The involvement of primary care physicians in care for childhood cancer survivors
DCOG-LATER Study Group
(2019) Pediatric Blood and Cancer, volume 66, issue 8, pp.
(Article)
Abstract
Background: Childhood cancer survivors (CCS) are at risk of developing long-term morbidity, which is likely to be presented to a primary care physician (PCP). Therefore, insight into CCS's PCP-based health care use is needed. We investigated the volume and underlying health problems of PCP-based health care use and the determinants
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for PCP-based health care use in CCS. Procedure: Data from a Dutch cohort of 6018 eligible five-year CCS were linked to the Nivel Primary Care database, which contains detailed data from a representative sample of 10% of all Dutch PCPs. Per CCS, two matched controls were selected. Negative binomial regression was performed to compare the annual number of contacts between CCS and controls, and to identify determinants for PCP-based care use among CCS. Results: This study included 602 CCS and 1204 controls. CCS were 1.3 times more likely to contact their PCP than controls (95% CI, 1.2–1.5), up to 1.5 times at attained age over 40 years (95% CI, 1.2–1.8). CCS were 4.9 times more likely to contact their PCP for new malignancies, 3.1 for hematological conditions, and 2.8 for endocrine conditions. Female sex, higher attained age, and treatment with radiotherapy were determinants for having more PCP contacts. Conclusions: PCPs play an important role in care for CCS. CCS use more PCP-based care than matched controls, mainly for severe conditions such as malignancies, hematological, and endocrine conditions. Our results emphasize the importance of disseminating the current knowledge on long-term morbidity in CCS and on their optimal follow-up care among PCPs.
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Keywords: cancer survivorship, late effects, primary care, survivorship care, Prognosis, Follow-Up Studies, Humans, Practice Patterns, Physicians'/standards, Cancer Survivors/statistics & numerical data, Child, Preschool, Male, Survival Rate, Case-Control Studies, Physicians, Primary Care/statistics & numerical data, Young Adult, Neoplasms/therapy, Aftercare/standards, Adolescent, Adult, Female, Surveys and Questionnaires, Child, Quality of Health Care, Hematology, Oncology, Pediatrics, Perinatology, and Child Health, Research Support, Non-U.S. Gov't, Journal Article
ISSN: 1545-5009
Publisher: Wiley-Liss Inc.
Note: Funding Information: We thank Nynke Hollema for her contribution at the DCOG-LATER registry and coordinating office as well as all data managers in the seven participating centers and Aslihan Mantici for obtaining the data for this study. Furthermore, we thank Lilian Batenburg for her contribution as late effects outpatient clinic physicians, Monique Jaspers, Lideke Postma, Lideke van der Steeg, and Margreet Veening for their contribution as a DCOG-LATER board member, and Marleen van den Berg and Gea Huizinga for their contribution as DCOG-LATER researchers. We also thank the staff of The Netherlands Institute for Health Services Research (Nivel), especially Rodrigo Davids and Bram Elffers, for providing record linkage data. Publisher Copyright: © 2019 Wiley Periodicals, Inc.
(Peer reviewed)