Florian Kaiser1, Xenia Schulz2, Ana Hoffmann3, Felix Kaiser4, Ursula Vehling-Kaiser4, Ulrich Kaiser5. 1. Klinik für Hämatologie und medizinische Onkologie, Universitätsmedizin Göttingen, Göttingen, Deutschland. Electronic address: florian.kaiser@med.uni-goettingen.de. 2. Institut für Medizinische Statistik, Universitätsmedizin Göttingen, Göttingen, Deutschland. 3. VK&K Studien GbR, Landshut, Deutschland. 4. Onkologisch/Palliativmedizinisches Netzwerk Landshut, Landshut, Deutschland. 5. Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Regensburg, Regensburg, Deutschland.
Abstract
INTRODUCTION: Oral tyrosine kinase inhibitor (TKI) therapies are becoming increasingly more important in therapy of malignant diseases. Monitoring with focus on adherence, side effects, and interactions poses new challenges for medical care. The role and capabilities of family doctors in the care of TKI-patients are yet unclear and should be uncovered in a nationwide survey. METHODS: From April - July 2016, 3.000 family doctors in Germany were asked to answer a written questionnaire regarding their capabilities for co-supervision of TKI-patients. RESULTS: The response rate was 18% (n=553). The peak age was between 50-60 years. 81% were general practitioners, 14% specialists for internal medicine and 5% practical doctors. 98% cared for no or less than 10 TKI-patients per quarter. Knowledge of side effects and interaction potential of TKI was low in over 90%. 83% preferred monitoring by the treating oncologist and 93% were uncertain in therapy monitoring. The control of adherence was of little importance in 66%. The number of treated TKI-patients had a significant impact on knowledge and opportunities for therapy monitoring. Knowledge about TKI and confidence in therapy monitoring correlated significant. Younger doctors showed to be more confident in therapy monitoring in general. Specialists for internal medicine tended to have more knowledge than general practitioners and practical doctors. DISCUSSION: Currently, low number of TKI patients, low knowledge about TKI, and wish for specialist care are limiting the possibilities for co-care of TKI patients by family doctors. CONCLUSION: Despite a basic motivation for the care of tumor patients, routinely conducted therapy controls of TKI patients by family doctors seem hardly possible at the moment and should currently remain with the specialist.
INTRODUCTION: Oral tyrosine kinase inhibitor (TKI) therapies are becoming increasingly more important in therapy of malignant diseases. Monitoring with focus on adherence, side effects, and interactions poses new challenges for medical care. The role and capabilities of family doctors in the care of TKI-patients are yet unclear and should be uncovered in a nationwide survey. METHODS: From April - July 2016, 3.000 family doctors in Germany were asked to answer a written questionnaire regarding their capabilities for co-supervision of TKI-patients. RESULTS: The response rate was 18% (n=553). The peak age was between 50-60 years. 81% were general practitioners, 14% specialists for internal medicine and 5% practical doctors. 98% cared for no or less than 10 TKI-patients per quarter. Knowledge of side effects and interaction potential of TKI was low in over 90%. 83% preferred monitoring by the treating oncologist and 93% were uncertain in therapy monitoring. The control of adherence was of little importance in 66%. The number of treated TKI-patients had a significant impact on knowledge and opportunities for therapy monitoring. Knowledge about TKI and confidence in therapy monitoring correlated significant. Younger doctors showed to be more confident in therapy monitoring in general. Specialists for internal medicine tended to have more knowledge than general practitioners and practical doctors. DISCUSSION: Currently, low number of TKI patients, low knowledge about TKI, and wish for specialist care are limiting the possibilities for co-care of TKI patients by family doctors. CONCLUSION: Despite a basic motivation for the care of tumorpatients, routinely conducted therapy controls of TKI patients by family doctors seem hardly possible at the moment and should currently remain with the specialist.