Dixit Niharika, Avilez Leslie, Honcharov Vlad, Knopf Kevin, Bedi Teja, Nekhlyudov Larissa, Sarkar Urmimala
University of California San Francisco/Zuckerberg San Francisco General Hospital, San Francisco, CA, USA.
Division of Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
J Cancer Surviv. 2024 Nov 18. doi: 10.1007/s11764-024-01662-8.
More than 60% of cancer survivors report unmet physical, psychosocial, and informational needs. The care of cancer survivors includes surveillance, health maintenance monitoring, referral for long-term adverse effects of cancer treatment, and coordination of care. Group medical visits (GMV) include medical care, education, and peer support and can be used to facilitate the delivery of multidisciplinary survivorship care. We aimed to characterize the current state of related research describing the role of GMV in cancer survivorship care.
For this scoping review, we searched for published literature using PubMed, Embase, and other resources. We included intervention studies of multidisciplinary care involving GMVs of adult patients with a history of cancer requiring the presence of medical personnel, physicians, advanced practitioners, or oncology nurses. We included studies that focused on broad cancer survivorship care, rather than those using specific modalities, such as yoga, or limited to specific aspects of cancer survivorship care, such as weight loss. We characterized the studies by cancer type, structure of GMVs, and reported outcomes.
We identified 2311 studies (2122 from PubMed and 189 from Embase). We excluded 1524 duplicates and screened 787 studies for title and abstract review. Finally, 63 studies were retrieved for full-text review, and six were included in this scoping review. Of the included studies, four were non-randomized, and two were randomized. Breast cancer was the most common site (4); other studies included breast and other cancers (1) and hematopoietic transplant cancer survivors (1). There was heterogeneity in the structure and frequency of sessions and the survivorship domains addressed. The outcomes studied included quality of life, healthcare utilization, and costs.
Limited high-quality research exists on the role of GMV in cancer survivorship. Though shown to be effective in chronic disease, the evidence for the effectiveness of this important and widely used approach in multidisciplinary survivorship care remains inconsistent and preliminary; the literature to date provides a starting point for larger-scale studies of GMV in cancer survivorship care.
While Group medical visits are a promising intervention to provide multidisciplinary care, larger studies are needed to support their benefit in the care of cancer survivors.
超过60%的癌症幸存者报告存在未满足的身体、心理社会和信息需求。癌症幸存者的护理包括监测、健康维护监测、癌症治疗长期不良反应的转诊以及护理协调。小组医疗就诊（GMV）包括医疗护理、教育和同伴支持，可用于促进多学科生存护理的提供。我们旨在描述当前相关研究的现状，这些研究描述了GMV在癌症生存护理中的作用。
对于这项范围综述，我们使用PubMed、Embase和其他资源搜索已发表的文献。我们纳入了涉及有癌症病史的成年患者GMV的多学科护理干预研究，这些研究需要有医务人员、医生、高级从业者或肿瘤护士在场。我们纳入了关注广泛癌症生存护理的研究，而不是那些使用特定方式（如瑜伽）或仅限于癌症生存护理特定方面（如体重减轻）的研究。我们根据癌症类型、GMV的结构和报告的结果对研究进行了描述。
我们识别出2311项研究（2122项来自PubMed，189项来自Embase）。我们排除了1524项重复研究，并筛选了787项研究进行标题和摘要审查。最后，检索到63项研究进行全文审查，其中6项纳入了本范围综述。在纳入的研究中，4项为非随机研究，2项为随机研究。乳腺癌是最常见的部位（4项）；其他研究包括乳腺癌和其他癌症（1项）以及造血移植癌症幸存者（1项）。会议的结构和频率以及所涉及的生存领域存在异质性。研究的结果包括生活质量、医疗保健利用和成本。
关于GMV在癌症生存中的作用，高质量研究有限。尽管在慢性病中已显示有效，但这种重要且广泛使用的方法在多学科生存护理中的有效性证据仍然不一致且初步；迄今为止的文献为GMV在癌症生存护理中的大规模研究提供了一个起点。
虽然小组医疗就诊是提供多学科护理的一种有前景的干预措施，但需要更大规模的研究来支持其在癌症幸存者护理中的益处。
