Poster Presentation NSW State Cancer Conference 2023

Examining the current state of supportive care for colorectal cancer survivors in general practice settings (#290)

Bora Kim 1 2 3 , Marguerite Tracy 4 , Janani Mahadeva 5 , Cheri Ostroff 6 7 , Julie Marker 6 8 , Louise Acret 1 2 , Kate White 1 2 3 , Simon Willcock 5 , Claudia Rutherford 1 2
  1. The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
  2. Cancer Care Research Unit, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  3. Sydney Local District, Sydney, NSW, Australia
  4. General Practice Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
  5. MQ Health, Macquarie University Hospital, Primary Care, Sydney, NSW, Australia
  6. Consumer representative, Adelaide, SA, Australia
  7. Business, University of South Australia, Adelaide, SA, Australia
  8. Cancer Voices SA, Adelaide, SA, Australia

Introduction

Colorectal cancer (CRC) treatment can lead to lasting effects such as faecal incontinence/urgency, sexual dysfunction, psychosocial concerns and return-to-work challenges. Therefore, ongoing support is required, and primary healthcare providers (PCP), including general practitioners (GPs) and practice nurses (PNs), are well suited for this vital role. Our research aimed to examine the experiences and perspectives of CRC survivors, GPs and PNs regarding current care after CRC treatment and ways to improve care. 

 

Methods

We conducted a mixed-method study using surveys and qualitative interviews. CRC survivors and PCP were asked about their experience with care in general practices and suggestions for improved care. Survey data were descriptively analysed, and interviews were thematically analysed. 

 

Results

Survey participants included 51 CRC survivors (79% female, 41% aged <50 years), 19 GPs and eight PNs. Interview participants included 19 CRC survivors (13 female, eight aged <50 years), 4 GPs and one PN.  

 

CRC survivors often experienced a wide range of post-treatment issues but did not discuss them with their PCP. The common unaddressed issues were Fatigue/lack of energy (experienced vs discussed: 86% vs 47%), psychological/emotional concern (78% vs 27%), impaired sleep (63% vs 22%), weight loss/gain (69% vs 29%), urinary problems (35% vs 12%), pain/discomfort (69% vs 45%), and feeling isolated from others (59% vs 16%). 51% of the participants said they felt more comfortable discussing health concerns when their PCP initiated the discussion.

Interviews with CRC survivors revealed that when they had unaddressed concerns, they sought information independently, explored service options and managed their own care through trial and error, making them feel that they had inadequate support. Another issue was not having adequate patient education to know possible CRC treatment issues they might experience, which was described as ‘don’t know where to from here.’

According to GPs, a significant obstacle to their capacity to deliver optimal care was insufficient information received from cancer services, with almost half feeling the information received was inadequate (47%). They expressed a need for comprehensive discharge letters, details on specialised support services, and contact details of key clinicians at the cancer services.

 

Conclusion

This study identified several gaps in care after CRC treatment, namely the need for improved post-treatment education and strategies to better elicit post-treatment concerns. Additionally, detailed discharge letters to facilitate information transfer might be one way to enable GPs to play a more active role in post-treatment care for CRC survivors.