The role of the general practitioner in cancer survivorship care

This thesis responds to a societal call for increased general practitioner (GP) involvement and patients’ self-management in cancer survivorship care. The thesis is divided into two parts.
Part 1 Current state of affairs. First, we explore the current literature on cancer survivorship care in primary versus secondary care (Chapter 2). Next, we provide an overview of studies on GPs’ knowledge and confidence to provide survivorship care for cancer survivors (Chapter 3). We also describe colon cancer patients’ needs and how healthcare providers respond to these needs during current routine follow-up consultations in hospital (Chapter 4).
Part 2 Results of a randomised controlled trial. Next, we discuss the results of the randomised controlled I CARE study. We assess whether GP involvement and access to Oncokompas, a supporting eHealth application, has had an impact on quality of life recovery within the first year after colon cancer treatment (Chapter 5). We evaluate the effect of GP involvement on the detection of recurrences, and evaluate the pattern and stages of recurrences (Chapter 6). We explore patients’ experiences (Chapter 7) and GPs’ experiences with the study to help understand the impact and implementation of the intervention (Chapter 8). We evaluate whether survivorship care by a GP is cost-effective in comparison to traditional hospital-based care (Chapter 9). And finally, we address the reasons for patients and physicians to decline participation, to better understand the support base and generalisability of the trial results (Chapter 10).
We end the thesis with a general discussion of the main findings, including the implications and directions for future research and practices (Chapter 11).