Cancer survivors with comorbid chronic conditions are heavy users of general practice care.

Schellevis, F.G., Jabaaij, L., Korevaar, J., Akker, M. van den. Cancer survivors with comorbid chronic conditions are heavy users of general practice care. Abstract. The Cancer and Primary Care Research International Network (Ca-PRI) 4th international Annual Meeting 'New pathways in cancer care: Substitution from Secondary to Primary Care?', 26-27 mei 2011, Noordwijkerhout. In: Abstractbook Ca-PRI 2011. Noordwijkerhout: The Cancer and Primary Care Research International Network, 2011. 18
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Introduction: The expected increase of the number of cancer patients and of the number of patients surviving initial treatment will inevitably lead to a higher burden on health care. Traditionally, follow-up monitoring of cancer patients takes place in secondary care settings. However, the expected increasing health care burden may lead to more involvement of general practitioners in the follow-up of cancer patients. Aim: To establish the health care use of surviving cancer patients in general practice. Methods: We compared the use of general practice care of surviving cancer patients with the use of age and gendermatched controls without cancer from the same practice. Data originate from the Netherlands Information Network of General Practice. This nationally representative network consists of 92 general practices with appr. 350,000 enlisted patients. Routinely recorded data on seven years (2001-2007) on patient contacts, referrals, prescription medicines, and relevant health problems (ICPC coded) were derived from electronic medical records. Data of appr. 8,700 cancer patients and their matched controls were used. Health care utilisation was operationalized as annual consultation rates, drug prescription rates and referral rates. The existence of comorbid chronic conditions was taken into account. Results: Compared to matched controls, cancer patients had on average more contacts in one year with the practice (19.5 vs. 11.9), more consultations with the GP (3.5 vs. 2.7), more home visits (1.6 vs. 0.4) and they received more drug prescriptions (18.7 vs. 11.6). Cancer patients had more often a chronic condition than their matched controls (52% vs. 44%). Having a chronic condition increased health care use. Not surprisingly, this was the case both for patients with and patients without cancer. Patients with cancer and a comorbid chronic condition had the highest health care use. Conclusions: Cancer patients had a higher demand for general practice care and suffer more often from chronic comorbid conditions compared to controls. Taking the average use of general practice care into account, surviving cancer patients are heavy users of general practice care, partly due to their comorbid chronic conditions. General practitioners are already heavily involved in the care for surviving cancer patients. This provides a good starting point for involving general practitioners also in the follow-up care for cancer.(aut. ref.)