Delivery of survivorship care by primary care physicians: the perspective of breast cancer patients.
OBJECTIVE
Most of the 182,460 women diagnosed with breast cancer in the United States this year will become long-term survivors. Helping these women transition from active treatment to survivorship is a challenge that involves both oncologists and primary care physicians (PCPs). This study aims to describe postmenopausal breast cancer survivors' (BCS) perceptions of PCP-related survivorship care.


METHODS
We conducted a cross-sectional survey of 300 BCSs seen in an outpatient breast oncology clinic at a large university hospital. The primary outcome measure was a seven-item self-reported measure on perceived survivorship care (Cronbach's alpha = .89). Multivariate regression analyses were used to identify factors associated with perceived care delivery.


RESULTS
Overall, BCSs rated PCP-related survivorship care as 65 out of 100 (standard deviation = 17). The areas of PCP-related care most strongly endorsed were general care (78%), psychosocial support (73%), and health promotion (73%). Fewer BCSs perceived their PCPs as knowledgeable about cancer follow-up (50%), late effects of cancer therapies (59%), or treating symptoms related to cancer or cancer therapies (41%). Only 28% felt that their PCPs and oncologists communicated well. In a multivariate regression analysis, nonwhite race and level of trust in the PCP were significantly associated with higher perceived level of PCP-related survivorship care (P = .001 for both).


CONCLUSIONS
Although BCSs perceived high quality of general care provided by their PCPs, they were not as confident with their PCPs' ability to deliver cancer-specific survivorship care. Interventions need to be tested to improve oncology-primary care communication and PCP knowledge of cancer-specific survivorship care.
Mao
Jun J
JJ
Department of Family Medicine and Community Health, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Health System, Philadelphia, PA 19104, USA. jun.mao@uphs.upenn.edu
Bowman
Marjorie A
MA
Stricker
Carrie T
CT
DeMichele
Angela
A
Jacobs
Linda
L
Chan
Dingyun
D
Armstrong
Katrina
K
D000368:Aged; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011320:Primary Health Care; D017741:Survivors / Q000523:psychology*