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Involvement of Family Physicians in the Care of Cancer Patients Seen in the Palliative Rapid Response Radiotherapy Program

Elizabeth A. Barnes, Grace Fan, Kristin Harris, Meagan Doyle, Lawrence S. Librach, Edward Chow, Lisa Barbera, May Tsao, Kelvin Lam, Cyril Danjoux

From the Department of Radiation Oncology, Toronto Sunnybrook Regional Cancer Centre; The Temmy Latner Centre for Palliative Care, Mount Sinai Hospital; and Institute for Clinical Evaluative Studies, Toronto, Ontario, Canada

Address reprint requests to Elizabeth A. Barnes, MD, Department of Radiation Oncology, Toronto Sunnybrook Regional Cancer Centre, 2075 Bayview Ave, Toronto, Ontario, Canada, M4N 3M5; e-mail: toni.barnes{at}sunnybrook.ca

Purpose It is important for cancer patients to maintain continuity of care with their family physician (FP) while being followed at the cancer center. The primary objective of this study was to determine the perception of patients seen in the palliative Rapid Response Radiotherapy Program (RRRP) on FP involvement in their cancer care. Secondary objectives were to identify factors predicting for perceived FP involvement in patient cancer care.

Patients and Methods Consecutive patients were approached for study enrollment at the time of RRRP visit and asked to complete a 15-item survey.

Results Three hundred sixty-five patients were accrued over 15 months. Ninety-eight percent had an FP, and 43% felt their FP was involved in their cancer care. Eighty percent of patients were satisfied with the overall medical care provided by their FP, and 71% had been with their FP for 5 years. The most common reason patients gave for perceiving limited FP involvement was the medical oncologist looking after all of their cancer needs. Multivariate analysis found that satisfaction with overall medical care provided by the FP, shorter time since last FP visit, seeing the FP since cancer diagnosis, and FP providing on-call service for after-hour emergencies all significantly predicted for patients perceiving FP involvement in their cancer care.

Conclusion Less than half of patients surveyed perceived their FP as involved in their cancer care. Encouraging continuity of care between patients and FPs may allow for easier transition of care back to the FP once palliative treatment at the cancer center has finished and help facilitate end-of-life planning.

Supported by the Department of Radiation Oncology, Toronto Sunnybrook Regional Cancer Center, Toronto, Ontario, Canada.

Presented in part at the 20th Annual Meeting of the Canadian Association of Radiation Oncologists, September 13-16, 2006, Calgary, Alberta, Canada.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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