The Effectiveness of Shared Care in Cancer Survivors—A Systematic Review

Yan Zhao,Ling Qiu,Alison Brettle

doi:10.5334/ijic.3954

Abstract

Objectives:To determine whether the shared care model during the follow-up of cancer survivors is effective in terms of patient-reported outcomes, clinical outcomes, and continuity of care.Methods:Using systematic review methods, studies were searched from six electronic databases—MEDLINE (n = 474), British Nursing Index (n = 320), CINAHL (n = 437), Cochrane Library (n = 370), HMIC (n = 77), and Social Care Online (n = 210). The review considered all health-related outcomes that evaluated the effectiveness of shared care for cancer survivors.Results:Eight randomised controlled trials and three descriptive papers were identified. The results showed the likelihood of similar effectiveness between shared care and usual care in terms of quality of life, mental health outcomes, unmet needs, and clinical outcomes in cancer survivorship. The reviewed studies indicated that shared care overall is highly acceptable to cancer survivors and primary care practitioners, and shared care might be cheaper than usual care.Conclusions:The results from this review suggest that the patient satisfaction of shared care is higher than usual care, and the effectiveness of shared care is similar to usual care in cancer survivorship. Interventions that formally involve primary care and improve the communication between primary care and hospital care could support the PCPs in the follow-up.

Highlights

With the improvements in medical treatment and ageing populations, the number of cancer survivors is increasing worldwide [1, 2]
Review questions and objectives In this study, we systematically review the literature that focuses on the effectiveness and feasibility of shared care in the management of follow-up for cancer patients in different settings, and critically appraise the quality of evidence
Implications for practice The present review shines a light on improving the followup, with current evidence indicating that shared care is an affordable model as well as being feasible and acceptable for cancer survivors

Summary

Introduction

With the improvements in medical treatment and ageing populations, the number of cancer survivors is increasing worldwide [1, 2]. Most cancer patients were followed up by hospital specialists [5, 6]. Nielsen et al [7] believes that most cancer patient might feel left alone after they are discharged from the hospital. Yang et al [8] argues that cancer specialists might not be able to provide necessary care unless there is enhanced oncological productivity. Due to the increased need, stabilised health care costs, and the sustainable burden of hospitals, the involvement of primary care has been increasingly recognized as a vital component in the management of cancer survivors [9, 10]

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Discussion

Conclusion