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Fam Pract. 2015 Apr;32(2):129-40. doi: 10.1093/fampra/cmu082. Epub 2014 Dec 14.

A comprehensive framework and key guideline recommendations for the provision of evidence-based breast cancer survivorship care within the primary care setting.

Author information

1
Faculty of Health Sciences, School of Nursing, mfl1@queensu.ca.
2
Faculty of Health Sciences, School of Rehabilitation Therapy, Canadian Institute for Military and Veteran Health Research.
3
Faculty of Health Sciences, School of Rehabilitation Therapy, Centre for Health Services and Policy Research and.
4
Faculty of Health Sciences, School of Nursing, Department of Public Health Sciences, Queen's University, Kingston, Canada.

Abstract

BACKGROUND:

Breast cancer survivors continue to experience physical and psychosocial health care needs post-treatment. Primary care involvement is increasing as cancer centres move forward with earlier discharge of stable breast cancer survivors to primary care follow-up. Research suggests primary care providers (PCPs) are willing to provide survivorship care but many lack knowledge and confidence to provide evidence-based care. Although clinical practice guidelines (CPGs) exist for follow-up surveillance and certain aspects of survivorship care, no single comprehensive guideline addresses all significant breast cancer survivorship issues encountered in primary care.

PURPOSE:

The purpose of this research was to create a comprehensive clinical practice framework to guide the provision of breast cancer survivorship care in primary care settings.

METHODS:

This study consisted of an extensive search, appraisal and synthesis of CPGs for post-treatment breast cancer care using a modified Delphi method. Breast cancer survivorship issues and relevant CPGs were mapped to four essential components of survivorship care to create a comprehensive clinical practice framework to guide provision of breast cancer survivorship care.

RESULTS:

The completed framework consists of a one-page checklist outlining breast cancer survivorship issues relevant to primary care, a three-page summary of key recommendations and a one-page list of guideline sources. The framework and key guideline recommendations were verified by a panel of experts for comprehensiveness, importance and relevance to primary care.

CONCLUSIONS:

This framework may serve as a tool to remind PCPs about issues impacting breast cancer survivors, as well as the evidence-based recommendations and resources to provide the associated care.

KEYWORDS:

Aftercare; breast neoplasms; nurse practitioners; physicians; practice guideline; primary care; primary health care.

PMID:
25500746
DOI:
10.1093/fampra/cmu082
[Indexed for MEDLINE]

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