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Specialist versus primary care prostate cancer follow-up: A process evaluation of a randomized controlled trial
Wollersheim,Barbara M. Van Asselt,Kristel M. Pos,Floris J. Akdemir,Emine Crouse,Shifra Van Der Poel,Henk G. Aaronson,Neil K. van de Poll-Franse,Lonneke V. Boekhout,Annelies H.
Wollersheim,Barbara M.
Van Asselt,Kristel M.
Pos,Floris J.
Akdemir,Emine
Crouse,Shifra
Van Der Poel,Henk G.
Aaronson,Neil K.
van de Poll-Franse,Lonneke V.
Boekhout,Annelies H.
Abstract
Background: A randomized controlled trial (RCT) is currently comparing the effectiveness of specialist- versus primary care-based prostate cancer follow-up. This process evaluation assesses the reach and identified constructs for the implementation of primary care-based follow-up. Methods: A mixed-methods approach is used to assess the reach and the implementation through the Consolidated Framework for Implementation Research. We use quantitative data to evaluate the reach of the RCT and qualitative data (interviews) to indicate the perspectives of patients (n = 15), general practitioners (GPs) (n = 10), and specialists (n = 8). Thematic analysis is used to analyze the interview transcripts. Results: In total, we reached 402 (67%) patients from 12 hospitals and randomized them to specialist- (n = 201) or to primary care-based (n = 201) follow-up. From the interviews, we identify several advantages of primary care- versus specialist-based follow-up: it is closer to home, more accessible, and the relationship is more personal. Nevertheless, participants also identified challenges: guidelines should be implemented, communication and collaboration between primary and secondary care should be improved, quality indicators should be collected, and GPs should be compensated. Conclusion: Within an RCT context, 402 (67%) patients and their GPs were willing to receive/provide primary care-based follow-up. If the RCT shows that primary care is equally as effective as specialist-based follow-up, the challenges identified in this study need to be addressed to enable a smooth transition of prostate cancer follow-up to primary care. Netherlands Trial Registry, Trial NL7068 (NTR7266).
Description
This work is funded by the Dutch Cancer Society (Delfandlaan 17, 1062 EA, Amsterdam, The Netherlands), grant number NKI 2015-7932.
Date
2022
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Publisher
Research Projects
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Keywords
BREAST-CANCER, COLON-CANCER, Consolidated Framework for Implementation Research, EXPERIENCES, GENERAL-PRACTITIONERS, PHYSICIANS, follow-up care, general practice, primary health care, process evaluation, prostate cancer survivors, SDG 3 - Good Health and Well-being
Citation
Wollersheim, B M, Van Asselt, K M, Pos, F J, Akdemir, E, Crouse, S, Van Der Poel, H G, Aaronson, N K, van de Poll-Franse, L V & Boekhout, A H 2022, 'Specialist versus primary care prostate cancer follow-up : A process evaluation of a randomized controlled trial', Cancers, vol. 14, no. 13, 3166. https://doi.org/10.3390/cancers14133166