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初级保健医生对癌症幸存者常规随访护理的看法。

Primary care physicians' views of routine follow-up care of cancer survivors.

作者信息

Del Giudice M Elisabeth, Grunfeld Eva, Harvey Bart J, Piliotis Eugenia, Verma Sunil

机构信息

Department of Family and Community Medicine, University of Toronto, Canada.

出版信息

J Clin Oncol. 2009 Jul 10;27(20):3338-45. doi: 10.1200/JCO.2008.20.4883. Epub 2009 Apr 20.

Abstract

PURPOSE

Routine follow-up of adult cancer survivors is an important clinical and health service issue. Because of a lack of evidence supporting advantages of long-term follow-up care in oncology clinics, there is increasing interest for the locus of this care to be provided by primary care physicians (PCPs). However, current Canadian PCP views on this issue have been largely unknown.

METHODS

A mail survey of a random sample of PCPs across Canada, stratified by region and proximity to urban centers, was conducted. Views on routine follow-up of adult cancer survivors and modalities to facilitate PCPs in providing this care were determined.

RESULTS

A total of 330 PCPs responded (adjusted response rate, 51.7%). After completion of active treatment, PCPs were willing to assume exclusive responsibility for routine follow-up care after 2.4 +/- 2.3 years had elapsed for prostate cancer, 2.6 +/- 2.6 years for colorectal cancer, 2.8 +/- 2.5 years for breast cancer, and 3.2 +/- 2.7 years for lymphoma. PCPs already providing this care were willing to provide exclusive care sooner. The most useful modalities PCPs felt would assist them in assuming exclusive responsibility for follow-up cancer care were (1) a patient-specific letter from the specialist, (2) printed guidelines, (3) expedited routes of rereferral, and (4) expedited access to investigations for suspected recurrence.

CONCLUSION

With appropriate information and support in place, PCPs reported being willing to assume exclusive responsibility for the follow-up care of adult cancer survivors. Insights gained from this survey may ultimately help guide strategies in providing optimal care to these patients.

摘要

目的

成年癌症幸存者的常规随访是一个重要的临床和卫生服务问题。由于缺乏证据支持肿瘤诊所长期随访护理的优势,越来越多的人关注由初级保健医生(PCP)提供这种护理的场所。然而,目前加拿大初级保健医生对这个问题的看法在很大程度上尚不为人所知。

方法

对加拿大各地的初级保健医生进行随机抽样邮件调查,按地区和与城市中心的距离分层。确定了对成年癌症幸存者常规随访的看法以及促进初级保健医生提供这种护理的方式。

结果

共有330名初级保健医生做出回应(调整后的回应率为51.7%)。在完成积极治疗后,对于前列腺癌,初级保健医生愿意在2.4±2.3年过去后承担常规随访护理的独家责任;对于结直肠癌,为2.6±2.6年;对于乳腺癌,为2.8±2.5年;对于淋巴瘤,为3.2±2.7年。已经提供这种护理的初级保健医生愿意更早地提供独家护理。初级保健医生认为最有助于他们承担癌症随访护理独家责任的方式是:(1)专科医生提供的针对患者的信件;(2)印刷指南;(3)加快重新转诊的途径;(4)加快对疑似复发进行检查的途径。

结论

有了适当的信息和支持,初级保健医生报告愿意承担成年癌症幸存者随访护理的独家责任。从这项调查中获得的见解最终可能有助于指导为这些患者提供最佳护理的策略。

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