Patrice Lazure (AXDEV Group); Sean Hayes (AXDEV Group); France St-Germain (Sanofi Canada); Sunil Verma (UoT Sunnybrook Health Centre); Maureen Trudeau (UoT Sunnybrook Health Centre); Robert Gryfe (Samuel Lunenfeld Research Institute)

Synopsis

As gaps and barriers in the care of patients with breast and colorectal cancer prevail, it is critical that needs assessments provide an accurate and comprehensive picture of interprofessional challenges faced by healthcare providers. It is with that goal in mind that a national needs assessment of Canadian healthcare providers caring for patients with breast and colorectal cancer was designed and carried out. Through the use of a mixed-method analysis, and through triangulation approaches that included the viewpoints of patients and caregivers, interprofessional gaps and barriers that could be addressed through the development of targeted physician education and professional development were identified.

Purpose

The care of persons with breast (BC) or colorectal (CRC) cancer involves individuals from multiple professions and medical specialties that are required to work collaboratively to ensure optimal delivery of care. Thus, a complete assessment of gaps and barriers in these therapeutic areas should include strategies that allow proper identification of interprofessional challenges. A national IRB-approved needs assessment was undertaken to determine the gaps (and their underlying causes) in knowledge, attitudes, skills and competencies of Canadian healthcare providers caring for persons with BC or CRC.

Methods

A mixed-method approach was employed in this study. Methodological triangulation (qualitative data from semi-structured interviews and quantitative data from an online survey) as well as source triangulation (multiple professions and medical specialties, patients and caregivers) were used to ensure reliability of findings. This study sample (n=238) included 24 family physicians and general practitioners, 48 medical oncologists, 34 oncology surgeons, 48 radiation oncologists, 34 hospital pharmacists, 25 oncology nurses, 10 psychosocial oncologists and 15 patients and caregivers.

Results

Gaps and barriers were identified across the continuum of care for BC and CRC. Source triangulation was particularly valuable in identifying interprofessional challenges such as a lack of collaboration among providers, inconsistencies in communication between patient and provider, and inconsistencies in the timing, format, and content of referrals, which ultimately hinder optimal treatment and management of BC and CRC.