Article Figures & Data
Figures
- Figure 1. Flow of participants
Tables
Characteristics Totalan (%) Capital Region of Denmark, n (%) Region of Southern Denmark, n (%) P valueb Total 173 (100) 76 (43.9) 97 (56.1) Sex 0.25 Female 94 (54.3) 45 (59.2) 49 (50.5) Male 79 (45.7) 31 (40.8) 48 (49.5) Mean age, years (range) 53 (32–72) 52 (32–72) 54 (37–70) Age groups 30–39 years 11 (6.4) 3 (3.9) 8 (8.2) 0.62 40–49 years 57 (32.9) 24 (31.6) 33 (34.0) 50–59 years 60 (34.7) 27 (35.5) 33 (34.0) ≥60 years 45 (26.0) 22 (28.9) 23 (23.7) Seniority in practice <10 years 56 (32.4) 24 (31.6) 32 (33.0) 0.95 10–19 years 60 (34.7) 26 (34.2) 34 (35.1) ≥20 years 57 (32.9) 26 (34.2) 31 (32.0) Practice type Partnership practice 96 (55.5) 36 (47.4) 60 (61.9) 0.06 Single-handed practice 77 (44.5) 40 (52.6) 37 (38.1) ↵ aNational data 2021: women = 58%; men = 42%. Mean age = 51.5 years. Practice type: partnership = 59%; single-handed = 41%. bχ2 test for difference between the two regions.
Very rarely or rarely n (%) Sometimes n (%) Frequently or very frequently n (%) How often do you identify patients in need of follow-up cancer care in your practice by: Reaching out to the patients with cancer through written communication or telephone, and encouraging them to contact the practice if necessary? 40 (23.1) 62 (35.8) 71 (41.0) Contacting patients through written communication or by telephone to offer consultation in practice? 45 (26.0) 65 (37.6) 63 (36.4) Receiving information through discharge cards or by telephone from the hospital regarding patients’ requiring follow-up? 35 (20.2) 53 (30.6) 85 (49.1) Receiving information through written communication or telephone from the patients’ home municipality? 80 (46.2) 49 (28.3) 44 (25.4) Being contacted in writing or by telephone by a patient or relative? 18 (10.4) 74 (42.8) 81 (46.8) Not at all or very low or low n (%) Somewhat n (%) Highly or very highly n (%) To what extent do you feel qualified to assess the following possible sequelae after the patients’ cancer diagnosis and treatment: Other somatic disease and treatment? 5 (2.9) 66 (38.2) 102 (59.0) Physical sequelae 17 (9.8) 99 (57.2) 57 (32.9) Challenges and problems related to sexuality and intimacy? 52 (30.1) 88 (50.9) 33 (19.1) Mental sequelae? 3 (1.7) 49 (28.3) 121 (69.9) Social consequences? 27 (15.6) 79 (45.7) 67 (38.7) Existential considerations? 19 (11.0) 66 (38.2) 88 (50.9) Challenges and lifestyle-related issues? 6 (3.5) 58 (33.5) 109 (63.0) To what extent does the written information you receive from specialised hospital departments met your need for knowledge about: The patient’s cancer diagnosis? 11 (6.4) 49 (28.3) 113 (65.3) The patient’s cancer treatment? 28 (16.2) 75 (43.4) 70 (40.5) Possible side effects and long-term effects of the patient’s cancer diagnosis and treatment? 113 (65.3) 46 (26.6) 14 (8.1) Who is responsible for cancer follow-up? 67 (38.7) 73 (42.2) 33 (19.1) - Table 3. Associations between GP and practice characteristics and the GP’s self-assessment of competences regarding late effects of cancer. Higher OR indicates higher self-asesssment of competences
Other somatic diseases and treatment Physical sequelae Sexual sequelae Mental sequelae Social sequelae Existential considerations Lifestyle challenges Adj OR
(95% CI)Adj OR
(95% CI)Adj OR
(95% CI)Adj OR
(95% CI)Adj OR
(95% CI)Adj OR
(95% CI)Adj OR
(95% CI)Sex Male 1 1 1 1 1 1 1 Female 2.4 (1.2 to 4.6)* 0.4 (0.2 to 0.7)* 0.5 (0.3 to 0.9)* 0.4 (0.2 to 0.8)* 0.7 (0.4 to 1.4) 0.9 (0.5 to 1.7) 0.6 (0.3 to 1.1) Seniority in practice <10 years 1 1 1 1 1 1 1 10–19 years 0.7 (0.3 to 1.5) 1.6 (0.7 to 0.5) 1.1 (0.5 to 2.2) 1.5 (0.7 to 3.5) 1.3 (0.6 to 2.6) 1.4 (0.7 to 3.0) 0.9 (0.4 to 1.9) ≥20 years 0.5 (0.3 to 1.2) 1.4 (0.6 to 3.3) 1.2 (0.6 to 2.6) 1.2 (0.5 to 2.9) 0.9 (0.4 to 1.9) 1.0 (0.5 to 2.3) 0.9 (0.4 to 2.1) Practice type Single-handed practice 1 1 1 1 1 1 1 Partnership practice 0.5 (0.3 to 0.9) 0.9 (0.5 to 1.7) 1.1 (0.6 to 1.9) 2.4 (1.2 to 5.0)* 1.4 (0.8 to 2.5) 1.8 (1.0 to 3.3) 1.5 (0.4 to 2.9) Region Capital Region of Denmark 1 1 1 1 1 1 1 Region of Southern Denmark 1.2 (0.7 to 2.2) 0.9 (0.5 to 1.7) 0.8 (0.5 to 1.5) 1.0 (0.5 to 2.1) 0.8 (0.5 to 1.5) 0.8 (0.5 to 1.5) 1.0 (0.5 to 1.8) Bold and asterisk indicates significance at 5% level. Adjusted for: sex, seniority in practice, practice type, and region.
Adj OR = adjusted odds ratio. CI = confidence interval. OR = odds ratio.
- Table 4. Systematic efforts for follow-up cancer care in general practice, reported by the GPs (n = 173)
Yes, n (%) No, n (%) Has your practice introduced systematic efforts for patients with cancer? 49 (28.3) 124 (71.7) Quotes from the GPs describing the systematic efforts 'We write a letter/e-mail or call the patient, when we become aware of the diagnosis. Always offers time for follow-up in general practice. In the event of non-appearance, we give the patient a call.’
'Instructions phrased approximately: the one who reads the discharge summary/correspondence and becomes aware that a patient has been diagnosed with cancer or [their cancer has been diagnosed as terminal], puts a reminder on the calendar of the usual GP. This GP then contacts the patient and clarifies whether there is a need for follow-up now or later and evaluate the resources around the patient.’
‘A list of cancer patients, which is reviewed every six months.’
‘Letter to the patient that we know they have been diagnosed with cancer and that they can contact us in need of help. If we have not heard from them, we call them after one month.’
‘Either a standard letter (adjusted Danish Society of General Practice template) or a call, depending on previous knowledge of the patient. However, it varies when in a cancer course, the contact is established.’
‘We either call or write to patients with newly diagnosed cancer, and follow-up on the cancer patients we already know.’
‘As soon as I see in a discharge summary that a patient has been diagnosed with cancer, I send a letter, with an invitation to a conversation together with relatives, either at home or in the clinic.’
‘We call the patients, when we see a discharge summary with a newly diagnosed cancer, change to palliative care treatment, or information that the cancer has metastasised.’
‘I contact them by email. In that way they can read the email when they have the time and surplus energy and write me back, when they can handle it. Unfortunately, I have just found out that you are not allowed to do that. At least one must not charge a fee for it. However, I still believe that regular follow-up is the right thing to do. Then I must just waive the fee.’
'A palliation list, which is reviewed by the nurse, followed by phone calls and/or written offers of a consultation or visit.’
‘In relation to diagnosis, we always send a letter inviting the patient to take contact when needed and inform that we follow their treatment at the hospital “from behind the scenes”.’
- Table 5. Associations between GP and practice characteristics and having implemented systematic efforts for follow-up cancer care (n = 173)
Systematic efforts Crude OR Adja OR (95 % CI) Sex Male 1 1 Female 0.5 (0.3 to 1.1) 0.7 (0.3 to 1.4) Seniority in practice <10 years 1 1 10–19 years 1.1 (0.5 to 2.4) 1.0 (0.4 to 2.2) ≥20 years 3.0 (1.2 to 7.3) 2.3 (0.9 to 6.2) Practice type Single-handed practice 1 1 Partnership practice 0.6 (0.3 to 1.3) 0.8 (0.4 to 1.7) Region Capital Region of Denmark 1 1 Region of Southern Denmark 0.6 (0.3 to 1.2) 0.6 (0.3 to 1.2) Bold indicates significance at 5% level. aAdjusted for: sex, seniority in practice, practice type, and region.
Adj OR = adjusted odd ratio. OR = odd ratio.
Supplementary Data
- LMSS_10.3399BJGPO.2023.0215_supp.pdf -
Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.
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