Anne Dahlhaus1, Thomas Semlitsch2, Klaus Jeitler3, Karl Horvath4, Andrea Siebenhofer5. 1. Institute of General Practice, Goethe-University Frankfurt, Frankfurt am Main, Germany, German Cancer Research Center (DKFZ), Heidelberg, Germany, German Cancer Consortium (DKTK), Heidelberg, Germany and andrea.siebenhofer@medunigraz.at. 2. Institute of General Practice and Health Services Research, Medical University of Graz, Graz, Austria. 3. Institute of General Practice and Health Services Research, Medical University of Graz, Graz, Austria, Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria and. 4. Institute of General Practice and Health Services Research, Medical University of Graz, Graz, Austria, Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria. 5. Institute of General Practice, Goethe-University Frankfurt, Frankfurt am Main, Germany, German Cancer Research Center (DKFZ), Heidelberg, Germany, German Cancer Consortium (DKTK), Heidelberg, Germany and Institute of General Practice and Health Services Research, Medical University of Graz, Graz, Austria, andrea.siebenhofer@medunigraz.at.
Abstract
BACKGROUND: GPs regard cancer guidelines as useful yet criticise their limited applicability to the primary care setting. OBJECTIVES: To determine the extent to which English-language breast, colorectal and prostate cancer guidelines contain recommendations that are relevant to GPs and to find out which of the GPs' roles in cancer care the recommendations refer to. METHODS: Evidence- and consent-based English-language breast, colorectal and prostate cancer guidelines were searched for in guideline databases and selected guideline providers' web pages, and checked against inclusion and exclusion criteria. Relevant recommendations were identified, extracted and examined. The involvement of GPs in guideline development as well as whether they were named as a target group was further investigated. RESULTS: Of the 65 identified guidelines, 35 were eligible and contained recommendations applicable to GPs. GPs were directly involved in the development of the majority of only breast cancer guidelines and were explicitly named as a target group in fewer than 50% of guidelines. The majority of recommendations dealt with patient-physician communication, with a focus on cancer therapy. Rarer procedural recommendations predominantly concentrated on follow-up/survivorship care. Less than one-third of all relevant recommendations concerned diagnosis. Only breast cancer guidelines provided a high number of recommendations on transitions between primary and secondary care. CONCLUSION: Greater consideration of GPs would increase their acceptance of guidelines, promote delivery of high-quality cancer care and clarify responsibilities between cancer care providers. The GP's role in cancer diagnosis is not appropriately reflected in cancer guideline recommendations.
BACKGROUND: GPs regard cancer guidelines as useful yet criticise their limited applicability to the primary care setting. OBJECTIVES: To determine the extent to which English-language breast, colorectal and prostate cancer guidelines contain recommendations that are relevant to GPs and to find out which of the GPs' roles in cancer care the recommendations refer to. METHODS: Evidence- and consent-based English-language breast, colorectal and prostate cancer guidelines were searched for in guideline databases and selected guideline providers' web pages, and checked against inclusion and exclusion criteria. Relevant recommendations were identified, extracted and examined. The involvement of GPs in guideline development as well as whether they were named as a target group was further investigated. RESULTS: Of the 65 identified guidelines, 35 were eligible and contained recommendations applicable to GPs. GPs were directly involved in the development of the majority of only breast cancer guidelines and were explicitly named as a target group in fewer than 50% of guidelines. The majority of recommendations dealt with patient-physician communication, with a focus on cancer therapy. Rarer procedural recommendations predominantly concentrated on follow-up/survivorship care. Less than one-third of all relevant recommendations concerned diagnosis. Only breast cancer guidelines provided a high number of recommendations on transitions between primary and secondary care. CONCLUSION: Greater consideration of GPs would increase their acceptance of guidelines, promote delivery of high-quality cancer care and clarify responsibilities between cancer care providers. The GP's role in cancer diagnosis is not appropriately reflected in cancer guideline recommendations.
Authors: Ellen B Rubinstein; William L Miller; Shawna V Hudson; Jenna Howard; Denalee O'Malley; Jennifer Tsui; Heather Sophia Lee; Alicja Bator; Benjamin F Crabtree Journal: JAMA Intern Med Date: 2017-12-01 Impact factor: 21.873