title: Views of health professionals on the role of primary care in the follow-up of men with prostate cancer.
abstract: BACKGROUND
  Follow-up care for prostate cancer has traditionally been led by secondary care in hospital out-patient clinics. As the number of men with prostate cancer increases and secondary care resources face pressure, alternative follow-up models are being sought. Current National Institute for Health and Clinical Excellence guidance recommends follow-up outside the hospital setting for patients who are stable 2 years following radical treatment and for those undergoing 'watchful waiting'.
  
  
  OBJECTIVE
  To describe current practice in a sample of relevant health care professionals and to seek their views on the role of primary care in prostate cancer follow-up.
  
  
  METHODS
  Semi-structured telephone interviews with 38 UK health care professionals, from both secondary and primary care. Transcripts were analysed using the constant comparative method.
  
  
  RESULTS
  There are marked variations in current follow-up practice around the country, with hospital-based follow-up ranging from 6 months to lifetime. The predominant, although not universal, view expressed was that there is both scope and support for primary care to play a greater role, particularly for men with stable disease. This was qualified by the need for supporting education, including guidance on interpretation of prostate-specific antigen values, introduction of robust follow-up systems in primary care, easy access back into secondary (hospital) care, a mechanism for ensuring follow-up data can still be collected for audit purposes and appropriate resourcing.
  
  
  CONCLUSIONS
  If primary care is to play a significant role in providing high-quality follow-up care for men with prostate cancer, then steps need to be taken to address the barriers to increased primary care involvement identified by this study.
authors.affiliation: School of Health and Social Care, Oxford Brookes University, Jack Straws Lane, Marston, Oxford OX3 0FL, UK. ewatson@brookes.ac.uk
authors.forename: Eila K
authors.initials: EK
authors.lastname: Watson
authors.forename: Rosaleen
authors.initials: R
authors.lastname: O'Brien
authors.forename: Christine
authors.initials: C
authors.lastname: Campbell
authors.forename: David
authors.initials: D
authors.lastname: Weller
authors.forename: Richard D
authors.initials: RD
authors.lastname: Neal
authors.forename: Clare
authors.initials: C
authors.lastname: Wilkinson
authors.forename: Peter W
authors.initials: PW
authors.lastname: Rose
mesh_terms: D000359:Aftercare; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010819:Physician's Role; D011320:Primary Health Care; D011471:Prostatic Neoplasms / Q000628:therapy*; D036301:Qualitative Research; D006113:United Kingdom