What is the evidence behind cancer care reviews, a British primary care cancer support tool? A scoping review

Conference:

SAPC ASM 2022 - UCLan

Talk Code:

4B.6

Presenter:

Dipesh Gopal

Twitter:

@dipeshgopal

Co-authors:

Tahania Ahmad(1), Stephanie J. C. Taylor(1)

Author institutions:

1. Primary Care Unit, Centre for Primary Care, Wolfson Institute of Population Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London

Problem

A “cancer care review” is a conversation between an adult patient recently diagnosed with cancer and their primary care practitioner, either general practitioner (GP) or practice nurse, soon after a diagnosis of cancer. Cancer care reviews (CCRs) were introduced in the UK in 2003. In recent years there have been review articles evaluating similar care assessments and plans such as holistic needs assessments, treatment summaries and survivorship care plans but there has been limited formal academic evaluation of CCRs. For adults who are living with and beyond cancer, this scoping review aims to answer the following research questions: 1. What methodology and validated outcome measures have been used to evaluate CCRs?2. What is the evidence that CCRs improve quality of life or patient symptoms?3. What are the views of patients, their carers, and healthcare professionals on CCRs?

Approach

A scoping review was centred on population of adults who are living with and beyond cancer, a concept of cancer care reviews, and context of English language primary and secondary quantative and qualitative research. Five databases were searched including Medline, Embase, PsychINFO, Scopus and Web of Science. Records were screened initially at title and abstract level by DPG and TA independently before screening at full text level.

Findings

After removing duplicates, 3552 unique articles were found and after full text screening, 6 articles were identified. There were no papers on evaluation of CCRs and no papers showing improvement in patient symptoms or quality of life. Views of GPs and practice nurses were captured through qualitative research. GPs and practice nurses felt that CCRs were a tick-box exercise, and 53-60% found CCRs useful for clinical care. They said they had inadequate time to deliver cancer care whilst others found inadequate care coordination between primary care and secondary care which was echoed by patients. Interviews with patients found few recalled CCRs and those that recalled one did not find it particularly helpful. Partners of patients would welcome CCRs to keep themselves informed and raise personal health concerns.

Consequences

There was no research to evaluate cancer care reviews via rigorous methodology or validated outcomes and no research measuring the effect on patient symptoms and quality of life. Current research is mainly qualitative research on stakeholders’ views including patients, their partners, policymakers, and GPs. Further studies should aim to identify ways to evaluate cancer care reviews and the effect on patients. Future studies with stakeholders would identify difficulties in delivering CCRs during the COVID-19 pandemic.

Submitted by:

Dipesh Gopal

Funding acknowledgement:

Dipesh Gopal is an In-Practice Fellow supported by the Department of Health and Social Care and the National Institute for Health Research. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.