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Fri 30th Aug 2013
Session 2 / Talk 4
11:20 – 11:40
BROOKLYN 2
RADIOTHERAPY
Paul KANE
• ABSTRACT
• Cancer patients and their families in New Zealand frequently report that provision of support services is
disjointed and subject to regional variation. The publication of the Implementation of Support Care
guidance document by the Ministry of Health indicates this as a priority issue. A recent Cancer Society
report indicates one factor is lack of clarity around the role of GPs here. Oncologists have varying and
often ill-defined expectations in terms of the support that could or should be provided by GPs. Patients are
often confused about who to refer to for care after specialist treatment has been completed. With confused
lines of communication GPs appear to be “out of the loop”.
• The study highlighted core issues for GPs. These include; variable standards of communication with
specialists and ideas how this can be improved; a belief that GPs have a significant role to play in support
of patients; comparison with a range of chronic conditions to guide the role of GPs in the care for cancer
patients; concerns over currency of their oncology knowledge; barriers to patients accessing GP services;
limited awareness of services and information which may be of benefit to patients and discussion around
cultural considerations pertinent to the NZ setting.
• GPs seem willing to engage in supporting patients manage their condition in the short and long term.
Unsurprisingly there are barriers to that engagement. It is important to establish the perceptions of
oncologists to complete the picture and construct viable pathways to improving overall service to patients.
THE ROLE OF GPS IN THE
SUPPORTIVE CARE OF
CANCER PATIENTS
NZIMRT Conference 2013
Hamilton
Kane P, Jasperse M, Egan
R, Pullon S, McBain L,
MacKinlay E.
Why did we do this study?
Life is a journey
The journey…with cancer…..
“…cancer’s chronic...“
(F6GP6)
GPs
Oncologists
Cancer Patient
Oncologists
GPs
Cancer Patient
Study Design
• Maori Consultation
• Ethical approval from MOH Multi-Region Committee
• Grounded Theory approach
• Interviews and focus groups with GPs across New
Zealand (n=34)
• Transcription
• Line by line, constant comparison coding
‘I’m happy to be involved…’
(I1GP1)
‘I had no idea what was going on....
(with my patient)’(F5GP6)
‘its not to us really, its their clinical notes’ (FG6GP1)
Dear Doctor Jones,
Mrs Cancer Patient has recently completed her treatment with
me for Glioblastoma Multiforme.
She was given 60Gy/30#/2Gy per #/5# per week/6weeks
This was delivered concomittantly with a course of
Temozolomide, Bevacizumab, Irinotecan followed by adjuvant
chemotherapy of same over 6 months.
She has been prescribed dexamethasone, 4gm/daily
We will review Mrs Patient in 6 months.
Regards
Dr Oncologist
‘…”Look, I’ve got some problem with
diarrhoea” then we can look up in
their last letter and it says:
“Diarrhoea is very common…..this is
how we manage it in our department”
……..we are able to treat them then’
(FG5GP3)
‘I knew exactly what to do!’
F5GP6)
Summary
• Cancer becomes part of a patients life journey
• GPs are part of the patient journey
• Their role must be CLARIFIED
• Next step is to understand how oncologists view
the role of GPs.
• Then develop workable solutions
• You can help!
Acknowledgements
• Cancer Society New Zealand - funding
• GP participants
• My collaborators and co-authors