Primary Care Physicians' Perspectives in Leading Breast Cancer Follow-Up Care

Fernando A Angarita; Nicole Jedrzejko; David Eisen; Maria Muraca; Marla Ash; Fahima Osman

doi:10.1016/j.clbc.2021.11.011

Primary Care Physicians' Perspectives in Leading Breast Cancer Follow-Up Care

Clin Breast Cancer. 2022 Jun;22(4):e497-e505. doi: 10.1016/j.clbc.2021.11.011. Epub 2021 Dec 2.

Authors

Fernando A Angarita¹, Nicole Jedrzejko², David Eisen³, Maria Muraca³, Marla Ash³, Fahima Osman⁴

Affiliations

¹ Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY; Division of Surgical Oncology, Department of Surgery, Houston Methodist Hospital, Houston, TX, USA.
² Department of Surgery, Division of General Surgery, University of British Columbia, Vancouver, BC, Canada.
³ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
⁴ Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Department of Surgery, North York General Hospital, Toronto, ON, Canada. Electronic address: fahima.osman@nygh.on.ca.

PMID: 34955431
DOI: 10.1016/j.clbc.2021.11.011

Abstract

Introduction: Limited data exist on the barriers associated with transitioning breast cancer follow-up care to primary care physicians (PCPs). This study aimed to describe the current perspectives of PCPs in managing breast cancer follow-up.

Method: An online survey was distributed to PCPs in Toronto, ON, Canada. Questions examined PCPs' view of transitioning breast cancer follow-up care to their practices.

Results: Of 800 PCPs invited, 126 responded (response rate: 15.7%). The types of practice models amongst respondents included blended capitation (42.9%), blended salary (27%), and fee-for-service (17.5%). Seventy-seven percent of respondents stated they provided follow-up care. Approximately half of the respondents stated they were somewhat comfortable providing follow-up care. PCP-led follow-up care was considered either very (49.2%) or somewhat appropriate (30.2%). When asked about financial remuneration, 43.7% of respondents stated it was somewhat important. The factors that influenced the feasibility of PCP-led follow-up care included receipt of a detailed follow-up care plan provided by the specialist after discharge (81%), the ability to re-refer to specialists rapidly (56.3%), and the ability to obtain regular updates of best practice changes (59.5%). The preferred means of educational updates included E-mail (40.5%), continuing medical education events (30.2%), and electronic medical records (19.8%). When the fee model was taken into consideration there was no significant difference in opinions regarding follow-up care.

Conclusions: Transitioning to a PCP-led model was supported by most of the PCPs who participated in this study. Their perspective on PCP-led follow up care and barriers associated with implementation of this model of care needs to be further explored with future studies that include larger sample size and a more diverse PCP population.

Keywords: Breast cancer; Breast cancer follow-up; Surveillance; Survivorship.

MeSH terms

Aftercare
Breast Neoplasms* / epidemiology
Breast Neoplasms* / therapy
Canada
Female
Humans
Physicians, Primary Care*
Practice Patterns, Physicians'
Surveys and Questionnaires