Skip to main content
SpringerLink
Log in

Primary care providers as partners in long-term follow-up of pediatric cancer survivors

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

To develop a model of shared healthcare delivery that includes primary care providers (PCP) and ensures best practice in follow-up of pediatric cancer survivors.

Method

Structured interviews with healthcare professionals (HCPs) were used to ascertain familiarity and confidence in providing care to survivors. Partnerships were made with HCP societies, and survivor care lectures were given at HCP meetings. HCP’s preferences for ongoing continuing education (CE) opportunities were ascertained. Cancer SurvivorLinkTM, a web-based tool, was developed to allow patients to securely store their healthcare documents and share them electronically with registered HCPs. Educational material developed for Cancer SurvivorLinkTM includes CE modules and QuickFacts—concise summaries of late effects. Website utilization was monitored utilizing Google Analytics.

Results

HCPs described moderate to very low familiarity with survivor care, but high interest in online CE learning. Thirty-one lectures were given to HCP groups to increase awareness. Preferred types of ongoing CE were: lectures, online text, and video modules. CE material was developed based on feedback from HCPs and website utilizations and includes 19 QuickFacts and 5 CE modules. During the first year, the website had 471 unique visitors and 1,129 total visits. QuickFacts received 345 views with Neurocognitive, Survivor Care 101, and Endocrine being most visited, and 49 CME modules have been completed.

Conclusions

PCPs are interested in partnering in models of shared care for pediatric cancer survivors. Effective educational initiatives include lectures within HCP’s professional education constructs and web-based CE opportunities. PCP involvement in survivor care alleviates some barriers to care such as geographic distance to the the cancer center and ensures that more pediatric cancer survivors receive recommended coordinated surveillance for late effects of cancer therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ries L. SEER Cancer Statistics Review, 1975–2004. vol. based on November 2006 SEER data. 2007.

  2. Robison LL, et al. Study design and cohort characteristics of the Childhood Cancer Survivor Study: a multi-institutional collaborative project. Med Pediatr Oncol. 2002;38(4):229–39.

    Article  PubMed  Google Scholar 

  3. Diller L, et al. Chronic disease in the Childhood Cancer Survivor Study cohort: a review of published findings. J Clin Oncol. 2009;27(14):2339–55.

    Article  PubMed  Google Scholar 

  4. Oeffinger KC, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355(15):1572–82.

    Article  PubMed  CAS  Google Scholar 

  5. Landier W, Wallace WH, Hudson MM. Long-term follow-up of pediatric cancer survivors: education, surveillance, and screening. Pediatr Blood Cancer. 2006;46(2):149–58.

    Article  PubMed  Google Scholar 

  6. Landier W, et al. Development of risk-based guidelines for pediatric cancer survivors: the Children’s Oncology Group Long-Term Follow-Up Guidelines from the Children’s Oncology Group Late Effects Committee and Nursing Discipline. J Clin Oncol. 2004;22(24):4979–90.

    Article  PubMed  Google Scholar 

  7. Hewitt M, Weiner SL, Simone JV. Childhood cancer survivorship: improving care and quality of life. Washington, DC: National Academy Press; 2003.

    Google Scholar 

  8. Geenen MM, et al. Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. JAMA. 2007;297(24):2705–15.

    Article  PubMed  CAS  Google Scholar 

  9. Hahn EE, Ganz PA. Survivorship programs and care plans in practice: variations on a theme. J Oncol Pract. 2011;7(2):70–5.

    Article  PubMed  Google Scholar 

  10. Hede K. Assessing survivorship care plans. J Natl Cancer Inst. 2011;103(16):1214–5.

    Article  PubMed  Google Scholar 

  11. Bober SL, et al. Caring for cancer survivors: a survey of primary care physicians. Cancer. 2009;115(18 Suppl):4409–18.

    Article  PubMed  Google Scholar 

  12. Seehusen DA, Baird D, Bode D. Primary care of adult survivors of childhood cancer. Am Fam Physician. 2010;81(10):1250–5.

    PubMed  Google Scholar 

  13. Potosky AL, et al. Differences between primary care physicians’ and oncologists’ knowledge, attitudes and practices regarding the care of cancer survivors. J Gen Intern Med. 2011;26(12):1403–10.

    Article  PubMed  Google Scholar 

  14. Oeffinger KC. Longitudinal risk-based health care for adult survivors of childhood cancer. Curr Probl Cancer. 2003;27(3):143–67.

    Article  PubMed  Google Scholar 

  15. Oeffinger KC, Hudson MM. Long-term complications following childhood and adolescent cancer: foundations for providing risk-based health care for survivors. CA Cancer J Clin. 2004;54(4):208–36.

    Article  PubMed  Google Scholar 

  16. Oeffinger KC, McCabe MS. Models for delivering survivorship care. J Clin Oncol. 2006;24(32):5117–24.

    Article  PubMed  Google Scholar 

  17. Oeffinger KC, et al. Health care of young adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Ann Fam Med. 2004;2(1):61–70.

    Article  PubMed  Google Scholar 

  18. Oeffinger KC, Nathan PC, Kremer LC. Challenges after curative treatment for childhood cancer and long-term follow up of survivors. Pediatr Clin North Am. 2008;55(1):251–73, xiii.

    Article  PubMed  Google Scholar 

  19. Oeffinger KC, Tonorezos ES. The cancer is over, now what?: understanding risk, changing outcomes. Cancer. 2011;117(10 Suppl):2250–7.

    Article  PubMed  Google Scholar 

  20. Nathan PC, et al. Medical care in long-term survivors of childhood cancer: a report from the childhood cancer survivor study. J Clin Oncol. 2008;26(27):4401–9.

    Article  PubMed  Google Scholar 

  21. Zebrack BJ, et al. Health care for childhood cancer survivors: insights and perspectives from a Delphi panel of young adult survivors of childhood cancer. Cancer. 2004;100(4):843–50.

    Article  PubMed  Google Scholar 

  22. Kadan-Lottick NS, et al. Childhood cancer survivors’ knowledge about their past diagnosis and treatment: Childhood Cancer Survivor Study. JAMA. 2002;287(14):1832–9.

    Article  PubMed  Google Scholar 

  23. Sabatino SA, et al. Health insurance coverage and cost barriers to needed medical care among U.S. adult cancer survivors age <65 years. Cancer. 2006;106(11):2466–75.

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no potential, perceived, or real conflicts of interest.

Grant support

Author LR Meacham received support from the Livestrong Foundation—“SurvivorLink—education of healthcare professionals in Georgia,” and AC Mertens is supported by the HS021251-01 AHRQ—Agency for Healthcare Research and Quality “Improving Pediatric Cancer Survivorship Care through SurvivorLink.” AC Mertens is also supported by CURE Childhood Cancer.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Emory University School of Medicine, Room 452, 2015 Uppergate Dr NE, Atlanta, GA, 30322, USA

    Lillian R. Meacham & Ann C. Mertens

  2. Aflac Cancer Center and Blood Disorders Service, Children’s Healthcare of Atlanta, 2015 Uppergate Dr NE, Atlanta, GA, 30322, USA

    Lillian R. Meacham, Brooke O. Cherven, Leann Hassen-Schilling & Ann C. Mertens

  3. HIMformatics–Healthcare Information Technology Consultants, 1735 Buford Highway suite 215-311, Cumming, GA, 30041, USA

    Paula J. Edwards & Michael Palgon

  4. Department of Industrial Engineering, Georgia Institute of Technology, 765 Ferst Ave, Atlanta, GA, 30332, USA

    Sofia Espinoza

Authors
  1. Lillian R. Meacham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paula J. Edwards
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brooke O. Cherven
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Palgon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sofia Espinoza
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leann Hassen-Schilling
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ann C. Mertens
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lillian R. Meacham.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Meacham, L.R., Edwards, P.J., Cherven, B.O. et al. Primary care providers as partners in long-term follow-up of pediatric cancer survivors. J Cancer Surviv 6, 270–277 (2012). https://doi.org/10.1007/s11764-012-0224-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-012-0224-z

Keywords

Search

Navigation