Department of Primary Care, University of Toulouse, Toulouse, France.
Oncology Unit, Auch Hospital, Auch, France.
Eur J Gen Pract. 2022 Dec;28(1):15-22. doi: 10.1080/13814788.2021.2003775.
The general practitioner (GP) is central to managing patients with cancer, whose numbers are increasing worldwide. The GP's involvement requires better coordination between involved partners, in particular oncologists and GPs.
To conduct a feasibility study of remote participation of GPs in multi-disciplinary consultation meetings (MCMs). We analysed participation, participants' satisfaction, and their impact on therapeutic decisions.
We conducted a feasibility study in the regional cancer centre of Toulouse, France. All patient cases discussed in the MCMs for myelodysplasia from 1 January to 31 March 2016 were included. Cases of patients aged over 18 years, with a diagnosis of myelodysplasia and registered with a GP were included if patients gave informed consent. One investigator collected the data provided by GPs during three telephone or video calls: before, during, and after the MCM, respectively.
Of 86 patient cases discussed during three months of MCMs, 44 were eligible for GP participation; 27 GPs participated in discussions of 27 patient cases. The GP's participation in the MCM led to a change in management in five cases, with four times treatment intensifications and once de-intensification. Medical, social, family-related, and psychological domains were discussed with input from the GPs. Overall, all participants were satisfied with the MCMs.
Remote participation of GPs in MCMs is feasible and may result in adapting oncological and haematological management for patients. This patient-centred approach requires a specific organisation that, when implemented, satisfies the needs of all participants.
全科医生(GP)是管理癌症患者的核心,而全球范围内癌症患者的数量正在增加。GP 的参与需要更好地协调相关方,特别是肿瘤医生和全科医生。
对全科医生远程参与多学科咨询会议(MCM)进行可行性研究。我们分析了参与情况、参与者的满意度及其对治疗决策的影响。
我们在法国图卢兹的区域癌症中心进行了一项可行性研究。纳入 2016 年 1 月 1 日至 3 月 31 日期间在 MCM 中讨论的所有骨髓增生异常患者病例。如果患者同意并告知其主治全科医生,将纳入年龄在 18 岁以上、诊断为骨髓增生异常且有全科医生注册的患者病例。一名研究人员在三次电话或视频通话中收集了全科医生提供的数据:分别是 MCM 前、MCM 期间和 MCM 后。
在三个月的 MCM 中讨论了 86 例患者病例,其中 44 例符合 GP 参与条件;27 名 GP 参与了 27 例患者病例的讨论。全科医生在 MCM 中的参与导致五例患者的管理发生变化,四次强化治疗,一次减疗。讨论了医疗、社会、家庭相关和心理领域,全科医生提供了相关信息。总体而言,所有参与者对 MCM 都感到满意。
GP 远程参与 MCM 是可行的,可能会导致调整患者的肿瘤学和血液学管理。这种以患者为中心的方法需要一种特定的组织形式,当实施时,能够满足所有参与者的需求。