From the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA (JST, EAR, SAS, MP).
J Am Board Fam Med. 2023 Oct 11;36(5):789-802. doi: 10.3122/jabfm.2023.230036R1. Epub 2023 Sep 29.
National organizations have issued comprehensive cancer survivorship care guidelines to improve care of cancer survivors, many of whom receive care from primary care providers (PCPs).
We analyzed Porter Novelli's 2019 fall DocStyles survey to assess use of cancer survivorship care guidelines, receipt of survivorship training, types of survivorship services provided, and confidence providing care among PCPs in the United States. We grouped PCPs by use of any guideline ("users") versus no guideline use ("nonusers"). We calculated descriptive statistics and conducted multivariable logistic regression analyses to examine guideline use, having received training on providing survivorship care services, and confidence in providing care. Within the panel, sampling quotas were set so that 1000 primary care physicians, 250 OB/GYNs, 250 pediatricians, and 250 nurse practitioners/physician assistants were recruited.
To reach selected quotas, 2696 health professionals were initially contacted to participate, resulting in a response rate of 64.9%. Sixty-two percent of PCPs reported using guidelines and 17% reported receiving survivorship care training. Use of any guidelines or receiving training was associated with reporting providing a range of survivorship services and confidence in providing care. After adjusting for demographic characteristics, guideline users were more likely than nonusers to report assessing genetic cancer risk (OR = 2.65 95% confidence interval (CI) (1.68, 4.17)), screening for cancer recurrence (OR = 2.32 95% CI (1.70, 3.18)) or a new cancer (OR = 1.63, 95% CI (1.20, 2.22)), and treating depression (OR = 1.64, 95% CI (1.20, 2.25)). Receipt of training was also positively associated with providing genetic risk assessment, surveillance for recurrence, as well as assessing late/long-term effects, and treating pain, fatigue, and sexual side effects.
Survivorship care guidelines and training support PCPs in providing a range of survivorship care services.
国家组织发布了全面的癌症生存者护理指南，以改善癌症生存者的护理，其中许多人接受初级保健提供者（PCP）的护理。
我们分析了 Porter Novelli 2019 年秋季 DocStyles 调查，以评估美国 PCP 使用癌症生存者护理指南、接受生存者护理培训、提供生存者服务的类型以及提供护理的信心。我们根据使用任何指南（“使用者”）与不使用指南（“非使用者”）对 PCP 进行分组。我们计算了描述性统计数据，并进行了多变量逻辑回归分析，以检查指南的使用、接受提供生存者护理服务培训以及提供护理的信心。在小组内，设置了抽样配额，以便招募 1000 名初级保健医生、250 名妇产科医生、250 名儿科医生和 250 名执业护士/医师助理。
为了达到选定的配额，最初联系了 2696 名卫生专业人员参与，回应率为 64.9%。62%的 PCP 报告使用了指南，17%报告接受了生存者护理培训。使用任何指南或接受培训与报告提供一系列生存者服务和提供护理的信心相关。在调整人口统计学特征后，与非使用者相比，指南使用者更有可能报告评估遗传癌症风险（OR=2.65，95%置信区间（CI）（1.68，4.17））、筛查癌症复发（OR=2.32，95%CI（1.70，3.18））或新癌症（OR=1.63，95%CI（1.20，2.22）），以及治疗抑郁症（OR=1.64，95%CI（1.20，2.25））。接受培训也与提供遗传风险评估、监测复发以及评估晚期/长期影响以及治疗疼痛、疲劳和性功能障碍呈正相关。
生存者护理指南和培训支持 PCP 提供一系列生存者护理服务。
