scholarly journals The crucial role of primary care providers in the long-term follow-up of adult survivors of childhood cancer

2019 ◽  
Vol Volume 11 ◽  
pp. 3411-3418
Author(s):  
Justin Jain ◽  
Bessi Qorri ◽  
Myron R Szewczuk
Keyword(s):  
Primary Care ◽  
Crucial Role ◽  
Adult Survivors ◽  
Primary Care Providers ◽  
Care Providers ◽  
Long Term Follow Up ◽  
Survivors Of Childhood Cancer

Primary care providers as partners in long-term follow-up of pediatric cancer survivors

2012 ◽  
Vol 6 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Lillian R. Meacham ◽  
Paula J. Edwards ◽  
Brooke O. Cherven ◽  
Michael Palgon ◽  
Sofia Espinoza ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Pediatric Cancer ◽  
Primary Care Providers ◽  
Care Providers ◽  
Pediatric Cancer Survivors ◽  
Long Term Follow Up

scholarly journals Survey of Perceptions and Educational Needs of Primary Care Providers Regarding Management of Patients with Class II and III Obesity in Ontario, Canada

2020 ◽  
Author(s):  
Boris Zevin ◽  
Mary Imelda Martin ◽  
Nancy Dalgarno ◽  
Linda Chan ◽  
Nardhana Sivapalan ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Primary Care Providers ◽  
Class Ii ◽  
Care Providers ◽  
Long Term Follow Up ◽  
Additional Education ◽  
Weight Loss Interventions

Abstract Background: Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; however, previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI).Methods: We performed an anonymous survey study between October 2017 and June 2018 to explore the knowledge, experiences, perceptions, and educational needs of PCPs in Southeastern Ontario in managing patients with class II and III obesity. Results: Surveys were distributed to 591 PCPs (n=538 family physicians; n=53 nurse practitioners) identified as practicing in the Southeastern Ontario and 103 (17.4%) participated. PCPs serving a rural population estimated that 14.2±10.9% of patients would qualify for MSWLI compared to 9.9±8.5% of patients of PCPs serving an urban population (p=.049). Overall, 57.5% of respondents did not feel competent prescribing MSWLI to patients with class II/III obesity, while 69.8% stated they had ‘good’ knowledge of the referral criteria for MSWLI. 22.2% of respondents were hesitant to refer patients for bariatric surgery (BS) due to concerns about postoperative surgical complications and risks associated with surgery. Only 25% of respondents were comfortable providing long-term follow up after BS, and only 39.1% had participated in continuing education on management of patients with class II/III obesity in the past five years. Conclusion: The majority of PCPs believe there is a need for additional education about MSWLI for patients with class II/III obesity. Future studies are needed to develop and compare the effectiveness of additional education and professional development around risks of contemporary BS, indications to consider referral for MSWLI, management and long-term follow-up of patients after BS.

scholarly journals Survey of perceptions and educational needs of primary care providers regarding management of patients with class II and III obesity in Ontario, Canada

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Boris Zevin ◽  
Mary Martin ◽  
Nancy Dalgarno ◽  
Linda Chan ◽  
Nardhana Sivapalan ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Primary Care Providers ◽  
Class Ii ◽  
Care Providers ◽  
Long Term Follow Up ◽  
Additional Education ◽  
Weight Loss Interventions

Abstract Background Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; however, previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI). Methods We performed an anonymous survey study between October 2017 and June 2018 to explore the knowledge, experiences, perceptions, and educational needs of PCPs in Southeastern Ontario in managing patients with class II and III obesity. Results Surveys were distributed to 591 PCPs (n = 538 family physicians; n = 53 nurse practitioners) identified as practicing in the Southeastern Ontario and 92 (15.6%) participated. PCPs serving a rural population estimated that 14.2 ± 10.9% of patients would qualify for MSWLI compared to 9.9 ± 8.5% of patients of PCPs serving an urban population (p = .049). Overall, 57.5% of respondents did not feel competent prescribing MSWLI to patients with class II/III obesity, while 69.8% stated they had ‘good’ knowledge of the referral criteria for MSWLI. 22.2% of respondents were hesitant to refer patients for bariatric surgery (BS) due to concerns about postoperative surgical complications and risks associated with surgery. Only 25% of respondents were comfortable providing long-term follow up after BS, and only 39.1% had participated in continuing education on management of patients with class II/III obesity in the past 5 years. Conclusion The majority of PCPs believe there is a need for additional education about MSWLI for patients with class II/III obesity. Future studies are needed to develop and compare the effectiveness of additional education and professional development around risks of contemporary BS, indications to consider referral for MSWLI, management and long-term follow-up of patients after BS.

scholarly journals Survey of Perceptions and Educational Needs of Primary Care Providers Regarding Management of Patients with Class II and III Obesity in Ontario, Canada

2020 ◽  
Author(s):  
Boris Zevin ◽  
Mary Imelda Martin ◽  
Nancy Dalgarno ◽  
Linda Chan ◽  
Nardhana Sivapalan ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Primary Care Providers ◽  
Class Ii ◽  
Care Providers ◽  
Long Term Follow Up ◽  
Additional Education ◽  
Weight Loss Interventions

Abstract Background: Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; however, previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI).Methods: We performed an anonymous survey study between October 2017 and June 2018 to explore the knowledge, experiences, perceptions, and educational needs of PCPs in Southeastern Ontario in managing patients with class II and III obesity. Results: Surveys were distributed to 591 PCPs (n=538 family physicians; n=53 nurse practitioners) identified as practicing in the Southeastern Ontario and 103 (15.6%) participated. PCPs serving a rural population estimated that 14.2±10.9% of patients would qualify for MSWLI compared to 9.9±8.5% of patients of PCPs serving an urban population (p=.049). Overall, 57.5% of respondents did not feel competent prescribing MSWLI to patients with class II/III obesity, while 69.8% stated they had ‘good’ knowledge of the referral criteria for MSWLI. 22.2% of respondents were hesitant to refer patients for bariatric surgery (BS) due to concerns about postoperative surgical complications and risks associated with surgery. Only 25% of respondents were comfortable providing long-term follow up after BS, and only 39.1% had participated in continuing education on management of patients with class II/III obesity in the past five years. Conclusion: The majority of PCPs believe there is a need for additional education about MSWLI for patients with class II/III obesity. Future studies are needed to develop and compare the effectiveness of additional education and professional development around risks of contemporary BS, indications to consider referral for MSWLI, management and long-term follow-up of patients after BS.

scholarly journals Survey of Perceptions and Educational Needs of Primary Care Providers Regarding Management of Patients with Class II and III Obesity in Ontario, Canada

2021 ◽  
Author(s):  
Boris Zevin ◽  
Mary Imelda Martin ◽  
Nancy Dalgarno ◽  
Linda Chan ◽  
Nardhana Sivapalan ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Primary Care Providers ◽  
Class Ii ◽  
Care Providers ◽  
Long Term Follow Up ◽  
Additional Education ◽  
Weight Loss Interventions

Abstract Background: Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; however, previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI)Methods: We performed an anonymous survey study between October 2017 and June 2018 to explore the knowledge, experiences, perceptions, and educational needs of PCPs in Southeastern Ontario in managing patients with class II and III obesity. Results: Surveys were distributed to 591 PCPs (n=538 family physicians; n=53 nurse practitioners) identified as practicing in the Southeastern Ontario and 103 (15.6%) participated. PCPs serving a rural population estimated that 14.2±10.9% of patients would qualify for MSWLI compared to 9.9±8.5% of patients of PCPs serving an urban population (p=.049). Overall, 57.5% of respondents did not feel competent prescribing MSWLI to patients with class II/III obesity, while 69.8% stated they had ‘good’ knowledge of the referral criteria for MSWLI. 22.2% of respondents were hesitant to refer patients for bariatric surgery (BS) due to concerns about postoperative surgical complications and risks associated with surgery. Only 25% of respondents were comfortable providing long-term follow up after BS, and only 39.1% had participated in continuing education on management of patients with class II/III obesity in the past five years. Conclusion: The majority of PCPs believe there is a need for additional education about MSWLI for patients with class II/III obesity. Future studies are needed to develop and compare the effectiveness of additional education and professional development around risks of contemporary BS, indications to consider referral for MSWLI, management and long-term follow-up of patients after BS.

Programs for adult survivors of childhood cancer.

1998 ◽  
Vol 16 (8) ◽  
pp. 2864-2867 ◽  
Author(s):  
K C Oeffinger ◽  
D A Eshelman ◽  
G E Tomlinson ◽  
G R Buchanan
Keyword(s):  
Health Care ◽  
Childhood Cancer ◽  
Health Care Providers ◽  
Primary Care Physicians ◽  
Adult Survivors ◽  
Care Providers ◽  
Care Needs ◽  
Survivors Of Childhood Cancer

PURPOSE The potential for late effects of treatment necessitates long-term monitoring of adult survivors of childhood cancer. The purpose of this study was to determine how institutions follow up young adult survivors of pediatric malignancy. Specifically, we were interested in the types of health care providers who follow up these patients, how the follow-up is administered, and what barriers to follow-up have been encountered. METHODS A 16-item questionnaire was mailed to the 219 members of the Children's Cancer Group (CCG) and the Pediatric Oncology Group (POG). The survey consisted of four categories of questions that asked for information regarding the existence of a program to follow up young adults, the setting of the program, routine activities of the program, and commonly encountered barriers to care. RESULTS One hundred eighty-two members returned the survey (83% response rate). Fifty-three percent of the respondents have a long-term follow-up clinic at their institution. Whereas 44% have a mechanism for following up adult survivors, only 15% of the programs have established a formal database for adults. Nearly all the programs (93%) use a pediatric oncologist. Although an adult oncologist assists in 13% of the programs, primary care physicians are uncommonly (8%) involved. CONCLUSION Few programs focus on the long-term health care needs of adult survivors of childhood cancer. The majority of existing programs are in pediatric institutions, without significant input from adult-oriented, generalist health care providers.

scholarly journals Primary Care Provider Involvement in Thyroid Cancer Survivorship Care

2020 ◽  
Vol 105 (9) ◽  
pp. e3300-e3306 ◽  
Author(s):  
Archana Radhakrishnan ◽  
David Reyes-Gastelum ◽  
Brittany Gay ◽  
Sarah T Hawley ◽  
Ann S Hamilton ◽  
...  
Keyword(s):  
Primary Care ◽  
Thyroid Cancer ◽  
Cancer Survivorship ◽  
Primary Care Providers ◽  
Survivorship Care ◽  
Care Providers ◽  
High Confidence ◽  
Neck Ultrasound

Abstract Context While prior research has examined how primary care providers (PCPs) can care for breast and colon cancer survivors, little is known about their role in thyroid cancer survivorship. Objective To understand PCP involvement and confidence in thyroid cancer survivorship care. Design/Setting/Participants We surveyed PCPs identified by thyroid cancer patients from the Georgia and LA SEER registries (n = 162, response rate 56%). PCPs reported their involvement in long-term surveillance and confidence in handling survivorship care (role of random thyroglobulin levels and neck ultrasound, and when to end long-term surveillance and refer back to the specialist). We examined: 1) PCP-reported factors associated with involvement using multivariable analyses; and 2) bivariate associations between involvement and confidence in handling survivorship care. Main Outcome Measures PCP involvement (involved vs not involved) and confidence (high vs low). Results Many PCPs (76%) reported being involved in long-term surveillance. Involvement was greater among PCPs who noted clinical guidelines as the most influential source in guiding treatment (OR 4.29; 95% CI, 1.56-11.82). PCPs reporting high confidence in handling survivorship varied by aspects of care: refer patient to specialist (39%), role of neck ultrasound (36%) and random thyroglobulin levels (27%), and end long-term surveillance (14%). PCPs reporting involvement were more likely to report high confidence in discussing the role of random thyroglobulin levels (33.3% vs 7.9% not involved; P < 0.01). Conclusions While PCPs reported being involved in long-term surveillance, gaps remain in their confidence in handling survivorship care. Thyroid cancer survivorship guidelines that delineate PCP roles present one opportunity to increase confidence about their participation.

scholarly journals Genomic decision support needs in pediatric primary care

2017 ◽  
Vol 24 (4) ◽  
pp. 851-856 ◽  
Author(s):  
Jeffrey W Pennington ◽  
Dean J Karavite ◽  
Edward M Krause ◽  
Jeffrey Miller ◽  
Barbara A Bernhardt ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Primary Care Providers ◽  
Pediatric Primary Care ◽  
Care Providers ◽  
Further Development

Abstract Clinical genome and exome sequencing can diagnose pediatric patients with complex conditions that often require follow-up care with multiple specialties. The American Academy of Pediatrics emphasizes the role of the medical home and the primary care pediatrician in coordinating care for patients who need multidisciplinary support. In addition, the electronic health record (EHR) with embedded clinical decision support is recognized as an important component in providing care in this setting. We interviewed 6 clinicians to assess their experience caring for patients with complex and rare genetic findings and hear their opinions about how the EHR currently supports this role. Using these results, we designed a candidate EHR clinical decision support application mock-up and conducted formative exploratory user testing with 26 pediatric primary care providers to capture opinions on its utility in practice with respect to a specific clinical scenario. Our results indicate agreement that the functionality represented by the mock-up would effectively assist with care and warrants further development.

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