Title: Canadian Team to Improve Community-Based Cancer Care along the Continuum (CanIMPACT)
Background: Primary care is the first and most frequent point of contact for cancer patients within the healthcare system during most phases of cancer care. Coordination of patient care between primary care providers and specialist providers is vital to improve the quality and outcomes of care. Yet, this coordination of care is known to be problematic. From the perspective of primary care, cancer is of critical importance because of the complexity and urgency of care needs. It is estimated that the average family physician has approximately 60 patients with a history of cancer in their practice. As such, primary care providers must concurrently provide comprehensive care to cancer patients who are at different points along the continuum. Tools to remain current in this rapidly changing area and a framework to improve coordination of care could improve quality of care and patient outcomes.
Objective: To develop an inter-disciplinary multi-jurisdictional coordinated program of research and knowledge transfer to enhance the capacity of primary care to provide care to cancer patients and improve the link between primary care and specialty care along the cancer care continuum. This includes a focus on enabling primary care to respond to the challenges of personalized medicine in cancer. Our program will examine current practice, identify inter- and intra-provincial care gaps across healthcare sectors, and develop and test a shared care framework for comparative evaluation across jurisdictions to address those gaps. We will study four specific vulnerable populations: 1) older adults, 2) northern/rural/remote, 3) low income, and 4) immigrants. Special focus will be on breast cancer.
Research Plan: Our program involves four streams of inquiry: diagnosis of symptomatic cancer, treatment, survivorship, and personalized medicine. Using a mixed methods approach, we will use quantitative and qualitative methods (Step 1) and, based on the synthesis of findings (Step 2), we will develop and test a toolkit (Step 3) that is applicable to the cancer continuum and to personalized medicine. Based on our findings we will synthesize and disseminate best practices for scale-up (Step 4). The quantitative methods will be population-based descriptive and analytic studies involving 5 provinces; qualitative methods will incorporate diverse perspectives of stakeholders to explore contextual factors.
Research Team: We are a pan-Canadian team committed to improving care for cancer patients. The team is comprised of health professional scientists, research scientists with expertise in epidemiology, biostatistics, knowledge translation, qualitative methods, and quantitative methods (including administrative health database analysis and community-based pragmatic trials), and knowledge users. The team spans seven provinces as well as international liaisons from Denmark, Australia and the United States.
Impact: Outcomes from this program will result in: 1) tested explicit strategies useful to healthcare policy makers to direct system change; 2) demonstrated ability to use administrative health databases to measure and monitor system change; and 3) supporting tools and resources that can be used in primary care for cancer patients and that are potentially generalizable to other chronic diseases managed in primary care settings. This project is innovative as we are studying the continuum of cancer care from the primary care perspective.