Identifying priority areas to support primary care engagement in breast cancer survivorship care: A Delphi study

Author:

Mikesell Lisa12ORCID,O'Malley Denalee M.34,Kurtzman Rachel T.35,Howard Jenna3,Bates Benjamin246,Hemler Jennifer R.3,Fadem Sarah J.3,Ferrante Jeanne M.234,Bator Alicja3,Hudson Shawna V.234,Crabtree Benjamin F.34

Affiliation:

1. School of Communication and Information Rutgers University New Brunswick New Jersey USA

2. Institute for Health, Health Care Policy, and Aging Research Rutgers University New Brunswick New Jersey USA

3. Department of Family Medicine Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA

4. Rutgers Cancer Institute of New Jersey New Brunswick New Jersey USA

5. NORC at The University of Chicago Chicago Illinois USA

6. Department of Medicine, Division of General Internal Medicine Rutgers Robert Wood Johnson Medical School New Brunswick New Jersey USA

Abstract

AbstractIntroductionExisting approaches in cancer survivorship care delivery have proven to be insufficient to engage primary care. This study aimed to identify stakeholder‐informed priorities to improve primary care engagement in breast cancer survivorship care.MethodsExperts in U.S. cancer survivorship care delivery were invited to participate in a 4‐round online Delphi panel to identify and evaluate priorities for defining and fostering primary care's engagement in breast cancer survivorship. Panelists were asked to identify and then assess (ratings of 1–9) the importance and feasibility of priority items to support primary care engagement in survivorship. Panelists were asked to review the group results and reevaluate the importance and feasibility of each item, aiming to reach consensus.ResultsRespondent panelists (n = 23, response rate 57.5%) identified 31 priority items to support survivorship care. Panelists consistently rated three items most important (scored 9) but with uncertain feasibility (scored 5–6). These items emphasized the need to foster connections and improve communication between primary care and oncology. Panelists reached consensus on four items evaluated as important and feasible: (1) educating patients on survivorship, (2) enabling screening reminders and monitoring alerts in the electronic medical record, (3) identifying patient resources for clinicians to recommend, and (4) distributing accessible reference guides of common breast cancer drugs.ConclusionRole clarity and communication between oncology and primary care were rated as most important; however, uncertainty about feasibility remains. These findings indicate that cross‐disciplinary capacity building to address feasibility issues may be needed to make the most important priority items actionable in primary care.

Funder

National Cancer Institute

Publisher

Wiley

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