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Correspondence between primary and secondary care about patients with cancer: a Delphi consensus study.

ABSTRACT: INTRODUCTION:To provide optimal care for patients with cancer, timely and efficient communication between healthcare providers is essential. In this study, we aimed to achieve consensus regarding the desired content of communication between general practitioners (GPs) and oncology specialists before and during the initial treatment of cancer. METHODS:In a two-round Delphi procedure, three expert panels reviewed items recommended for inclusion on referral and specialist letters. RESULTS:The three panels comprised 39 GPs (42%), 42 oncology specialists (41%) (i.e. oncologists, radiotherapists, urologists and surgeons) and 18 patients or patient representatives (69%). Final agreement was by consensus, with 12 and 35 items included in the GP referral and the specialist letters, respectively. The key requirements of GP referral letters were that they should be limited to medical facts, a short summary of symptoms and abnormal findings, and the reason for referral. There was a similar requirement for letters from specialists to include these same medical facts, but detailed information was also required about the diagnosis, treatment options and chosen treatment. After two rounds, the overall content validity index (CVI) for both letters was 71%, indicating that a third round was not necessary. DISCUSSION:This is the first study to differentiate between essential and redundant information in GP referral and specialist letters, and the findings could be used to improve communication between primary and secondary care.

SUBMITTER: Stegmann ME

PROVIDER: S-EPMC6803614 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Correspondence between primary and secondary care about patients with cancer: a Delphi consensus study.

Stegmann M E ME Homburg T M TM Meijer J M JM Nuver J J Havenga K K Hiltermann T J N TJN Maduro J H JH Schuling J J Brandenbarg D D Berendsen A J AJ

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20190301 11

<h4>Introduction</h4>To provide optimal care for patients with cancer, timely and efficient communication between healthcare providers is essential. In this study, we aimed to achieve consensus regarding the desired content of communication between general practitioners (GPs) and oncology specialists before and during the initial treatment of cancer.<h4>Methods</h4>In a two-round Delphi procedure, three expert panels reviewed items recommended for inclusion on referral and specialist letters.<h4 ...[more]

PMID: 30825025

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Project description:BackgroundThe majority of severely ill and dying people in Germany can be administered primary palliative care (PPC) by general practitioners (GP). However, the current provision of PPC does not match the needs of the population. Although several public health strategies aim at strengthening the role of GPs in PPC provision, it remains challenging for GP teams to integrate PPC into their daily routines.AimA Delphi study with GPs was conducted to achieve consensus on specific measures for improving the integration of PPC into everyday GP practice.MethodsThe study is part of the junior research project "Primary Palliative Care in General Practice" (ALLPRAX). After having developed, tested and evaluated 26 practical measures for GP practices to improve their PPC, a Delphi consensus study among GPs took place. In 2020, 569 GPs were asked to rate the relevance and feasibility of the measures on a 4-point Likert scale via an anonymous online questionnaire. Consensus was defined as a sum percentage of 'strongly agree' and 'somewhat agree' responses ≥75% after two rounds. Between these rounds, measures that were not consented in the first round were adapted in light of respondents' free text comments and suggestions.ResultsThe response rate was 11.3% in round 1 (n = 64) and 53.1% in round 2 (n = 34). From the initial n = 26 measures, n = 20 measures achieved consensus and were included in the final intervention package. The consented measures pertained to four main topics: advance care planning with patients, consulting and informing patients and family caregivers, GP office organisation and continuing education. N = 6 measures did not achieve consensus, predominantly due to time and workload constraints.ConclusionThe consented measures provide valuable support to improve the provision of PPC by GPs. They can be used freely and flexibly, according to the needs of individual GP teams, and are thus suitable for implementation nationwide.Trial registrationThe study was registered in the German Clinical Trials Register (Registration N° DRKS00011821; 4 December 2017; https://apps.who.int/trialsearch/ ) and the German Register of Health Care Research (Registration N° VfD_ALLPRAX_16_003817; 30 March 2017).

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Correspondence between primary and secondary care about patients with cancer: a Delphi consensus study.

Publications

Correspondence between primary and secondary care about patients with cancer: a Delphi consensus study.

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