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Nicolaisen A, Lauridsen GB, Haastrup P, Hansen DG, Jarbøl DE. Healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective: a scoping review. Scand J Prim Health Care 2022; 40:11-28. [PMID: 35254205 PMCID: PMC9090364 DOI: 10.1080/02813432.2022.2036421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE General practice plays an important role in cancer trajectories, and cancer patients request the continuous involvement of general practice. The objective of this scoping review was to identify healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective. DESIGN, SETTING, AND SUBJECTS A scoping review of the literature published in Danish or English from 2010 to 2020 was conducted. Data was collected using identified keywords and indexed terms in several databases (PubMed, MEDLINE, EBSCO CINAHL, Scopus, and ProQuest), contacting key experts, searching through reference lists, and reports from selected health political, research- and interest organizations' websites. MAIN OUTCOME MEASURES We identified healthcare practices in cancer trajectories that increase quality care. Identified healthcare practices were grouped into four contextual domains and allocated to defined phases in the cancer trajectory. The results are presented according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping reviews (PRISMA-ScR). RESULTS A total of 45 peer-reviewed and six non-peer-reviewed articles and reports were included. Quality of care increases in all phases of the cancer trajectory when GPs listen carefully to the full story and use action plans. After diagnosis, quality of care increases when GPs and practice staff have a proactive care approach, act as interpreters of diagnosis, treatment options, and its consequences, and engage in care coordination with specialists in secondary care involving the patient. CONCLUSION This scoping review identified healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective. The results support general practice in investigating own healthcare practices and identifying possibilities for quality improvement.KEY POINTSIdentified healthcare practices in general practice that increase the quality of care in cancer trajectories:Listen carefully to the full storyUse action plans and time-out-consultationsPlan and provide proactive careAct as an interpreter of diagnosis, treatment options, and its consequences for the patientCoordinate care with specialists, patients, and caregivers with mutual respectIdentified barriers for quality of care in cancer trajectories are:Time constraints in consultationsLimited accessibility for patients and caregiversHealth practices to increase the quality of care should be effective, safe, people-centered, timely, equitable, integrated, and efficient. These distinctions of quality of care, support general practice in investigating and improving quality of care in cancer trajectories.
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Affiliation(s)
- Anne Nicolaisen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
- CONTACT Anne Nicolaisen Research Unit for General Practice, Department of Public Health, University of Southern Denmark, DK-5000Odense C, Denmark
| | - Gitte Bruun Lauridsen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Peter Haastrup
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Dorte Gilså Hansen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
- Center for Shared Decision Making, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- The Department of Regional Health Research, University of Southern Denmark, Odense C, Denmark
| | - Dorte Ejg Jarbøl
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
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Rotbain EC, Rostgaard K, Andersen MA, Da Cunha-Bang C, Niemann CU, Frederiksen H, Hjalgrim H. Healthcare Utilization and Comorbidity in Chronic Lymphocytic Leukemia. Clin Epidemiol 2021; 13:1155-1165. [PMID: 35002328 PMCID: PMC8722577 DOI: 10.2147/clep.s337495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/04/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Age-related comorbidity is highly prevalent in chronic lymphocytic leukemia (CLL). The purpose of this study was to provide information on current patterns of healthcare utilization in CLL. PATIENTS AND METHODS We used data from Danish nation-wide registers to study healthcare utilization the year before and the year after CLL diagnosis and in relation to first-line treatment. Patients diagnosed with CLL between 1997 and 2018 were included and stratified on number of comorbidities, presence of specific comorbidities, and fitness status, respectively. Healthcare utilization was studied in terms of hospital admissions, in-hospital bed days, out-patient visits, emergency room visits, and prescription drugs. Odds ratios with 95% confidence intervals were calculated using multivariable logistic regression analyses adjusting for age, sex, and calendar year. RESULTS The study comprised 9170 patients with CLL with a median age of 71 years, of whom 35% had ≥1 comorbidity. Healthcare utilization increased markedly upon CLL diagnosis both in patients with and without comorbidities. During the year after CLL diagnosis, 39% were hospitalized, 16% visited an emergency room, 88% visited an out-patient clinic, and 93% received prescription drugs. Both individual comorbidities and the total number of comorbidities were associated with increased healthcare utilization of all types, except for contacts to hematological departments. CONCLUSION Our results suggest that CLL diagnosis may unveil incipient diseases and aggravate comorbidities and thereby have considerably wider health implications than those directly related to CLL. These findings may be used by clinicians and decisions makers to guide planning of multidisciplinary care for cancer patients.
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Affiliation(s)
- Emelie C Rotbain
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Department of Hematology, Rigshospitalet, Denmark
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Danish Cancer Society Research Center, Hematology Research Group, Copenhagen, Denmark
| | - Klaus Rostgaard
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Danish Cancer Society Research Center, Hematology Research Group, Copenhagen, Denmark
| | - Michael A Andersen
- Department of Hematology, Rigshospitalet, Denmark
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | | | | | - Henrik Frederiksen
- Department of Hematology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Academy of Geriatric Cancer Research (AGECARE), Odense University Hospital, Odense, Denmark
| | - Henrik Hjalgrim
- Department of Hematology, Rigshospitalet, Denmark
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Danish Cancer Society Research Center, Hematology Research Group, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
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Cho J, Nilo D, Sterling MR, Kern LM, Safford MM, Pinheiro LC. Eliciting primary care and oncology provider perspectives on diabetes management during active cancer treatment. Support Care Cancer 2021; 29:6881-6890. [PMID: 34018032 DOI: 10.1007/s00520-021-06264-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/30/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE We sought to elicit the perspectives of primary care providers (PCPs) and oncologists regarding their expectations on who should be responsible for diabetes management, as well as communication mode and frequency about diabetes care during cancer treatment. METHODS In-depth interviews were conducted with PCPs (physicians and nurse practitioners) and oncologists who treat cancer patients with type 2 diabetes. Interviews were audio-recorded and professionally transcribed. A grounded theory approach was used to analyze the qualitative data and identify key themes. RESULTS Ten PCPs and ten oncologists were interviewed between March and July 2019. Two broad themes emerged from our interviews with PCPs: (1) cancer patients pausing primary care during cancer treatments, and (2) patients with poorer prognoses and advanced cancer. The following theme emerged from our interviews with oncologists: (3) challenges in caring for cancer patients with uncontrolled diabetes. Three common themes emerged from our interviews with both PCPs and oncologists: (4) discomfort with providing care outside of respective specialty, (5) the need to individualize care plans, and (6) lack of communication across primary and oncology care. CONCLUSIONS Our findings suggest that substantial barriers to optimal diabetes management during cancer care exist at the provider level. Interventions prioritizing effective communication and educational resources among PCPs, oncologists, and additional members of the patients' care team should be prioritized to achieve optimal outcomes.
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Affiliation(s)
- Jacklyn Cho
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA
| | - Daniela Nilo
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA
| | - Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA
| | - Lisa M Kern
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA
| | - Monika M Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA
| | - Laura C Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA.
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Hansen DG, Trabjerg TB, Sisler JJ, Søndergaard J, Jensen LH. Cross-sectoral communication by bringing together patient with cancer, general practitioner and oncologist in a video-based consultation: a qualitative study of oncologists' and nurse specialists' perspectives. BMJ Open 2021; 11:e043038. [PMID: 33952540 PMCID: PMC8103367 DOI: 10.1136/bmjopen-2020-043038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED Shared care models in the field of cancer aim to improve care coordination, role clarification and patient satisfaction. Cross-sectoral communication is pivotal. Involvement of patients may add to intended mechanisms.A randomised controlled trial 'The Partnership Study' tested the effect of bringing together patient, general practitioner (GP) and oncologist for a consultation conducted by video. PURPOSE As part of the process evaluation, this study aimed to explore experiences, attitudes and perspectives of the oncological department on sharing patient consultations with GPs using video. METHODS Four semistructured interviews with five oncologists and four nurse specialists were conducted in February 2020. We focused on the informants' experiences and reflections on the potential of future implementation of the concept 'inviting the GP for a shared consultation by video'. The analyses were based on an inductive, open-minded, hermeneutic phenomenological approach. RESULTS A total of six overall themes were identified: structuring consultation and communication, perceptions of GP involvement in cancer care, stressors, making a difference, alternative ways of cross-sector communication and needs for redesigning the model. The concept made sense and was deemed useful, but solving the many technical and organisational problems is pivotal. Case-specific tasks and relational issues were targeted by pragmatically rethinking protocol expectations and the usual way of communication and structuring patient encounters. Case selection was discussed as one way of maturing the concept. CONCLUSION This Danish study adds new insight into understanding different aspects of the process, causal mechanisms as well as the potential of future implementation of video-based tripartite encounters. Beyond solving the technical problems, case selection and organisational issues are important. Acknowledging the disruption of the usual workflow, the introduction of new phases of the usual encounter and the variety of patient-GP relationships to be embraced may help to better understand and comply with barriers and facilitators of communication and sharing. TRIAL REGISTRATION NUMBER NCT02716168.
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Affiliation(s)
- Dorte Gilså Hansen
- Research Unit for General Practice, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Center for Shared Decision Making, Lillebælt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
| | - Theis Bitz Trabjerg
- Research Unit for General Practice, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jeffrey James Sisler
- Department of Family Medicine, University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
| | - Jens Søndergaard
- Research Unit for General Practice, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Lars Henrik Jensen
- Institute of Regional Health Research, University of Southern Denmark, Vejle, Denmark
- Department of Oncology, Lillebælt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
- Danish Colorectal Cancer Center South, Center of Clinical Excellence, Lillebaelt Hospital, University Hospital of Southern Denmark, University of Southern Denmark, Vejle, Denmark
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Hopstaken JS, van Dalen D, van der Kolk BM, van Geenen EJM, Hermans JJ, Gootjes EC, Schers HJ, van Dulmen AM, van Laarhoven CJHM, Stommel MWJ. Continuity of care experienced by patients in a multi-institutional pancreatic care network: a pilot study. BMC Health Serv Res 2021; 21:416. [PMID: 33941181 PMCID: PMC8094517 DOI: 10.1186/s12913-021-06431-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Over the past decades, health care services for pancreatic surgery were reorganized. Volume norms were applied with the result that only a limited number of expert centers perform pancreatic surgery. As a result of this centralization of pancreatic surgery, the patient journey of patients with pancreatic tumors has become multi-institutional. To illustrate, patients are referred to a center of expertise for pancreatic surgery whereas other parts of pancreatic care, such as chemotherapy, take place in local hospitals. This fragmentation of health care services could affect continuity of care (COC). The aim of this study was to assess COC perceived by patients in a pancreatic care network and investigate correlations with patient-and care-related characteristics. Methods This is a pilot study in which patients with (pre) malignant pancreatic tumors discussed in a multidisciplinary tumor board in a Dutch tertiary hospital were asked to participate. Patients were asked to fill out the Nijmegen Continuity of Care-questionnaire (NCQ) (5-point Likert scale). Additionally, their patient-and care-related data were retrieved from medical records. Correlations of NCQ score and patient-and care-related characteristics were calculated with Spearman’s correlation coefficient. Results In total, 44 patients were included (92% response rate). Pancreatic cancer was the predominant diagnosis (32%). Forty percent received a repetition of diagnostic investigations in the tertiary hospital. Mean scores for personal continuity were 3.55 ± 0.74 for GP, 3.29 ± 0.91 for the specialist and 3.43 ± 0.65 for collaboration between GPs and specialists. Overall COC was scored with a mean 3.38 ± 0.72. No significant correlations were observed between NCQ score and certain patient-or care-related characteristics. Conclusion Continuity of care perceived by patients with pancreatic tumors was scored as moderate. This outcome supports the need to improve continuity of care within multi-institutional pancreatic care networks. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06431-2.
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Affiliation(s)
- J S Hopstaken
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands.,Radboud Institute for Health Sciences, Radboud university medical center, Nijmegen, the Netherlands
| | - D van Dalen
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands
| | - B M van der Kolk
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands
| | - E J M van Geenen
- Department of Gastroenterology, Radboud university medical center, Nijmegen, the Netherlands
| | - J J Hermans
- Department of Medical Imaging, Radboud university medical center, Nijmegen, the Netherlands
| | - E C Gootjes
- Department of Medical Oncology, Radboud university medical center, Nijmegen, the Netherlands
| | - H J Schers
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, the Netherlands
| | - A M van Dulmen
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, the Netherlands.,Nivel (Netherlands institute for health services research), Utrecht, the Netherlands
| | - C J H M van Laarhoven
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands
| | - M W J Stommel
- Department of Surgery, Radboud university medical center, Geert Grooteplein 10 (route 618), 6525 GA, Nijmegen, the Netherlands.
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Cross-sectoral video consultation in cancer care: GPs' evaluation of a randomised controlled trial. BJGP Open 2020; 5:BJGPO.2020.0114. [PMID: 33293407 PMCID: PMC8170612 DOI: 10.3399/bjgpo.2020.0114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/28/2020] [Indexed: 11/09/2022] Open
Abstract
Background Shared care models present an opportunity for patients to receive the benefits of specialist care combined with the continuity of care provided by a GP. Aim To test the effects on GP-perceived involvement in cancer care and their satisfaction with this cross-sectoral information after bringing the patient, GP, and oncologist together in a shared video consultation. Design & setting GPs from the Region of Southern Denmark evaluated a randomised controlled trial testing shared video consultations. Method This study describes secondary outcomes based on a 4 months' follow-up survey from GPs participating in The Partnership Project (PSP). Patient perception of coordination of care at 7 months' follow-up was the primary outcome of the PSP. A tripartite video consultation was conducted during cancer treatment to share tasks and roles between health professionals with the patient. Results The study included 281 patients, and 105 unique GPs returned 124 questionnaires. Video consultations were accomplished in 68% of scheduled cases. The study found an increased odds ratio (OR) of 3.03 for GP satisfaction with the distribution of tasks and roles, and they experienced more involvement in the cancer patients' trajectory. The study found an increased OR of 6.95 for the GP perception of more direct contact and dialogue with the Department of Oncology. There was a decreased OR of 0.88 for the GP to be engaged in handling anxiety and psychological concerns. Conclusion The study showed that involving the GP in one shared consultation increased the odds of the GP being satisfied with the distribution of tasks and roles, and feeling more involved in the cancer patient’s trajectory. However, recruitment and response rates from GPs were limiting factors.
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Zereshkian A, Forman J, Menjak I, Mehta R, Bristow B, Trudeau M, Gibson L, Neve MV, Norris M, Pasetka M, Wright FW, Rice K, McCullock F, Karim A, Szumacher E. Assessment of communication gaps among referring physicians and the multi-disciplinary team at the senior women breast Cancer clinic (SWBCC), Sunnybrook health sciences Centre, Toronto, Ontario, Canada. J Geriatr Oncol 2020; 12:676-679. [PMID: 33071212 DOI: 10.1016/j.jgo.2020.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/18/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Arman Zereshkian
- Undergraduate Medical Education, University of Toronto, Toronto, Ontario, Canada
| | - Jamie Forman
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Ines Menjak
- Department of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Rajin Mehta
- Department of Geriatric Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Bonnie Bristow
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Maureen Trudeau
- Department of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - Leslie Gibson
- Department of Occupational Therapy Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Matthew V Neve
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Mireille Norris
- Department of Geriatric Medicine, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Mark Pasetka
- Department of Pharmacy Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Frances W Wright
- Department of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Katie Rice
- Department of Social Work, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Fiona McCullock
- Department of Nursing, Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | | | - Ewa Szumacher
- Department of Radiation Oncology, Sunnybrook Hospital, Toronto, Ontario, Canada.
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Investigating whether shared video-based consultations with patients, oncologists, and GPs can benefit patient-centred cancer care: a qualitative study. BJGP Open 2020; 4:bjgpopen20X101023. [PMID: 32238390 PMCID: PMC7330209 DOI: 10.3399/bjgpopen20x101023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/29/2019] [Indexed: 12/12/2022] Open
Abstract
Background Guidelines have proposed that GPs should have a central role as coordinators of care and support patients with cancer during all stages of treatment, follow-up, and rehabilitation. Multidisciplinary video consultation involving the patient with cancer, the oncologist, and the GP may help to define roles and tasks, and this resulting clarity may enable greater support for patients with cancer. Aim To explore the consultation structure, content, and task clarification when a GP and an oncologist are attending a video consultation with a patient with cancer. Design & setting A qualitative study took place in the Region of Southern Denmark to investigate multidisciplinary video consultations, based on thematic analysis. Method Recordings of 12 video consultations were analysed using the framework method. A combined deductive and inductive approach was undertaken. The deductive themes were selected based on a consultation guide given to the doctors before the consultations. Results The study identified 15 themes, which were grouped into the following three categories: the implications of sharing a consultation; consultation structure; and health concerns. Conclusion Multidisciplinary video-based consultations with a patient and two health professionals succeeded in having a patient-centred communication style. In clarifying tasks between the GP and oncologist to support the patient, work-related issues and professional support for psychosocial challenges were always a task for the GP. Dissemination of this first-line evidence may improve acceptability among medical specialists and help assist GPs in supporting patients with cancer. However, focus on the involvement of relatives should be emphasised.
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Trabjerg TB, Jensen LH, Søndergaard J, Sisler JJ, Hansen DG. Cross-sectoral video consultations in cancer care: perspectives of cancer patients, oncologists and general practitioners. Support Care Cancer 2020; 29:107-116. [PMID: 32318872 PMCID: PMC7686003 DOI: 10.1007/s00520-020-05467-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 04/13/2020] [Indexed: 12/13/2022]
Abstract
Purpose Multidisciplinary video consultations are one method of improving coherence and coordination of care in cancer patients, but knowledge of user perspectives is lacking. Continuity of care is expected to have a significant impact on the quality of cancer care. Enhanced task clarification and shared responsibility between the patient, oncologist and general practitioner through video consultations might provide enhanced continuity in cancer care. Method We used descriptive survey data from patients and doctors in the intervention group based on a randomised controlled trial to evaluate the user perspectives and fidelity of the intervention. Results Patients expressed that they were able to present their concerns in 95% of the consultations, and believed it was beneficial to have both their doctors present in 84%. The general practitioner and oncologist found that tripartite video consultation would lead to better coordination of care in almost 90% of the consultations. However, the benefits of handling social issues and comorbidity were sparser. Consultations were not accomplished in 11% due to technical problems and sound and video quality were non-satisfactory in 20%. Conclusion Overall, multidisciplinary video consultations between cancer patient, general practitioner and oncologist were feasible in daily clinics. Initial barriers to address were technical issues and seamless planning. Patients reported high satisfaction, patient centredness and clarity of roles. General practitioners and oncologists were overall positive regarding role clarification and continuity, although less pronounced than patients. Trial registration www.clincialtrials.gov, NCT02716168.
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Affiliation(s)
- Theis Bitz Trabjerg
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsloews Vej 9A, 5000 Odense C, Denmark
| | - Lars Henrik Jensen
- Department of Oncology, Lillebaelt University Hospital, Vejle, Denmark
- Danish Colorectal Cancer Center South, Center of Clinical Excellence, Vejle Hospital, Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsloews Vej 9A, 5000 Odense C, Denmark
| | - Jeffrey James Sisler
- Department of Family Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Dorte Gilså Hansen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsloews Vej 9A, 5000 Odense C, Denmark
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