Ietje Perfors

193 Current needs and experiences of cancer patients regarding GP involvement after diagnosis. First, we explored the patients’ experiences and needs regarding GP involvement after a cancer diagnosis for patients treated with curative and palliative intent (Chapter 2). In a large survey among Dutch cancer patients distributed by the Dutch Federation of cancer patient organizations (NFK), patients’ call for more GP involvement shortly after cancer diagnosis was confirmed. Among 4,763 (former) cancer patients, 59% (N=2,804) expressed a need for GP involvement in cancer care, Of these patients, 79% experienced GP involvement. Regarding GP involvement in shared decision making (SDM), 82% of the patients (N=3,724) expressed that the GP should “listen to patient’s worries and considerations”, 69% (N=3,130) to “check patient’s understanding of information”, 66%(N=3,006) to “discuss patient’s priorities in life and the consequences of treatment options for these priorities”, and 67% (N=3,045) to “create awareness of the patient’s role in the decision making”. This GP involvement occurred in 47%, 17%, 15% and 10% of these patients, respectively. Patients’ needs for GP support in fundamental SDM steps remained largely unmet. Therefore, GPs should be made aware of these needs and enabled to support their patients in SDM. Current interventions to gain more GP involvement To explore the current knowledge of the effects of primary care interventions aimed to involve the GP shortly after cancer diagnosis we conducted a systematic review of clinical trials (Chapter 3). The small number of clinical trials we found examined various types of interventions. The studies reported a low uptake of intervention and heterogeneous results. However, results suggest a positive effect of GP involvement on patient satisfaction with care, but not on quality of life. Additional effects for vulnerable subgroups were found. More robust evidence for tailored interventions is needed to enable efficient and effective involvement of the GP during curative cancer treatment .