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Eliciting primary care and oncology provider perspectives on diabetes management during active cancer treatment

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Abstract

Purpose

We sought to elicit the perspectives of primary care providers (PCPs) and oncologists regarding their expectations on who should be responsible for diabetes management, as well as communication mode and frequency about diabetes care during cancer treatment.

Methods

In-depth interviews were conducted with PCPs (physicians and nurse practitioners) and oncologists who treat cancer patients with type 2 diabetes. Interviews were audio-recorded and professionally transcribed. A grounded theory approach was used to analyze the qualitative data and identify key themes.

Results

Ten PCPs and ten oncologists were interviewed between March and July 2019. Two broad themes emerged from our interviews with PCPs: (1) cancer patients pausing primary care during cancer treatments, and (2) patients with poorer prognoses and advanced cancer. The following theme emerged from our interviews with oncologists: (3) challenges in caring for cancer patients with uncontrolled diabetes. Three common themes emerged from our interviews with both PCPs and oncologists: (4) discomfort with providing care outside of respective specialty, (5) the need to individualize care plans, and (6) lack of communication across primary and oncology care.

Conclusions

Our findings suggest that substantial barriers to optimal diabetes management during cancer care exist at the provider level. Interventions prioritizing effective communication and educational resources among PCPs, oncologists, and additional members of the patients’ care team should be prioritized to achieve optimal outcomes.

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Data availability

The codebook generated from this study is included in the published article [Supplementary Material I].

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Funding

This study was funded by Weill Cornell Medicine.

Author information

Authors and Affiliations

  1. Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA

    Jacklyn Cho, Daniela Nilo, Madeline R. Sterling, Lisa M. Kern, Monika M. Safford & Laura C. Pinheiro

Authors
  1. Jacklyn Cho
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  2. Daniela Nilo
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  3. Madeline R. Sterling
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  4. Lisa M. Kern
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  5. Monika M. Safford
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  6. Laura C. Pinheiro
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Contributions

J. Cho, D. Nilo, and L. Pinheiro jointly conceptualized the study; J. Cho and L. Pinheiro led the data analysis; J. Cho, L. Pinheiro, D. Nilo, and M. Sterling jointly interpreted the data; J. Cho led the writing of the manuscript; L. Pinheiro, D. Nilo, M. Sterling, L. Kern, and M. Safford jointly provided critical feedback on the manuscript drafts; J. Cho and L. Pinheiro provided overall supervision.

Corresponding author

Correspondence to Laura C. Pinheiro.

Ethics declarations

Ethics approval and consent to participate

The methodology, questionnaire, and interview topic guide for this study were approved by the Human Research Ethics committee of Weill Cornell Medicine. Informed consent was obtained from all participants in the study.

Consent for publication

All participants provided written consent regarding publication of the content from the interviews.

Conflict of interest

Dr. Safford receives salary support for investigator-initiated research from Amgen, Inc. The other co-authors have no conflicts of interest to disclose.

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Supplementary Information

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Supplementary file1 (DOCX 20 KB)

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Cho, J., Nilo, D., Sterling, M.R. et al. Eliciting primary care and oncology provider perspectives on diabetes management during active cancer treatment. Support Care Cancer 29, 6881–6890 (2021). https://doi.org/10.1007/s00520-021-06264-z

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  • DOI: https://doi.org/10.1007/s00520-021-06264-z

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