Ietje Perfors

13 In 2013, the GRIP intervention was developed, aimed at improving personalised cancer care and continuity of care for cancer patients, by structural involvement of the primary care team after cancer diagnosis. The GRIP intervention includes two components: a Time Out consultation (TOC) with the GP after cancer was diagnosed, aimed at improving the SDMprocess, making more personalised treatment decisions and facilitating continuity of primary care. During the TOC, planned between diagnosis and treatment decision the GP discusses with the patient the diagnosis and prognosis of their cancer, reflects on psychosocial consequences, creates awareness that a choice of treatment exists and prepares the patient for the final treatment choice with the treating oncologist. 36 The second GRIP component is guidance during and after cancer treatment from primary care by a team consisting of the GP and a home care oncology nurse (HON). The guidance consists of a minimum of three contacts with the HON during and after treatment to monitor and support patients during and after treatment. The GRIP intervention was developed in close collaboration between the Dutch Federation of cancer patient organisations (NFK), the University Medical Centre Utrecht and regional primary care healthcare workers. In this thesis we present the background, the design of the GRIP intervention and we discuss the results of the evaluation in a large regional, practice- based RCT. Aim and outline of this thesis The first aim of this thesis is to explore the current knowledge and the needs and experiences of cancer patients, regarding GP involvement after cancer is diagnosed. In Chapter 2 we explore the patients’ experiences and needs regarding GP involvement after a cancer diagnosis in patients treated with curative and palliative intend. In Chapter 3 we present a systematic overview of the current evidence from clinical trials on the effects of primary care interventions, which aimed to involve the GP shortly after cancer diagnosis, on patient reported outcomes and healthcare utilisation. 1