Oncologist and General Practitioner Perspectives of Shared Care for Colorectal Cancer Survivors: A Qualitative Study.

BACKGROUND

There is a growing body of evidence to support shared survivorship care. The shared care of colorectal cancer survivors (SCORE) randomised controlled trial (RCT) demonstrated that shared care is an appropriate and cost-effective model. Understanding the perspectives of oncologists and general practitioners (GPs) who participated in SCORE will provide crucial insights to support wider implementation of shared care and adoption into clinical practice.

AIMS

To explore the experiences of oncologists and GPs who provided shared survivorship care for colorectal cancer survivors within the SCORE RCT, focussing on perceptions of acceptability and appropriateness of shared care, and facilitators and barriers to implementation.

METHODS

This qualitative descriptive study utilised semi-structured interviews for data collection. Interviews were recorded and transcribed, and data analysed by hybrid deductive/inductive thematic analysis.

RESULTS

Interviews from 20 HCPs (13 GPs and 7 oncologists) were analysed. Seven themes were developed describing overall acceptance of the shared care model, the importance and challenges regarding bilateral communication between providers, mixed views on the need for GP training, and patients suitable for shared care. The need to support GPs with a direct hospital-based contact person, as well as clear guidance on their role, was emphasised, as was the need for care coordination and logistical support.

CONCLUSIONS

Our study offers novel findings regarding shared care from the perspective of participants who have direct experience with delivering the model. While shared care was broadly supported by both GPs and specialists, successful implementation requires agreed-upon bilateral communication, clear guidance for GPs, and coordination support.

CLINICAL TRIAL REGISTRATION

The Shared Care for Colorectal Cancer (SCORE) Trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12617000004369p. Registered on 3 January 2017; protocol version 4 approved 24 February 2017.