描述三级和社区癌症提供者之间的关系：南加州医学肿瘤学家调查的结果。

Characterizing the relationships between tertiary and community cancer providers: Results from a survey of medical oncologists in Southern California.

机构信息

Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Department of Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

出版信息

Cancer Med. 2021 Aug;10(16):5671-5680. doi: 10.1002/cam4.4119. Epub 2021 Jul 31.

DOI:10.1002/cam4.4119

PMID:34331372

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8366095/

Abstract

BACKGROUND

Tertiary cancer centers offer clinical expertise and multi-modal approaches to treatment alongside the integration of research protocols. Nevertheless, most patients receive their cancer care at community practices. A better understanding of the relationships between tertiary and community practice environments may enhance collaborations and advance patient care.

METHODS

A 31-item survey was distributed to community and tertiary oncologists in Southern California using REDCap. Survey questions assessed the following attributes: demographics and features of clinical practice, referral patterns, availability and knowledge of clinical trials and precision medicine, strategies for knowledge acquisition, and integration of community and tertiary practices.

RESULTS

The survey was distributed to 98 oncologists, 85 (87%) of whom completed it. In total, 52 (61%) respondents were community practitioners and 33 (38%) were tertiary oncologists. A majority (56%) of community oncologists defined themselves as general oncologists, whereas almost all (97%) tertiary oncologists reported a subspecialty. Clinical trial availability was the most common reason for patient referrals to tertiary centers (73%). The most frequent barrier to tertiary referral was financial considerations (59%). Clinical trials were offered by 97% of tertiary practitioners compared to 67% of community oncologists (p = 0.001). Most oncologists (82%) reported only a minimal-to-moderate understanding of clinical trials available at regional tertiary centers.

CONCLUSIONS

Community oncologists refer patients to tertiary centers primarily with the intent of clinical trial enrollment; however, significant gaps exist in their knowledge of trial availability. Our results identify the need for enhanced communication and collaboration between community and tertiary providers to expand patients' access to clinical trials.

摘要

背景

三级癌症中心提供临床专业知识和多模式治疗方法，并整合研究方案。然而，大多数患者在社区诊所接受癌症治疗。更好地了解三级和社区实践环境之间的关系可以加强合作，改善患者的护理。

方法

使用 REDCap 向南加州的社区和三级肿瘤医生分发了一份 31 项的调查问卷。调查问卷评估了以下属性：人口统计学和临床实践特征、转诊模式、临床试验和精准医学的可用性和知识、知识获取策略以及社区和三级实践的整合。

结果

该调查分发给 98 名肿瘤医生，其中 85 名（87%）完成了调查。总共，52 名（61%）受访者是社区医生，33 名（38%）是三级肿瘤医生。大多数（56%）社区肿瘤医生自认为是普通肿瘤医生，而几乎所有（97%）三级肿瘤医生都报告了专业。临床试验的可及性是患者转诊到三级中心的最常见原因（73%）。转诊到三级医院的最常见障碍是经济考虑（59%）。97%的三级医生提供临床试验，而只有 67%的社区肿瘤医生提供临床试验（p=0.001）。大多数肿瘤医生（82%）报告仅对区域三级中心提供的临床试验有轻微至中度的了解。