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 Researchers found, though, that more primary care provider (PCP)
involvement was only tied to a better perception of treatment
decisions by the survey participants, who all had newly diagnosed
breast cancer, when compared to low PCP involvement.
“While we hypothesized that many women receive high quality primary
care during breast cancer treatment, we were surprised that the
majority of women in our study also reported high levels of
engagement and communication with their PCP during cancer treatment,
when the care is typically focused primarily on treating the
cancer,” said lead author Lauren P. Wallner of the University of
Michigan in Ann Arbor.
“In team-based cancer care, oncology care teams work together with
primary care and other specialty care teams to ensure patients
receive high-quality, coordinated cancer care,” she said.
The researchers randomly surveyed more than 2,000 women six months
after their breast cancer diagnosis, finding them via registries in
California and Georgia in 2013 and 2014. The mailed surveys included
six questions about primary care provider access and awareness and
three questions about doctors’ involvement in treatment. The
participants rated how informed their primary care doctors were
about breast cancer, how often they talked with their primary care
doctors and how often doctors were involved in treatment decisions.
Most women were white and over age 55, had private insurance and
some college education.
More than 60 percent of women said their primary care quality was
high, and their doctors were highly informed and highly
communicative. About 35 percent said doctors participated
considerably in treatment decisions. More decision participation
tended to align with higher rating of primary care quality,
according to the results published in the Journal of Clinical
Oncology.
Primary care doctors often know the patient best and are most
attuned to their values, preferences and needs, Wallner said, but
how involved they should be during treatment depends upon the
patient’s clinical situation, including whether they have other
medical conditions and the preferences of the patient, their
oncologist and the primary care doctor.
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“As mentioned by the authors, PCPs often play a limited role in
treatment decisions, as most breast cancer treatments are fairly
standard and patients often just have to agree to receive the
treatment prescribed,” said Dr. Lisa Del Giudice of Sunnybrook
Health Sciences Center at the University of Toronto, who was not
part of the new study. “Furthermore, many patients will receive all
the information that they need to make an informed decision from
their oncologists or other resources.”
But PCPs can and should be more directly involved in breast cancer
treatment decisions, especially among vulnerable populations,
including minority women, those with less education and more health
conditions, Del Giudice said.
“Understanding how patients perceive their PCPs’ involvement in
their cancer care during treatment is important because it allows us
to identify areas that need improvement,” Wallner told Reuters
Health by email. “We can then design interventions to promote the
involvement of the PCP and improve the quality of cancer care.”
“These findings are reassuring in that women with breast cancer in
our study received high quality primary care during treatment,”
Wallner said. “However, in order to support and encourage PCPs to
participate in team-based cancer care, efforts need to be made to
better incorporate PCPs, communicate with them, and educate them
about the specifics of cancer treatments.”
SOURCE: http://bit.ly/2dKmFfS Journal of Clinical Oncology, online
October 3, 2016.
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