Background: The number of survivors of colorectal cancer (CRC) is increasing and current models of survivorship care are unsustainable. There is a drive to implement alternative models including shared care between general practice and hospital-based providers. This study explored patient perspectives of shared and telehealth models of survivorship care, with a view to understanding the facilitators and barriers to shared care.
Method: On enrolment into the Shared Care for Colorectal Cancer Survivors (SCORE) randomised controlled trial (Jefford et al., Trials 2017), patients provided consent to be interviewed at trial completion. Qualitative data were collected via semi-structured interviews exploring patient experiences of usual and shared survivorship care during the SCORE trial. In response to the COVID pandemic, participant experiences of telehealth appointments were also explored. The interviews were recorded and transcribed for inductive content analysis.
Results: 20 survivors of CRC were interviewed with an even distribution from shared and usual care arms; 14 (70%) were male. Generally, participants perceived shared care as an acceptable alternative to usual care, particularly when they described a good relationship with their GP and planned to continue seeing them long-term. Several themes emerged including: the quality of communication with and between healthcare providers; accessibility of healthcare providers; beliefs about the capability of GPs to implement shared care; positive experiences of hospital-based treatment and preferences for continuity of care; quality and length of relationships with GPs; reducing pressures on the hospital system; and comfort and convenience of alternative models of care. Participants also commonly expressed a preference for telehealth-based follow up when there was no need for a clinical examination.
Conclusions: This is one of few studies that have explored patient experiences with shared and telehealth-based survivorship care. Findings can guide the implementation of these models, particularly around care coordination, communication, preparation and personalised pathways of care.