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

• 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
• Journal Title: Journal of Oncology Practice
• Volume: Volume 15, Number 4
• Publisher: American Society of Clinical Oncology | 2019-04-01, Pages 201-+
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1200/JOP.18.00497
• Subjects: Health Sciences, Oncology; Health Sciences, Health Care Management; Health Sciences, Epidemiology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Oncology; Health Care Sciences & Services; FOLLOW-UP CARE; SURVIVORSHIP CARE; PHYSICIANS

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.