Introduction
Colorectal cancer (CRC) treatment can lead to many after-effects, often requiring ongoing supportive care. General practitioners (GP) and practice nurses (PN) play a pivotal role in identifying ongoing issues post-treatment and making timely referrals. The aim of this study was to explore the current state of CRC supportive care in general practice settings and ways to improve care.
Methods
Mixed method study using surveys and qualitative interviews. Survey participants included 51 CRC survivors (79% female, 41% aged <50 years), 19 GPs and eight PNs. Interview participants included 19 CRC survivors (13 female, 8 aged <50 years), four GPs and one PN.
Data from CRC survivors included care during early survivorship in general practices and supportive care gaps. Data from GPs/PNs included the current management of CRC survivors in the community and barriers/facilitators to transitioning patients from acute care to GP-coordinated care.
Results
CRC survivors reported post-treatment effects include; fatigue (86%), emotional concerns (78%), bowel problems (75%), pain/discomfort (69%), neuropathy (71%), and weight loss/gain (69%). Survivors noted insufficient discharge preparation from cancer services, leaving them worried about consequences of treatment and felt disconnected from the health system. They saw their GP as their primary healthcare provider; however, the provision of supports and referrals to services could be improved. 13 GPs reported inadequate information from cancer services as a major barrier to their ability to provide optimal care. They wanted detailed discharge letters, information on specialist support services, and key contact persons at the hospital.
Conclusions
CRC survivors can experience various consequences of treatment that require timely detection and management. Improved discharge preparation for the patient and system-level changes that better enable GPs to care for CRC survivors with sufficient clinical information and access to specialist services will improve survivorship care for CRC survivors.