Preferences of healthcare providers regarding future follow-up care for breast, prostate, and colorectal cancer: A discrete choice experiment.

BACKGROUND

With rising cancer survival rates and an increasing number of cancer survivors, the sustainability of secondary care follow-up care is under pressure. Transferring certain follow-up tasks to primary care is suggested as a potential solution, but there is no consensus on the optimal strategy for this.

PURPOSE: To identify preferences of primary and secondary healthcare providers regarding the transfer of follow-up care for breast, colorectal, and prostate cancer, using a discrete choice experiment (DCE).

METHOD: A DCE was conducted among 153 primary and secondary healthcare professionals in the Netherlands. Attributes related to patient and follow-up characteristics included: type of cancer, age, time post-treatment, any protocolled care for comorbidities, recurrence risk, and types of check-up protocols. A conditional logit model and latent class analysis were used to assess preferences and identify subgroups.

RESULTS

Healthcare providers favored the transfer of follow-up care to primary care for prostate cancer patients. Across all cancer types, preferences for substitution were greater in patients aged above 75 years, longer post-treatment, a low recurrence risk, and who were already enrolled in protocolized chronic care. Transfer of basic check-up care was preferred, while extensive check-up was negatively valued, especially by GPs.

CONCLUSION

Future follow-up should focus on patient groups and tasks for which consensus exists that primary care involvement is feasible and appropriate, forming the basis for sustainable, collaborative, and patient-centered models of care.