Randomised controlled trial of a shared care programme for newly referred cancer patients: bridging the gap between general practice and hospital

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Abstract
Objective: To determine the effect of a shared care programme on the attitudes of newly referred cancer patients towards the healthcare system and their health related quality of life and performance status, and to assess patients’ reports on contacts with their general practitioner (GP). Setting: Department of Oncology at Aarhus University Hospital and general practices. Design: Randomised controlled trial in which patients completed questionnaires at three time points. The shared care programme included transfer of knowledge from the oncologist to the GP, improved communication between the parties, and active patient involvement. Participants: 248 consecutive cancer patients recently referred to the department. Main outcome measures: Patients’ attitudes towards the healthcare services, their health related quality of life, performance status, and reports on contacts with their GPs. Results: The shared care programme had a positive effect on patient evaluation of cooperation between the primary and secondary healthcare sectors. The effect was particularly significant in men and in younger patients (18–49 years) who felt they received more care from the GP and were left less in limbo. Young patients in the intervention group rated the GP’s knowledge of disease and treatment significantly higher than young patients in the control group. The number of contacts with the GP was significantly higher in the intervention group. The EORTC quality of life questionnaire and performance status showed no significant differences between the two groups. Conclusions: An intersectoral shared care programme in which GPs and patients are actively involved has a positive influence on patients’ attitudes towards the healthcare system. Young patients and men particularly benefit from the programme.