Ietje Perfors

192 Appendices Summary As cancer incidence is increasing and prognosis is improving, more patients live longer with cancer and experience more late effects of treatment, in the presence of co-existing chronic conditions. Consequently, the nature of cancer treatment is shifting towards chronic disease management. This shift requires more personalised and integrated care, based on individual preferences and medical profile. In primary care based healthcare systems, general practitioners (GPs) may be best positioned to provide continuous, personalised and integrated care during the cancer care continuum. GPs typically have a longstanding and personal relationship with their patients and are up to date with their patients’ comorbidities. Additionally, they are well equipped to provide personalised disease management within the context of the patients’ medical history and personal preferences. Therefore, patients, healthcare professionals and policy makers suggest a more prominent role of the GP in the guidance of patients during their cancer pathway with a focus on empowerment, psychological and lifestyle support and follow-up care in the chronic disease stage. Even though a substantial role for primary care is advocated in the Netherlands and internationally, involvement of primary care in cancer care remains sporadic and unstructured. Attempts to structurally involve primary care during cancer treatment have hardly been successful. This dissertation has two aims. The first aim of this thesis is to explore the needs and experiences of cancer patients, regarding GP involvement after cancer is diagnosed. The second aim is to investigate the effects of the GRIP intervention on patient outcomes and healthcare use for patients treated with curative intent. The GRIP intervention consists of structured care provided after diagnosis of cancer by a primary care team, including the GP and a homecare oncology nurse (HON). The aim of the GRIP intervention is to provide structured primary care and facilitate personalised continuous primary care to patients with cancer.