GP involvement after a cancer diagnosis; patients' call to improve decision support

Abstract

BACKGROUND: Shared decision making (SDM) is considered important to realise personalised cancer care. Increased GP involvement after a diagnosis is advocated to improve SDM. AIM: To explore whether patients with cancer are in need of GP involvement in cancer care in general and in SDM, and whether GP involvement occurs. DESIGN & SETTING: An online national survey was distributed by the Dutch Federation of Cancer Patient Organisations (NFK) in May 2019. METHOD: The survey was sent to (former) patients with cancer. Topics included GP involvement in cancer care in general and in SDM. Descriptive statistics and quotes were used. RESULTS: Among 4763 (former) patients with cancer, 59% ( n = 2804) expressed a need for GP involvement in cancer care. Of these patients, 79% ( n = 2193) experienced GP involvement. Regarding GP involvement in SDM, 82% of patients ( n = 3724) expressed that the GP should 'listen to patients' worries and considerations', 69% ( n = 3130) to 'check patients' understanding of information', 66% ( n = 3006) to 'discuss patients' priorities in life and the consequences of treatment options for these priorities', and 67% ( n = 3045) to 'create awareness of the patient's role in the decision making'. This happened in 47%, 17%, 15% and 10% of these patients, respectively. CONCLUSION: The majority of (former) patients with cancer expressed a need for active GP involvement in cancer care. GP support in the fundamental SDM steps is presently insufficient. Therefore, GPs should be made aware of these needs and enabled to support their patients with cancer in SDM.