title: Transfer of follow-up care to family physicians for early-stage breast cancer.
abstract: OBJECTIVE
  As a result of the rising prevalence of breast cancer and improved adjuvant treatment strategies, oncologists are faced with an ever-increasing workload of providing long-term follow-up care for early-stage breast cancer patients. In order to cope with these growing demands, innovative follow-up strategies are urgently required.
  
  
  METHODS
  To explore if patient transfer back to the family physician for follow-up was a potential option, a prospective programme of planned discharge was established for all patients who had completed adjuvant chemo/radiotherapy or had started adjuvant endocrine therapy. Patient and family physician information packages were also provided.
  
  
  RESULTS
  Between April and August 2005, of the 193 patients assessed for transfer back to the family physician for follow-up care, transfer was possible in 43%. Fifty-seven per cent (or 110 patients) were unsuitable for transfer back to the family physician. The reasons cited among those deemed unsuitable for transfer were as follows: clinical trial enrollment (50.9%), ongoing endocrine treatment (31.8%), new symptoms (6.3%), and patient refusal (0.9%). In both discharged and non-discharged groups, patients were also frequently being followed by other oncologists (surgical and/or radiation).
  
  
  CONCLUSIONS
  Transfer of care back to family physicians for follow-up may offer a strategy to control workload volumes, and thus enable oncologists to focus their efforts on newly diagnosed and advanced-stage patients with more complex patient care needs.
authors.affiliation: Division of Medical Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Vanhuyse
authors.forename: P L
authors.initials: PL
authors.lastname: Bedard
authors.forename: J
authors.initials: J
authors.lastname: Sheiner
authors.forename: B
authors.initials: B
authors.lastname: Fitzgerald
authors.forename: M
authors.initials: M
authors.lastname: Clemons
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000628:therapy*; D002173:Cancer Care Facilities; D003266:Continuity of Patient Care; D003695:Delivery of Health Care / Q000379:methods; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D008495:Medical Oncology; D008875:Middle Aged; D010351:Patient Discharge; D010821:Physicians, Family; D011364:Professional Practice; D011446:Prospective Studies; D012017:Referral and Consultation; D000078329:Workforce