University of British Columbia, Vancouver, BC, Canada
Ali Moghaddamjou , Caroline Speers , Winson Y. Cheung
Background: Survivorship care plans have strong face validity, but individualizing plans to each patient’s needs can be resource intensive. At our institution, a 1-page standardized letter that outlines the essential components of follow-up care is mailed to PCPs at the time of a patient’s discharge. This letter highlights the recommended frequency and interval of tests and physician visits. Our study aims were to 1) characterize PCPs’ attitudes regarding these letters and 2) identify potential strategies to improve this channel of communication with PCPs. Methods: Self-administered surveys were mailed to high-volume PCPs in British Columbia, defined as those whose practices followed >/=5 breast or colorectal CS in the preceding year. The survey asked about practice characteristics and PCPs’ views towards the content and format of these standardized letters. Logistic regression models were constructed to delineate factors associated with follow-up preferences. Results: Among 787 PCPs, 507 (64%) responded: median year since graduation was 27 (range 1-62), 67% were men, 38% had a faculty appointment, 71% practiced in a group, and 92% were paid fee-for-service. When asked about their perspectives regarding the care of CS, 388 (77%) indicated they were comfortable providing follow-up with 299 (74%) reporting that the standardized letter contained adequate information. In regression models, PCPs who were comfortable with cancer surveillance and those who graduated greater than 30 years ago were more likely to view the standardized letter as useful (OR 2.50, 95% CI 1.41-4.43 and OR 2.31, 95% CI 1.24-4.33, respectively) and important (OR 4.07, 95% CI 1.80-9.19 and OR 3.14, 95% CI 1.01-9.74, respectively). Among 103 (26%) PCPs who found the letter to be insufficient, most wanted additional details about the cancer diagnosis (88%), specific information on the toxicities of therapy (88%), and the estimated risk of recurrence (84%). Conclusions: Most PCPS were satisfied with a simple, standardized letter that outlines the necessary components of cancer follow-up. PCPs with less familiarity with cancer surveillance may be a target group that benefits most from individualized survivorship care plans.
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