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Knowledge and self-efficacy for caring for breast and colon cancer survivors among safety net primary care providers

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Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Background

Primary care providers (PCPs) are critical to the provision of comprehensive care for cancer survivors, yet there is very little data on the practices and quality of survivorship care occurring in safety net primary care settings. This study aimed to assess the knowledge and attitudes of PCPs and preferences for care models for breast and colon cancer survivors in a safety net health network.

Methods

A modified National Cancer Institute Survey of Physician Attitudes Regarding the Care of Cancer Survivors was sent electronically to 220 PCPs in 12 primary care clinics in the San Francisco Health Network affiliated with Zuckerberg San Francisco General Hospital and Trauma Center.

Results

The response rate was 50% (110/220). About half of PCPs strongly/somewhat agreed (vs. strongly/somewhat disagreed) that PCPs have the knowledge needed to provide follow-up care related to breast (50%) and colon cancer (54%). Most providers (93%) correctly reported recommended frequency of mammography, however, frequency of blood tests and other imaging surveillance were not as well recognized for breast or colon cancer. Recognition of long-term side effects of chemotherapy drugs ranged from 12% for oxaliplatin to 44% for doxorubicin. Only 33% of providers reported receiving any survivorship training. The most preferred model for survivorship care was shared care model (40%).

Conclusions

Safety net PCPs prefer a shared care model for care of cancer survivors but are limited by lack of training, poor communication, and poor delineation of roles. Patient-centered survivorship care can be improved through effective oncologist-PCP-patient partnerships and coordination.

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Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding

This study was funded by Center of Aging in Diverse Communities (CADC) Scholars grant from the National Institute of Aging, grant no. P30 AG15272; National Center for Advancing Translational Sciences of the National Institutes of Health” under award Number UL1TR001105; and the Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health. Dr. Sarkar was supported by K24 CA212294-01, National Cancer Society, National Institutes of Health.

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Authors and Affiliations

  1. University of California San Francisco/Zuckerberg San Francisco General Hospital and Trauma Center, 995 Potrero Avenue, Ward 84, San Francisco, CA, 94110, USA

    Niharika Dixit

  2. University of California, Merced, 5200 N Lake Rd, Merced, CA, 95343, USA

    Nancy Burke

  3. University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, USA

    Gladys Rodriguez

  4. Center for Vulnerable Populations, University of California San Francisco/Zuckerberg San Francisco General Hospital and Trauma Center Division of General Internal Medicine, 1001 Potrero Avenue, Ward 13, San Francisco, CA, 94110, USA

    Urmimala Sarkar

  5. Zuckerberg San Francisco General Hospital and Trauma Center, 995 Potrero Avenue, Ward 84, San Francisco, CA, 94110, USA

    Barbara Cicerelli

  6. Selby Lane, Redwood City, CA, USA

    Joanna Denise DeVore

  7. Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 9000 Rockville Pike, Building 3, Floor 5, Room E08, Bethesda, MD, 20892, USA

    Anna María Nápoles

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  1. Niharika Dixit
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  2. Nancy Burke
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  4. Urmimala Sarkar
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  7. Anna María Nápoles
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Correspondence to Niharika Dixit.

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Dixit, N., Burke, N., Rodriguez, G. et al. Knowledge and self-efficacy for caring for breast and colon cancer survivors among safety net primary care providers. Support Care Cancer 28, 4923–4931 (2020). https://doi.org/10.1007/s00520-019-05277-z

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  • DOI: https://doi.org/10.1007/s00520-019-05277-z

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