Patients' experiences of referral for colorectal cancer

Pascoe, Shane W., Veitch, Craig, Crossland, Lisa J., Beilby, Justin J., Spigelman, Allan, Stubbs, John and Harris, Mark F. (2013) Patients' experiences of referral for colorectal cancer. BMC Family Practice, 14 . doi:10.1186/1471-2296-14-124


Author Pascoe, Shane W.
Veitch, Craig
Crossland, Lisa J.
Beilby, Justin J.
Spigelman, Allan
Stubbs, John
Harris, Mark F.
Title Patients' experiences of referral for colorectal cancer
Journal name BMC Family Practice   Check publisher's open access policy
ISSN 1471-2296
Publication date 2013-08-26
Year available 2013
Sub-type Article (original research)
DOI 10.1186/1471-2296-14-124
Open Access Status DOI
Volume 14
Total pages 8
Place of publication London, United Kingdom
Publisher BioMed Central
Language eng
Formatted abstract
Background: Outcomes for colorectal cancer patients vary significantly. Compared to other countries, Australia has a good record with patient outcomes, yet there is little information available on the referral pathway. This paper explores the views of Australian patients and their experiences of referral for colorectal cancer treatment following diagnosis; the aim was to improve our understanding of the referral pathway and guide the development of future interventions.

Methods: A purposive sampling strategy was used, recruiting 29 patients representing urban and rural areas from 3 Australian states who participated in 4 focus groups. Seven patients provided individual interviews to supplement the data. Recordings were transcribed verbatim, data was coded with NVivo software and analysed thematically before deductive analysis.

Results: Four aspects of the referral process were identified by patients, namely detection/diagnosis, referral for initial treatment/specialist care, the roles of the GP/specialist, and the patient's perceived involvement in the process. The referral process was characterised by a lack of patient involvement, with few examples of shared decision-making and few examples of limited choice. However, patients did not always feel they had the knowledge to make informed decisions. Information exchange was highly valued by patients when it occurred, and it increased their satisfaction with the process. Other factors mediating care included the use of the public versus private health system, the quality of information exchange (GP to specialist and GP to patient), continuity of care between GP and specialist, and the extent of information provision when patients moved between specialist and GP care.

Conclusions: Patients described poor GP continuity, ad hoc organisational systems and limited information exchange, at both interpersonal and inter-organisational levels, all leading to sub-optimal care. Implementation of a system of information feedback to GPs and engagement with them might improve information exchange for patients, enabling them to be more involved in improved referral outcomes.
Keyword Colorectal neoplasm
Referral and consultation
Patients
Qualitative research
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Thu, 31 Mar 2016, 15:35:02 EST by Lisa Crossland on behalf of Discipline of General Practice