding of the perspectives of PCP teams towards survivorship care and to develop and test an interdisciplinary training program to improve cancer survivorship care in rural practice.MethodsThis study was conducted in two phases. First, focus groups were conducted with rural PCP teams to gather information regarding beliefs, practices, and barriers related to cancer survivorship care delivery. A thematic analysis was completed using an iterative process of reviewing transcripts. Results from phase 1 were used to inform the development of a pilot intervention tested within seven rural PCPs (phase 2). Pre- and post-intervention knowledge changes were compared, and post-session interviews assessed planned or sustained practice changes.ResultsSeven PCPs participated in focus groups (phase 1). Cross-cutting themes identified included (1) organizational barriers affecting the delivery of cancer survivorship care, (2) challenges of role delineation with specialists and patients, (3) difficulty accessing survivorship care and resources, and (4) providers’ lack of knowledge of cancer survivorship care. For phase 2, seven practices participated in four case-based educational sessions. Within and between practice changes were identified.ConclusionThis project explored cancer survivorship perspectives among PCP teams. Lack of familiarity with evidence-based guidelines and the inability to identify cancer survivors was apparent during discussions and led to the implementation of the phase 2 intervention, iSurvive. As a result, PCPs either changed or planned changes to improve the identification and evidence-based care of cancer survivors.Implications for Cancer SurvivorsAddress barriers to access cancer survivorship care in rural primary care practices.
Highlights
While the incidence and mortality from cancer in the US continue to decline, the morbidity associated with treatment and recovery is a growing concern [1]
It is projected that by 2030 there will be over 22.2 million cancer survivors [2]. This will place a great burden on the oncology care workforce and require improved coordination and collaboration between oncology and primary care providers (PCP)
Cancer survivorship care remains inadequate for the vast majority of patients who have decreased the frequency or stopped seeing their oncologists and returned to routine care with a PCP [3, 4]
Summary
While the incidence and mortality from cancer in the US continue to decline, the morbidity associated with treatment and recovery is a growing concern [1]. It is projected that by 2030 there will be over 22.2 million cancer survivors [2]. This will place a great burden on the oncology care workforce and require improved coordination and collaboration between oncology and primary care providers (PCP). Cancer survivorship care remains inadequate for the vast majority of patients who have decreased the frequency or stopped seeing their oncologists and returned to routine care with a PCP [3, 4]. Significant research has documented that these PCPs may feel ill equipped to provide guideline-concordant cancer survivorship care to patients without input from cancer specialists [4, 5]. It is crucial to prepare PCPs to deliver evidence-based and guideline concordant survivorship care
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