Knowledge and experience of caring for cancer survivors by physicians and advanced practice providers: an implementation-focused mixed-methods research

Abstract

Advances in cancer care have led to an increased number of cancer survivors, many of whom are at higher risk for chronic conditions, recurrence, or development of another primary cancer. This patient population requires unique support, but many healthcare providers feel limited in their ability to provide survivorship care. To better understand barriers to survivorship care and propose solutions, this mixed-methods study surveyed providers at the University of Texas Medical Branch and examined existing literature. The 45 respondents most commonly saw 1–5 cancer survivors a month (48.9%), but the consensus on what constitutes a cancer survivor did not align with national definitions. Our survey also highlighted differences in training needs between advanced practice providers (APPs) and physicians. APPs most reported a need for training on management of pain and fatigue (40.9%), while physician respondents most commonly highlight a need for better understanding of cancer staging and available specialties for referrals (43.5%). Despite different training needs, physicians and APPs tended to report the same needs in their patients, with 62.2% of total respondents noting emotional concerns and 64.4% reporting challenged with pain and fatigue. There was also general agreement on barriers to survivorship care, with 51.1% of all survey respondents highlighting care coordination as a barrier. Physicians and APPs have different training needs but face similar challenges when caring for cancer survivors. These challenges can be addressed via developing provider education, leveraging clinical support tools, and standardizing care coordination.