19 February 2019
A study recently published in Cancer assessed primary care physician (PCP) knowledge about breast cancer treatment decisions, and their comfort level with having treatment option discussions with their patients.
PCPs were identified by their patients as part of a previous study. 61% of the 852 eligible PCPs responded to the survey request. Dr. Lauren Wallner and colleagues asked 4 questions:
– How frequently did the PCP discuss surgery, radiation and chemotherapy options with their patients
– How comfortable were they with these discussions
– Did they feel they had the necessary knowledge to participate in decision-making with their patients
– How confident were they in their ability to help
The survey responses indicated that 34% of the PCPs discussed surgery, 23% discussed radiation, and 22% discussed chemotherapy decisions. Those who appraised their ability to participate more positively were more likely to participate in the decision-making process. PCPs’ reporting of their participation in decision-making discussions was concordant with patients’ reporting of their PCPs’ involvement in their treatment decisions.
While approximately one-third of PCPs reported more involvement in surgery decisions, 22% of them noted that they were not comfortable having these discussions, and 17% felt they did not have the necessary knowledge to participate in treatment decision making. Similar gaps in comfort, knowledge and confidence were seen among those who reported that they were more involved in radiation therapy and chemotherapy decisions.
The authors noted that most research to date has focused on coordinating post-treatment survivorship care between the oncology team and the PCP. However, some patients and their PCPs may desire more PCP involvement early on. As oncology specialists, we need to do a better job educating and communicating with our PCP community so that they can be more active participants and better support their patients during a very challenging time.