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Primary Care Providers’ Knowledge, Attitudes, Beliefs, and Practices Regarding Their Preparedness to Provide Cancer Survivorship Care

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Abstract

Recent cancer care delivery models and clinical practice guidelines have expanded the role of primary care providers (PCPs) in routine follow-up of cancer survivors. We conducted a cross-sectional survey of PCPs affiliated with a large healthcare system to (1) examine practices, attitudes, and beliefs regarding preparedness to provide survivorship care and (2) explore predictors of confidence managing cancer survivors. We distributed a self-administered online survey to 1069 clinical affiliates providing primary care services within the University of Pittsburgh Medical Center system. Associations between PCPs’ professional characteristics and attitudes and preparedness were evaluated. Multiple logistic regression explored predictors of confidence monitoring common cancer treatment-related symptoms. One hundred twenty-seven eligible PCPs responded. The sample was split between academic and community practice (48.0% vs. 52.0%, respectively), predominantly comprised of physicians (81.8%), and 64.6% had > 15 years direct patient care experience. The majority agreed that PCPs play a valuable role in surveillance and adverse event monitoring in survivors, though less than 25% felt their professional training prepared them to perform each of these domains. Physicians were significantly more likely than advanced practice providers to be among the 65% of PCPs who were confident monitoring ≥ 1 symptom in each of the 5 evaluated symptom clusters (OR 3.6, 95% CI 1.2–10.8). PCPs appear willing to assume an enhanced role in cancer survivorship care but feel unprepared to do so. Enhanced training and dissemination of clinical practice guidelines are needed to facilitate effective implementation of PCP-delivered survivorship care.

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Funding

This work was supported by grant TL1 TR000145 from the National Center for Advancing Translational Sciences of the National Institutes of Health and grant P30 CA047904 from the National Cancer Institute.

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Author notes

  1. Emily M. Geramita and Ira R. Parker contributed equally to this work.

Authors and Affiliations

  1. Division of General Internal Medicine, Magee Womens’ Hospital, University of Pittsburgh Medical Center, 300 Halket Street, Room 3526, Pittsburgh, PA, USA

    Emily M. Geramita

  2. Geriatric Oncology Solutions, La Jolla, CA, USA

    Ira R. Parker

  3. Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Jill W. Brufsky & G. J. van Londen

  4. Graduate School of Public Health, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA

    Brenda Diergaarde

Authors
  1. Emily M. Geramita
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  2. Ira R. Parker
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  3. Jill W. Brufsky
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  4. Brenda Diergaarde
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  5. G. J. van Londen
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Correspondence to Emily M. Geramita.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Geramita, E.M., Parker, I.R., Brufsky, J.W. et al. Primary Care Providers’ Knowledge, Attitudes, Beliefs, and Practices Regarding Their Preparedness to Provide Cancer Survivorship Care. J Canc Educ 35, 1219–1226 (2020). https://doi.org/10.1007/s13187-019-01585-4

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