title: Discharge of breast cancer patients to primary care at the end of hospital follow-up: a cross-sectional survey.
abstract: OBJECTIVE
  The present study explored (a) the discharge of breast cancer patients to primary care by specialists, at the end of hospital follow-up and (b) the experiences and views of general practitioners (GPs) regarding transfer of follow-up to the primary care setting.
  
  
  METHODS
  A cross-sectional survey was performed by sending a self-administered questionnaire to 960 GPs working in the three northern provinces of the Netherlands. Data were analysed using descriptive statistics.
  
  
  RESULTS
  Of 949 eligible questionnaires, 502 were returned, providing an adjusted response rate of 53%. In the year before the survey took place, one or more patients aged >60 years, and 5 years after breast-conserving therapy, were discharged to 22% of GPs (n=112) for follow-up. According to 56% of these GPs, transfer of follow-up was communicated by the hospital. The initiative to arrange follow-up visits and mammography appointments was mainly taken by patients. In this survey, 40% of GPs (n=200) were willing to accept exclusive responsibility for follow-up earlier than 5 years after completion of active treatment. Perceived barriers in current and future primary care-based follow-up included: communication with breast cancer specialists, patients' preference for specialist follow-up, GPs' oncology knowledge and skills and the organisation of follow-up in general practice.
  
  
  CONCLUSIONS
  Primary care-based follow-up might be improved if breast cancer specialists discharge patients more actively to their GPs. Survivorship care plans are needed to facilitate communication across the primary/secondary interface and with patients. Training of GPs and developing administrative tools may be helpful in arranging follow-up care and using guidelines in general practice.
authors: Department of General Practice, University of Groningen, University Medical Center Groningen, P.O. Box 196, 9700 AD Groningen, The Netherlands. c.roorda-lukkien@umcg.nl
authors: Carriene
authors: C
authors: Roorda
authors: Annette J
authors: AJ
authors: Berendsen
authors: Manon
authors: M
authors: Haverkamp
authors: Klaas
authors: K
authors: van der Meer
authors: Geertruida H
authors: GH
authors: de Bock
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000628:therapy*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods; D005260:Female; D058005:General Practitioners / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010351:Patient Discharge; D011320:Primary Health Care / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors