Receiving WPP funding for the POISE WI study facilitated my professional development as an independent investigator, and allowed me to meaningfully contribute toward an important and unmet area (i.e., onco-primary care) within cancer survivorship care
At a Glance
There are more than 300,000 cancer survivors in Wisconsin, a number expected to rise significantly in the coming decade. Yet, survivorship care for patients with cancer remains suboptimal, with underserved patients often experiencing greater survivorship health disparities. Primary care plays an essential role across the cancer care continuum, but fragmentation between primary care and oncology is often observed, particularly during the active cancer treatment phase. This project, POISE Wisconsin, will conduct a mixed methods study to identify perspectives and multi-level barriers experienced by primary care providers (PCP) as they manage care for patients undergoing active cancer treatment. Guided by Implementation Science and a health equity lens, the study will identify PCP barriers and facilitators with the ultimate goal of improving care coordination and integration between primary care and oncology care in Wisconsin.
The Challenge
There are currently over 300,000 cancer survivors in Wisconsin, a population that is rapidly expanding. This growing number of cancer survivors will require integration and expansion of primary care services, but current models of cancer survivorship care are fragmented and siloed. Ineffective communication between primary care providers (PCPs) and oncology specialists can adversely affect patient care and health outcomes. A successful care model that emphasizes integration across the cancer care continuum will need to be tailored to the unique needs of Wisconsin cancer survivors, primary care clinics and cancer centers.
Project Goals
The aim of this project was to develop and conduct an implementation science-informed assessment of the unmet needs and care coordination challenges that primary care providers experience while treating patients receiving active cancer treatment and transitioning into post-treatment survivorship.
Results
The research team developed a brief survey through an iterative process involving literature review, consultation with implementation science and onco-primary care experts and close collaboration with PCPs. The survey was distributed to primary care providers across the state of Wisconsin. Recruitment strategies were designed to ensure representation from PCPs practicing in rural, federally qualified health centers and UW Health settings. Survey respondents overwhelmingly believed that the PCP should be responsible for managing patients’ pre-existing conditions during cancer treatment, although most reported it to be challenging. Notable challenges included: 1) lack of guidance about how specific cancer treatments may impact comorbidity management, 2) patients with cancer not scheduling appointments with PCP, 3) lack of time for communication and coordination, and 4) challenges in knowing whether new patient symptoms were related to the patient’s cancer diagnosis and treatment. PCPs who practice in rural locations and PCPs with Advanced Practice degrees may be experiencing communication and coordination challenges with more frequency.
The survey provided meaningful results to be considered for further use within Wisconsin and across the United States. A critical next step in this research will be to conduct focus groups, a script for which has already been developed and pilot tested.
