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Implementing a community-based shared care breast cancer survivorship model in Singapore: a qualitative study among primary care practitioners.


ABSTRACT:

Background

The adaptability of existing recommendations on shared care implementation to Asian settings is unknown. This qualitative study aims to elicit public- and private-sectors primary care practitioners' (PCPs) perspectives on the sustainable implementation of a shared care model among breast cancer survivors in Singapore.

Methods

Purposive sampling was employed to engage 70 PCPs from SingHealth Polyclinics, National University Polyclinics, National Healthcare Group Polyclinics, and private practice. Eleven focus groups and six in-depth interviews were conducted between June to November 2018. All sessions were audio-recorded and transcribed verbatim. Guided by the RE-AIM framework, we performed deductive thematic analysis in QSR NVivo 12.

Results

PCPs identified low-risk breast cancer survivors who demonstrated clear acceptability of PCPs' involvement in follow-up as suitable candidates for shared care. Engagement with institution stakeholders as early adopters is crucial with adequate support through PCP training, return pathways to oncologists, and survivorship care plans as communication tools. Implementation considerations differed across practices. Selection of participating PCPs could consider seniority and interest for public and private practice, respectively. Proposed adoption incentives included increased renumeration for private PCPs and work recognition for public PCPs. Public PCPs further proposed integrating shared care elements to their existing family medicine clinics.

Conclusions

PCPs perceived shared care favorably as it echoed principles of primary care to provide holistic and well-coordinated care. Contextual factors should be considered when adapting implementation recommendations to Asian settings like Singapore. With limited competitive pressure, the government is then pivotal in empowering primary care participation in survivorship shared care delivery.

SUBMITTER: Ke Y 

PROVIDER: S-EPMC8991467 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Implementing a community-based shared care breast cancer survivorship model in Singapore: a qualitative study among primary care practitioners.

Ke Yu Y   Fok Rose Wai Yee RWY   Soong Yoke Lim YL   Loh Kiley Wei-Jen KW   Farid Mohamad M   Low Lian Leng LL   Quah Joanne Hui Min JHM   Vasanwala Farhad Fakhrudin FF   Low Sher Guan SG   Soh Ling Ling LL   Tan Ngiap-Chuan NC   Chan Alexandre A  

BMC primary care 20220408 1


<h4>Background</h4>The adaptability of existing recommendations on shared care implementation to Asian settings is unknown. This qualitative study aims to elicit public- and private-sectors primary care practitioners' (PCPs) perspectives on the sustainable implementation of a shared care model among breast cancer survivors in Singapore.<h4>Methods</h4>Purposive sampling was employed to engage 70 PCPs from SingHealth Polyclinics, National University Polyclinics, National Healthcare Group Polyclin  ...[more]

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