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将初级保健提供者纳入癌症幸存者护理:证据差距与未来机遇

Integrating primary care providers in the care of cancer survivors: gaps in evidence and future opportunities.

作者信息

Nekhlyudov Larissa, O'malley Denalee M, Hudson Shawna V

机构信息

Division of General Medicine and Primary Care, Department of Medicine, Brigham & Women's Hospital and Department of Population Medicine, Harvard Medical School, Boston, MA, USA.

Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Rutgers School of Social Work, New Brunswick, NJ, USA.

出版信息

Lancet Oncol. 2017 Jan;18(1):e30-e38. doi: 10.1016/S1470-2045(16)30570-8.

Abstract

Since the release of the Institute of Medicine report: From cancer patient to cancer survivor: lost in transition, in 2005, there has been a national call in the USA to provide coordinated, comprehensive care for cancer survivors, with an emphasis on the role of primary care. Several models of care have been described, which focus on primary care providers (PCPs) as receiving cancer survivors who are transferred after successful treatment, and who are given specific types of information from oncology-based care (eg, survivorship care plans), and not as active members of the cancer survivorship team. In this Series paper, we assessed survivorship models that have been described in the literature, with a specific focus on strategies that aim to integrate PCPs into the care of cancer survivors across different settings. We offer insights differentiating PCPs' level of expertise in cancer survivorship and how such expertise could be used. We provide recommendations for education, clinical practice, research, and policy initiatives that might advance the integration of PCPs in the care of cancer survivors in diverse clinical settings.

摘要

自2005年医学研究所发布《从癌症患者到癌症幸存者:过渡中的迷失》报告以来,美国全国范围内呼吁为癌症幸存者提供协调、全面的护理,重点强调初级保健的作用。已经描述了几种护理模式,这些模式将重点放在初级保健提供者(PCP)接收成功治疗后转诊的癌症幸存者,并从基于肿瘤学的护理中获得特定类型的信息(例如,生存护理计划),而不是将其作为癌症生存护理团队的积极成员。在本系列论文中,我们评估了文献中描述的生存护理模式,特别关注旨在将初级保健提供者纳入不同环境下癌症幸存者护理的策略。我们提供了见解,以区分初级保健提供者在癌症生存护理方面的专业水平以及如何利用这种专业知识。我们为教育、临床实践、研究和政策倡议提供建议,这些建议可能会推动初级保健提供者在不同临床环境中融入癌症幸存者的护理工作。

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