Ietje Perfors

12 Chapter 1 The changing role of the GP in cancer care In general, the GP has a longstanding and personal relationship with the patients and their family, and is up to date with their medical and psychosocial background. Therefore, GPs are probably best positioned to help the patient to balance treatment options in the perspective of medical history and personal preferences. 31, 32 Therefore for many years patients, governmental and professional organisations suggest a more prominent role of the GP during their cancer journey to facilitate personalised care and empowerment, to improve psychological and lifestyle support and to improve continuity of care. 7,8,33,34 With the increasing number and prolonged survival of cancer patients and, the need for personalised and continuity of care, the role of the GP in cancer care is rapidly changing. It does not only focus on traditional domains such as early diagnosis, palliative care and end-of-life care, but will also include care provision during and after treatment. Interventions to improve GP involvement in cancer care Even though an increased role of the GP and the primary care team is widely advocated, the most effective approach to involve primary care during cancer treatment remains unclear. So far, there are no effective interventions, and recommendations for GPs guidance during treatment are not embedded in professional guidelines. In 2012, a Cochrane review aimed to identify the evidence for effectiveness of interventions ensuring continuity of care in the follow-up of patients with cancer. 35 Three care models were identified to achieve this, i.e., case management, shared care and involving an interdisciplinary team. However, the review concluded that interventions were too divers and no effects on patients’ health-related outcomes could be found. Structural involvement of the GP from diagnosis onwards was not addressed in these studies.