Barriers and opportunities for long-term follow-up care of cancer survivors. A focus group study among Norwegian general practitioners and oncologists

Background: Cancer therapy can cause persisting or late-onset health problems, late effects. At present, there is no consensus regarding the appropriate organization and content of follow-up care of cancer survivors with, or at risk for, late effects. The aim of the study is to examine oncologists' and general practitioners’ views and preferences for models of long-term follow-up care of cancer survivors regarding late effects. Methods & Materials: We conducted qualitative, focus groups interviews with GPs and oncologists across Norway. So far, 22 oncologists and 24 GPs have participated in 10 focus groups. Six further focus-group interviews are planned. The interviews were audio-recorded, transcribed and analyzed using principles of content analysis. Results: Preliminary analysis of barriers for long-term follow-up care showed that oncologists seldom meet cancer survivors with late effects in their daily clinical practice, while GPs seldom meet the patient during his/her cancer treatment. Both groups expressed limited knowledge of late effects, available treatment for late effects and rehabilitation options. In order to facilitate better long-term follow-up care, both oncologists and GPs expressed a need for better communication between primary and specialist care. Dedicated survivorship clinics/coordinators would allow for better coordination of care between health care professionals, serve as a place to contact for information and to accumulate important knowledge regarding late effects and rehabilitation services. GPs regard themselves as the main responsible for the follow-up care, as long the oncologists provide specific procedures for follow-up care for each survivor (e.g. survivorship care passport), and the survivors themselves take responsibility for contacting health care providers when necessary. Conclusion: Preliminary analysis indicates that oncologists and GPs supports a shard care model for long term follow-up of cancer survivors in Norway, a model in which the specialist and the primary care physicians have defined responsibilities in survivorship care pathways.