Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Support Care Cancer. 2021 Jan;29(1):85-96. doi: 10.1007/s00520-020-05624-5. Epub 2020 Aug 17.
To care for the growing population of cancer survivors, health services worldwide must reconsider how to deliver care to people living with and beyond a cancer diagnosis. Shared care, defined as cancer care that is shared between specialist and primary care providers, is one model that has been investigated; however, practical guidance to support implementation is lacking. This systematic review aimed to explore facilitators and barriers to implementing shared cancer care and to develop practice and policy recommendations to support implementation.
A systematic literature search was conducted in June 2019 across MEDLINE, Embase, Emcare, and PsycINFO databases. Quantitative and qualitative data relevant to the review question were extracted and synthesized following a mixed methods approach.
Thirteen papers were included in the review, 10 qualitative and three quantitative. Included articles were from Australia (n = 8), the USA (n = 3), and one each from the UK and the Netherlands. Sixteen themes were developed under four categories of patient, healthcare professional, process, and policy factors. Key themes included the perceived need for primary care provider training, having clearly defined roles for each healthcare provider, providing general practitioners with diagnostic and treatment summaries, as well as protocols or guidelines for follow-up care, ensuring rapid and accurate communication between providers, utilizing electronic medical records and survivorship care plans as communication tools, and developing consistent policy to reduce fragmentation across services.
Recommendations for practice and policy were generated based on review findings that may support broader implementation of shared cancer care.
为了照顾不断增长的癌症幸存者群体，全球卫生服务机构必须重新考虑如何为癌症诊断后和超越癌症诊断的患者提供护理。共同照护是一种已经被研究过的模式，它被定义为专科医生和初级保健提供者共同提供的癌症护理；然而，缺乏支持实施的实用指南。本系统评价旨在探讨实施共同癌症护理的促进因素和障碍，并制定支持实施的实践和政策建议。
在 2019 年 6 月，我们在 MEDLINE、Embase、Emcare 和 PsycINFO 数据库中进行了系统文献检索。采用混合方法提取和综合与综述问题相关的定量和定性数据。
共纳入了 13 篇文章，10 篇定性研究和 3 篇定量研究。纳入的文章来自澳大利亚（n=8）、美国（n=3），以及英国和荷兰各 1 篇。在四个类别的患者、医疗保健专业人员、过程和政策因素下，共开发了 16 个主题。主要主题包括初级保健提供者培训的必要性、明确界定每个医疗保健提供者的角色、为全科医生提供诊断和治疗总结、以及后续护理的协议或指南、确保提供者之间快速准确的沟通、利用电子病历和生存护理计划作为沟通工具、以及制定一致的政策以减少服务碎片化。
基于综述结果提出了实践和政策建议，这可能有助于共同癌症护理的更广泛实施。
