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Oncology
Information needs of oncologists and general practitioners
October 30, 2016
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Information needs of oncologists, general practitioners and other professionals caring for patients with cancer.

https://www.ncbi.nlm.nih.gov/pubmed/27550233

Ciarlo and colleagues recently published the results of a survey focusing on the information needs of oncologists and general practitioners (https://www.ncbi.nlm.nih.gov/pubmed/27550233). Its goals were to identify the specific needs of oncologists and general practitioners attending cancer patients. Survey participants were members of the German Cancer Society (Deutsche Krebsgesellschaft, DKG) and the German Association of General Medical Practitioners (Hausärzteverband, HÄV). Oncologists and general practitioners showed significantly different information needs and different ways to access specific information. In order to better integrate general practitioners while simultaneously serving the needs of oncologists, a database that is up to date, rapidly accessible and does not incur high costs would be helpful.

From their data, some hints on how to address different information needs from different groups of professionals may be derived and summarized as follows:

  • Information should be brief and precise, current, reliable and transparent.
  • It must offer rapid access to all information, as well as be easy to browse and read.
  • Information should be offered from primary sources and provide contextual examples.
  • Extracts from guidelines, compilations from textbooks and expert commentaries would be able to provide this context.
  • A desirable feature would be an option to directly contact experts to discuss interdisciplinary cases or ask for medical advice.
  • Free access to all publications would also enhance transparency.
  • Information should be available in German.

The treatment of cancer patients requires an interdisciplinary, multi-professional approach in which healthcare professionals exchange their knowledge on a regular basis. Currently, cancer patient care is in many cases already provided by non-specialized institutions such as the practices of general practitioners as well as medical care centers. General practitioners may gain even more in importance with respect to the treatment of older and cancer patients with multiple morbidities. Accordingly, the need among healthcare professionals for just-in-time, up-to-date and precise information is high, and will continue to increase in the future. In recent years, the Internet has become an important source of information. Not only physicians but also patients and their relatives use the Internet to acquire information on health-related concerns, diseases and treatments. Facing an ever mounting number of different information sources, lay people as well as experts are confronted with several obstacles to acquiring knowledge.

  • 495 questionnaires were included in the evaluation. The 3 analyzed groups (oncologists, general practitioners, others [specialists without oncological focus, junior doctors, psycho-oncologists, nurses and an open category “others” in the questionnaire]) differ in workplaces: oncologists and participants from the group “others” most often work in hospitals and certified centers, while general practitioners more often in medical practices. There was a majority of male participants, especially among the oncologists.
  • Participants from all three categories frequently used congresses and symposia as a source of information. For oncologists and general practitioners, these were the most frequently used sources of information (83.7% and 70.7% respectively). General practitioners (42.2%) were less interested in journals than oncologists (77.6%). Contrariwise, textbooks were significantly more often used by general practitioners than by oncologists (p < .001)
  • Compared to general practitioners, oncologists and the other participants working in certified centers preferred to search online (p < .001 both)
  • Male physicians searched for information significantly more often online than female physicians did (men: 69.5%, women: 59.6%; p = .032).
  • Elderly general practitioners preferred to gather information from scientific journals (p = .016) and colleagues (p < .001). On the other hand, younger professionals seemed to prefer online research (p < .001) as well as congresses and symposia (p = .015) as a valuable source of information.
  • Regarding the topics of questions frequently asked by patients, 44.2% of oncologists, 56.5% of general practitioners and 49.0% of “others” reported being asked about diagnostics. Regarding tumor therapy, 91.2% of oncologists and only 23.1% of general practitioners reported being asked on a regular basis (p < .001). In contrast, 39.5% of oncologists, 53.1% of general practitioners and 44% of “others” were consulted about drugs (not significant). However, general practitioners were significantly more often consulted on issues such as mental problems, complementary medicine, survivorship, palliative medicine and physical activity as well as physiotherapy (p < .001, p = .017, p = .005, p = .007 and p < .001 respectively) than oncologists.
  • Participants from all three categories of professionals were consulted by patients regarding supportive therapy (oncologists = 36.1%, general practitioners = 27.2%, others = 33.0%, no significant differences) and on nutrition (oncologists = 40.1%, general practitioners = 33.3%, others = 38.5%, no significant differences). Women significantly more often reported being asked about complementary medicine than men (men: 17.7%, women: 23.6%; p = .04).
  • The survey question about feeling under-confident during patient consultations was answered with “sometimes” by 48.3% of oncologists, 61.2% of general practitioners and 69.5% of “others.” The option “rarely” was the second most frequently selected answer (oncologists 40.1%, general practitioners 21.1%, others 23.0%). Less than 20% of participants selected “often/daily” and less than 2% chose “never.”
    • Regarding the reasons for uncertainty, participants most often pointed to a lack of time and lack of data (equally important). Oncologists cited lack of time as the most common cause (59.9%). For general practitioners, the most common reason was lack of knowledge (61.2%), whereas only 25.9% of oncologists chose this answer (p < .001). Lack of data was an important factor for all three categories of professionals (over 50% of participants in all three groups marked this answer).
  • Participants stated that they were generally satisfied with the information currently available. Most of the participants evaluated the existing information with the mark “good” (Oncologists = 53.06%, general practitioners = 38.78%, others = 56.5%). Most of the evaluations were in the range between the marks “very good” and “satisfying”.
  • Asked about which sources of information they would prefer, most participants cited the “Internet”; predominantly oncologists and others (59.9%, 47.0% respectively) preferred this medium. For general practitioners, information provided by “mobile devices” would be as well accepted as the “Internet” (36.3% each). Regarding important features of currently used sources of information, 50.3% preferred the “experience and knowledge of (their) colleagues.” While for oncologists, “expert knowledge” and “currency of the data” were especially important (37.4% and 54.4%), for general practitioners, “experiences of others” were of high relevance (50.4%).
  • Precise and short information was important for all participants (oncologists 38.8%, general practitioners 36.7%, others 47.5%).
  • Original works represented the most popular type of information for 87.1% of oncologists and were also important for the group “others.” From the general practitioners, 55.8% preferred German translations with abridged versions.
  • In general, summaries with expert commentary were favored by 51.7% of oncologists, 70.7% of general practitioners and 59.5% of others. “Summaries without expert commentary” were not at all valued. Some of the participants added other sources to the list such as “reviews,” “guidelines from professional associations,” “literature” as well as “internal training” and “education/colleagues.”