Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA.
Support Care Cancer. 2021 Nov;29(11):6881-6890. doi: 10.1007/s00520-021-06264-z. Epub 2021 May 21.
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.
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.
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.
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.
我们旨在了解初级保健提供者（PCP）和肿瘤学家对谁应负责管理糖尿病的期望，以及在癌症治疗期间关于糖尿病护理的沟通方式和频率。
对治疗 2 型糖尿病癌症患者的 PCP（医生和执业护士）和肿瘤学家进行了深入访谈。访谈进行了录音，并由专业人员进行了转录。采用扎根理论方法对定性数据进行分析并确定关键主题。
2019 年 3 月至 7 月期间对 10 名 PCP 和 10 名肿瘤学家进行了访谈。我们对 PCP 的访谈中出现了两个广泛的主题：（1）癌症患者在癌症治疗期间暂停初级保健，以及（2）预后较差和晚期癌症患者。我们对肿瘤学家的访谈中出现了以下主题：（3）在照顾控制不佳的糖尿病癌症患者方面存在挑战。我们对 PCP 和肿瘤学家的访谈中出现了三个共同的主题：（4）对提供超出各自专业范围的护理感到不适，（5）需要个性化护理计划，以及（6）缺乏初级保健和肿瘤学护理之间的沟通。
我们的研究结果表明，在癌症护理期间进行最佳糖尿病管理存在着实质性的提供者层面障碍。应优先考虑优先考虑 PCP、肿瘤学家和患者护理团队其他成员之间的有效沟通和教育资源的干预措施，以实现最佳结果。
