TY - JOUR
T1 - Off to a good start after a cancer diagnosis
T2 - implementation of a time out consultation in primary care before cancer treatment decision
AU - Noteboom, Eveline A.
AU - de Wit, Niek J.
AU - van Asseldonk, Ingrid J.E.M.
AU - Janssen, Monique C.A.M.
AU - Lam-Wong, Wai Yee
AU - Linssen, Rob H.P.J.
AU - Pepels, Manon J.A.E.
AU - Schrama, Natascha A.W.P.
AU - Trompper, Mariëlle E.H.
AU - Veldhuizen, L. Maaike
AU - Wijtvliet, Anne P.
AU - Zeldenrust, Ed G.F.
AU - Hendrikx, Ans M.
AU - van de Boomen, Wil A.
AU - Elbersen, Dorothé M.
AU - Jacobs, Esther M.G.
AU - van der Wall, Elsken
AU - Helsper, Charles W.
N1 - Funding Information:
The authors are grateful to the participants of the study. Financial support was provided by the Dutch Cancer Society (KWF Kankerbestrijding) and the Danone Ecosystem Fund.
Publisher Copyright:
© 2019, The Author(s).
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Purpose: Supportive care for cancer patients may benefit from improving treatment decisions and optimal use of the family physicians’ and specialists’ strengths. To improve shared decision-making (SDM) and facilitate continuity of primary care during treatment, a cancer care path including a “time out consultation” (TOC) in primary care before treatment decision, was implemented. This study assesses the uptake of a TOC and the added value for SDM. Methods: For patients with metastatic lung or gastro-intestinal cancer, a TOC was introduced in their care path in a southern region of The Netherlands, from April until October 2016. Uptake of a TOC was measured to reflect on facilitation of continuity of primary care. The added value for SDM and overall experiences were evaluated with questionnaires and semi-structured interviews among patients, family physicians, and specialists. Results: Of the 40 patients who were offered a TOC, 31 (78%) had a TOC. Almost all patients, family physicians, and specialists expressed that they experienced added value for SDM. This includes a stimulating effect on reflection on choice (expressed by 83% of patients) and improved preparation for treatment decision (75% of patients). Overall added value of a TOC for SDM, only evaluated among family physicians and specialists, was experienced by 71% and 86% of these physicians, respectively. Conclusion and Implications for Cancer Survivors: The first experiences with a TOC in primary care before cancer treatment decision suggest that it may help to keep the GP “in the loop” after a cancer diagnosis and that it may contribute to the SDM process, according to patients, family physicians, and specialists.
AB - Purpose: Supportive care for cancer patients may benefit from improving treatment decisions and optimal use of the family physicians’ and specialists’ strengths. To improve shared decision-making (SDM) and facilitate continuity of primary care during treatment, a cancer care path including a “time out consultation” (TOC) in primary care before treatment decision, was implemented. This study assesses the uptake of a TOC and the added value for SDM. Methods: For patients with metastatic lung or gastro-intestinal cancer, a TOC was introduced in their care path in a southern region of The Netherlands, from April until October 2016. Uptake of a TOC was measured to reflect on facilitation of continuity of primary care. The added value for SDM and overall experiences were evaluated with questionnaires and semi-structured interviews among patients, family physicians, and specialists. Results: Of the 40 patients who were offered a TOC, 31 (78%) had a TOC. Almost all patients, family physicians, and specialists expressed that they experienced added value for SDM. This includes a stimulating effect on reflection on choice (expressed by 83% of patients) and improved preparation for treatment decision (75% of patients). Overall added value of a TOC for SDM, only evaluated among family physicians and specialists, was experienced by 71% and 86% of these physicians, respectively. Conclusion and Implications for Cancer Survivors: The first experiences with a TOC in primary care before cancer treatment decision suggest that it may help to keep the GP “in the loop” after a cancer diagnosis and that it may contribute to the SDM process, according to patients, family physicians, and specialists.
KW - Decision-making
KW - Medical oncology
KW - Primary health care
UR - https://www.scopus.com/pages/publications/85076769350
U2 - 10.1007/s11764-019-00814-5
DO - 10.1007/s11764-019-00814-5
M3 - Article
C2 - 31734854
SN - 1932-2259
VL - 14
SP - 9
EP - 13
JO - Journal of cancer survivorship : research and practice
JF - Journal of cancer survivorship : research and practice
IS - 1
ER -