Jacklyn Cho1, Daniela Nilo1, Madeline R Sterling1, Lisa M Kern1, Monika M Safford1, Laura C Pinheiro2. 1. Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA. 2. Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, 420 East 70th Street, 3rd Floor (LH359), New York, NY, 10021, USA. lcp2003@med.cornell.edu.
Abstract
PURPOSE: We sought to elicit the perspectives of primary care providers (PCPs) and oncologists regarding their expectations on who should be responsible for diabetes management, as well as communication mode and frequency about diabetes care during cancer treatment. METHODS: In-depth interviews were conducted with PCPs (physicians and nurse practitioners) and oncologists who treat cancer patients with type 2 diabetes. Interviews were audio-recorded and professionally transcribed. A grounded theory approach was used to analyze the qualitative data and identify key themes. RESULTS: Ten PCPs and ten oncologists were interviewed between March and July 2019. Two broad themes emerged from our interviews with PCPs: (1) cancer patients pausing primary care during cancer treatments, and (2) patients with poorer prognoses and advanced cancer. The following theme emerged from our interviews with oncologists: (3) challenges in caring for cancer patients with uncontrolled diabetes. Three common themes emerged from our interviews with both PCPs and oncologists: (4) discomfort with providing care outside of respective specialty, (5) the need to individualize care plans, and (6) lack of communication across primary and oncology care. CONCLUSIONS: Our findings suggest that substantial barriers to optimal diabetes management during cancer care exist at the provider level. Interventions prioritizing effective communication and educational resources among PCPs, oncologists, and additional members of the patients' care team should be prioritized to achieve optimal outcomes.
PURPOSE: We sought to elicit the perspectives of primary care providers (PCPs) and oncologists regarding their expectations on who should be responsible for diabetes management, as well as communication mode and frequency about diabetes care during cancer treatment. METHODS: In-depth interviews were conducted with PCPs (physicians and nurse practitioners) and oncologists who treat cancer patients with type 2 diabetes. Interviews were audio-recorded and professionally transcribed. A grounded theory approach was used to analyze the qualitative data and identify key themes. RESULTS: Ten PCPs and ten oncologists were interviewed between March and July 2019. Two broad themes emerged from our interviews with PCPs: (1) cancer patients pausing primary care during cancer treatments, and (2) patients with poorer prognoses and advanced cancer. The following theme emerged from our interviews with oncologists: (3) challenges in caring for cancer patients with uncontrolled diabetes. Three common themes emerged from our interviews with both PCPs and oncologists: (4) discomfort with providing care outside of respective specialty, (5) the need to individualize care plans, and (6) lack of communication across primary and oncology care. CONCLUSIONS: Our findings suggest that substantial barriers to optimal diabetes management during cancer care exist at the provider level. Interventions prioritizing effective communication and educational resources among PCPs, oncologists, and additional members of the patients' care team should be prioritized to achieve optimal outcomes.
Authors: Leigha Rowbottom; Jordan Stinson; Rachel McDonald; Urban Emmenegger; Susanna Cheng; Julia Lowe; Angie Giotis; Paul Cheon; Ronald Chow; Mark Pasetka; Nemica Thavarajah; Natalie Pulenzas; Edward Chow; Carlo DeAngelis Journal: Ann Palliat Med Date: 2015-04
Authors: D M Greenfield; K Absolom; C Eiser; S J Walters; G Michel; B W Hancock; J A Snowden; R E Coleman Journal: Br J Cancer Date: 2009-07-28 Impact factor: 7.640
Authors: Kelly B Stein; Claire F Snyder; Bethany B Barone; Hsin-Chieh Yeh; Kimberly S Peairs; Rachel L Derr; Antonio C Wolff; Frederick L Brancati Journal: Dig Dis Sci Date: 2010-07 Impact factor: 3.199
Authors: Lauren Irizarry; Qijuan E Li; Ian Duncan; Andrew L Thurston; Karen A Fitzner; Beatrice J Edwards; Judith M McKoy-Bent; Katrina M Tulas; June M McKoy Journal: Popul Health Manag Date: 2012-10-31 Impact factor: 2.459
Authors: Pauline A J Vissers; Louise Falzon; Lonneke V van de Poll-Franse; Frans Pouwer; Melissa S Y Thong Journal: J Cancer Surviv Date: 2015-10-01 Impact factor: 4.442
Authors: Kerry A McBrien; Noah Ivers; Lianne Barnieh; Jacob J Bailey; Diane L Lorenzetti; David Nicholas; Marcello Tonelli; Brenda Hemmelgarn; Richard Lewanczuk; Alun Edwards; Ted Braun; Braden Manns Journal: PLoS One Date: 2018-02-20 Impact factor: 3.240
Authors: Anne Beiter Arreskov; Maria Å Olsen; Sandra Sinius Pouplier; Volkert Siersma; Christen L Andersen; Søren Friis; Niels de Fine Olivarius Journal: BMC Endocr Disord Date: 2019-06-11 Impact factor: 2.763
Authors: Laura C Pinheiro; Mangala Rajan; Monika M Safford; David M Nanus; Lisa M Kern Journal: J Am Board Fam Med Date: 2022 Jul-Aug Impact factor: 2.395
Authors: Laura Ashley; Saifuddin Kassim; Ian Kellar; Lisa Kidd; Frances Mair; Mike Matthews; Mollie Price; Daniel Swinson; Johanna Taylor; Galina Velikova; Jonathan Wadsley Journal: BMJ Open Date: 2022-02-22 Impact factor: 2.692
Authors: Laura C Pinheiro; Jacklyn Cho; Lisa M Kern; Noel Higgason; Ronan O'Beirne; Rulla Tamimi; Monika Safford Journal: Support Care Cancer Date: 2022-05-11 Impact factor: 3.359