title: Interventions to improve care coordination between primary healthcare and oncology care providers: a systematic review.
abstract: Coordination of patient care between primary care and oncology care providers is vital to care quality and outcomes across the cancer continuum, yet it is known to be challenging. We conducted a systematic review to evaluate current or new models of care and/or interventions aimed at improving coordination between primary care and oncology care providers for patients with adult breast and/or colorectal cancer. MEDLINE, EMBASE, CINAHL, Cochrane Library Database of Systematic Reviews, and the Centre for Reviews and Dissemination were searched for existing English language studies published between January 2000 and 15 May 2015. Systematic reviews, meta-analyses, randomised controlled trials (RCTs) and non-randomised studies were included if they evaluated a specific model/intervention that was designed to improve care coordination between primary care and oncology care providers, for any stage of the cancer continuum, for patients with adult breast and/or colorectal cancer. Two reviewers extracted data and assessed risk of bias. Twenty-two studies (5 systematic reviews, 6 RCTs and 11 non-randomised studies) were included and varied with respect to the targeted phase of the cancer continuum, type of model or intervention tested, and outcome measures. The majority of studies showed no statistically significant changes in any patient, provider or system outcomes. Owing to conceptual and methodological limitations in this field, the review is unable to provide specific conclusions about the most effective or preferred model/intervention to improve care coordination. Imprecise results that lack generalisability and definitiveness provide limited evidence to base the development of future interventions and policies.
  
  
  BACKGROUND
  CRD42015025006.
authors.affiliation: School of Kinesiology and Health Studies, Queen's University , Kingston, Ontario , Canada.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Tomasone
authors.affiliation: Department of Oncology , McMaster University & the Escarpment Cancer Research Institute , Hamilton, Ontario , Canada.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Brouwers
authors.affiliation: Department of Oncology , McMaster University & the Escarpment Cancer Research Institute , Hamilton, Ontario , Canada.
authors.forename: Marija
authors.initials: M
authors.lastname: Vukmirovic
authors.affiliation: Department of Family and Community Medicine , University of Toronto , Toronto, Ontario , Canada.
authors.forename: Eva
authors.initials: E
authors.lastname: Grunfeld
authors.affiliation: Department of Family and Community Medicine , University of Toronto , Toronto, Ontario , Canada.
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: O'Brien
authors.affiliation: Department of Surgery , Dalhousie University , Halifax, Nova Scotia , Canada.
authors.forename: Robin
authors.initials: R
authors.lastname: Urquhart
authors.affiliation: Division of Cancer Care and Epidemiology, Cancer Research Institute , Queen's University , Kingston, Ontario , Canada.
authors.forename: Melanie
authors.initials: M
authors.lastname: Walker
authors.affiliation: Department of Family and Community Medicine , University of Toronto , Toronto, Ontario , Canada.
authors.forename: Fiona
authors.initials: F
authors.lastname: Webster
authors.affiliation: Bloomberg Faculty of Nursing, University of Toronto , Toronto, Ontario , Canada.
authors.forename: Margaret
authors.initials: M
authors.lastname: Fitch
keywords: cancer care; continuity of care; coordination of care; oncology; primary care