Guidelines unmet: Assessing gaps in breast cancer survivorship care

指南未得到满足:评估乳腺癌幸存者护理方面的差距

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Abstract

BACKGROUND: In Canada, after completing their treatment at oncology centers in tertiary care facilities, most breast cancer patients are discharged and receive survivorship care from primary care providers (PCPs). Evidence-based guidelines exist to inform appropriate care for breast cancer survivor follow-up. OBJECTIVES: This study analyzed the concordance of breast cancer survivorship follow-up care by PCPs with recommended guidelines at an academic Family Health Team (FHT) in Ottawa. DESIGN: Retrospective chart review of electronic medical records of rostered patients from FHT. METHODS: Data was extracted from the charts of 60 breast cancer survivors. Concordance of breast cancer survivorship care by PCPs with evidence-based guidelines was established in three key survivorship domains: surveillance for recurrence or new cancers, management of treatment side effects and preventative health. RESULTS: PCPs provide care concordant with guidelines only 20% of the time, with areas such as preventative care at 86.7% concordance far better than management of side effects at 58.3% and oncological surveillance at 38.3%. Care did not significantly differ by age at diagnosis. CONCLUSION: These results highlight gaps in the current survivorship care delivery and function as a baseline for comparative analyses for future interventions to optimize survivorship follow-up care.

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