Provider Involvement in Care During Initial Cancer Treatment and Patient Preferences for Provider Roles After Initial Treatment

• Type of Material: Article
• Authors: Archana Radhakrishnan, University of Michigan; Yun Li, University of Michigan; Allison K. C. Furgal, University of Michigan; AS Hamilton, University of Southern California; Kevin C. Ward, Emory University; Reshma Jagsi, University of Michigan; Steven J. Katz, University of Michigan; Sarah T. Hawley, University of Michigan; Lauren P. Wallner, University of Michigan
• Language: English
• Date: 2019-04-01
• Publisher: American Society of Clinical Oncology
• Publication Version: Final Published Version
• Copyright Statement: © 2019 by American Society of Clinical Oncology
• Final Published Version (URL): http://dx.doi.org/10.1200/JOP.18.00497
• Title of Journal or Parent Work: Journal of Oncology Practice
• ISSN: 1554-7477
• Volume: 15
• Issue: 4
• Start Page: 201
• End Page: +
• Grant/Funding Information: L.P.W. is also supported by a career development grant from the NCI (Grant No. K07 CA201052).; Supported by Grant No. P01CA163233 to the University of Michigan from the National Cancer Institute (NCI); and Michigan Medicine Rogel Cancer Center Research Grant.; Cancer incidence data collection in Georgia was supported by contract HHSN261201300015I; Task Order HHSN26100006 from the NCI; and cooperative agreement 5NU58DP003875-04-00 from the CDC.; Cancer incidence data collection was supported by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP003862-04/DP003862; the NCI’s SEER Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California; contract HHSN261201000035C awarded to the University of Southern California; and contract HHSN261201000034C awarded to the Public Health Institute.
• Keywords: Life Sciences & Biomedicine; PHYSICIANS; FOLLOW-UP CARE; SURVIVORSHIP CARE; Oncology; Science & Technology; Health Care Sciences & Services
• Research Categories: Health Sciences, Oncology; Health Sciences, Epidemiology; Health Sciences, Health Care Management

Abstract

PURPOSE: Patients report strong preferences regarding which provider-oncologist or primary care provider (PCP)-handles their primary care after initial cancer treatment (eg, other cancer screenings, preventive care, comorbidity management). Little is known about associations between provider involvement during initial cancer treatment and patient preferences for provider roles after initial treatment. METHODS: Women who received a diagnosis of early-stage breast cancer in 2014 to 2015 were identified from the Georgia and Los Angeles County SEER registries and surveyed (N = 2,502; 68% response rate). Women reported the level of their providers' involvement in their care during initial cancer treatment. Associations between level of medical oncologist's participation and PCP's engagement during initial cancer treatment and patient preferences for oncologist led ( v PCP led) other cancer screenings after initial treatment were examined using multivariable logistic regression models. RESULTS: During their initial cancer treatment, 20% of women reported medical oncologists participated substantially in delivering primary care and 66% reported PCPs were highly engaged in their cancer care. Two-thirds (66%) of women preferred medical oncologists to handle other cancer screenings after initial treatment. Women who reported substantial medical oncologist participation in primary care were more likely (adjusted odds ratio, 1.42; 95% CI, 1.05 to 1.91) and those who reported high PCP engagement in cancer care were less likely (adjusted odds ratio, 0.41; 95% CI, 0.31 to 0.53) to prefer oncologist-led other cancer screenings after initial treatment. CONCLUSIONS: Providers' involvement during initial cancer treatment may affect patient preferences regarding provision of follow-up primary care. Clarifying provider roles as early as during cancer treatment may help to better delineate their roles throughout survivorship.