527 A Shared Care For Newly Referred Cancer Patients

Conference: 
Author(s): 
J. Damgaard Nielsen, T. Palshof, J. Mainz, A.B. Jensen, F. Olesen
The Research Unit for General Practice, University of Aarhus, Aarhus, Denmark
Text: 
Background.
Psychological morbidity and dissatisfaction with provision of information and care are seen in newly referred cancer patients. Most cancer patients are usually treated as outpatients and this may increase the risk of their feeling left alone at crucial moments. Especially at moments like these patients consult their family physician for further advice, information and repetition of information. These contacts puts the family physician in a key position in which s/he may have problems due to lack of specific knowledge of cancer and lack of collaboration with the oncologists. This indicates that there is a need for shared care between family physicians and oncologists.
Aim. To assess the effect of a shared care programme on newly referred cancer patients’ attitude towards the health care system, their health related quality of life and performance status, and to describe patients’ reports on contact with the family physicians.
Methods Randomized controlled trial. Questionnaires to patients at three stages. The shared care programme consisted of knowledge transfer to the family physician, improved communication channels between the settings and active involvement of the patient.
248 consecutive cancer patients newly referred to the department of oncology were included in the study.
Results The shared care programme had a significantly positive influence on patient evaluations of cooperation between the sectors. The feeling of not being left in limbo and of care from the family physician revealed significantly higher rates in the intervention group for men and young patients (18-49 of age). Young patients rated the family physician’s knowledge of disease and treatment significantly higher. Finally, the number of contacts with the family physician were significantly higher in the intervention group. The health related quality of life questions (EOR-TC QLQ C-30) showed a non-significant trend towards better symptom relief.
Conclusions
A shared care programme between sectors, where the family physicians and the patients are actively involved, has a positive influence on patients’ attitude towards the health care system. Especially young patients and men profit by the programme.
Literature: 
527 a Shared Care for Newly Referred Cancer Patients