Aim
To care for the growing number of cancer survivors in Australia, health services must reconsider appropriate models of care. Sharing care between specialists and primary care providers may allow for more effective and efficient care for cancer survivors, and this approach has been endorsed by Cancer Australia. However, many unknowns remain regarding practical evidence-based recommendations to guide implementation. The aim of this systematic review was to explore facilitators and barriers to shared care between primary and specialist providers for people with cancer.
Methods
A literature search was constructed by a library scientist and conducted in July 2018 across MEDLINE, Embase and Emcare databases, without date restrictions. Two reviewers selected eligible studies and assessed their quality using study-specific appraisal tools. Data relevant to the review question were extracted and synthesised following a mixed methods approach.
Results
Twelve studies were included; eight qualitative, two cross sectional, one program evaluation and one case report. Studies were from Australia (n=5), US (n=4), and one each from the Netherlands, UK and Canada. Seven major themes were developed: 1) the importance of communication between different providers, and also between providers and patients; 2) potential roles of electronic medical records and survivorship care plans to enhance communication; 3) the need for clarity between GPs and specialists regarding roles and responsibilities; 4) further training for GPs to increase their knowledge and confidence in providing survivorship care, and increase patient trust; 5) the need for established shared care guidelines; 6) the importance of care coordination and clear referral pathways; 7) and the need for a supportive policy framework encompassing information sharing, privacy and funding issues.
Conclusion
Based on review findings, a set of recommendations for support future implementation of shared survivorship care are proposed.