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Review
. 2017 Jan;18(1):e30-e38.
doi: 10.1016/S1470-2045(16)30570-8.

Integrating primary care providers in the care of cancer survivors: gaps in evidence and future opportunities

Larissa Nekhlyudov  1 , Denalee M O'malley  2 , Shawna V Hudson  3
Affiliations
Review

Integrating primary care providers in the care of cancer survivors: gaps in evidence and future opportunities

Larissa Nekhlyudov et al. Lancet Oncol. 2017 Jan.

Abstract

Since the release of the Institute of Medicine report: From cancer patient to cancer survivor: lost in transition, in 2005, there has been a national call in the USA to provide coordinated, comprehensive care for cancer survivors, with an emphasis on the role of primary care. Several models of care have been described, which focus on primary care providers (PCPs) as receiving cancer survivors who are transferred after successful treatment, and who are given specific types of information from oncology-based care (eg, survivorship care plans), and not as active members of the cancer survivorship team. In this Series paper, we assessed survivorship models that have been described in the literature, with a specific focus on strategies that aim to integrate PCPs into the care of cancer survivors across different settings. We offer insights differentiating PCPs' level of expertise in cancer survivorship and how such expertise could be used. We provide recommendations for education, clinical practice, research, and policy initiatives that might advance the integration of PCPs in the care of cancer survivors in diverse clinical settings.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors declared no conflicts of interest.

Figures

Figure 1
Figure 1. Models of Care
PCP = primary care providers ONC = oncology providers
Figure 2
Figure 2. Survivorship Care Strategies
Notes:​ *5 years is based on general recommendations in the cancer community, transition of care may vary **Risk categories, as examples:

  1. Low risk common cancers (i.e. breast, colorectal, prostate), early stage, standard treatment, high non-cancer chronic condition burden.

  2. Intermediate less common cancers, advanced stages, multimodal treatment, moderate non-cancer chronic condition burden.

  3. High risk rare cancers, advanced stages, complex medical treatment with significant late/long term effects.

***Any of these models may be appropriate for NP/PA involvement.
Figure 3
Figure 3
Examples of Barriers to Primary Care Integration in Cancer Survivorship
See this image and copyright information in PMC

Comment in

References

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