Treatment

Our aim is to improve coordination of care to optimize the role of primary care in providing care to cancer patients during active cancer treatment.

Cancer patients continue to see their primary care provider regularly even during active cancer treatment. But, little is known about the role of primary care providers during the treatment phase.

For many patients, the cancer treatment phase is often marked by intense contact with specialty and acute care systems. This is especially true for cancer patients requiring chemotherapy, which is associated with high rates of adverse events and the need for acute care.

Available data suggest that patients continue to see their family physician while receiving cancer treatment but there is limited interaction between primary care and oncologists, increasing the risk of poor coordination of care. Survey data from Ontario and Quebec indicate that many family physicians are interested in being more involved during this phase, but their optimum role, and strategies and tools to support that role are not well understood.

The potential for harnessing multi-disciplinary care (such as community pharmacists) available through new models of multi-disciplinary primary care team practices, has not been explored.

We will describe care patterns for breast cancer patients during active cancer treatment. We are studying the role that comorbidities play during active cancer treatment, as well as the association between chemotherapy treatment delay and overall survival. We are also evaluating inter- and intra-provincial variations in patterns of care for identified vulnerable populations to determine access. Quality will be assessed by recommended management of toxicities. Study outcomes that will be measured include emergency department visits, hospitalizations, type and continuity of primary care visits, and survival.