ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 210
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Qualitative evaluation of the Breast cAncer Survivorship
Inter-professional Community (BASIC) model as part of a
pilot randomised controlled trial in Singapore
Dr Wai-Yee Rose Fok2, Yu Ke1, Ngiap Chuan Tan3, Wei Teen Wong3, Charmaine Shuyi Kwan3, Wing
Lam Chung4, Kiley Wei-Jen Loh2, Gretchen Ser Hua Tan5, Ivy Cheng6, Joyce Lee7, Alexandre Chan6,7
1
Division of Supportive and Palliative Care, National Cancer Centre Singapore, 2Division of Medical
Oncology, National Cancer Centre Singapore, 3SingHealth Polyclinics, 4Department of Pharmacy,
Watson’s Personal Care Stores Pte Ltd, 5Department of Pharmacy, National University of Singapore,
6
Department of Pharmacy, National Cancer Centre Singapore, 7Department of Clinical Pharmacy
Practice, University of California Irvine
Aim
An innovative shared-care model involving oncologists, family physicians (FPs) and community
pharmacists via telehealth was developed for low-risk breast cancer survivors (BCS) in Singapore. This
study aimed to supplement results from a piloted randomised controlled trial by gathering perspectives
from participating survivors and healthcare professionals (HCPs) to elucidate the underlying logic
model supporting the new model’s potential impact.
Content
This qualitative study recruited 17 BCS who were ≥21 years old, diagnosed with breast cancer, three
or more years after active primary treatment, ascertained to be low risk by an oncologist and received
the shared-care model. Additionally, 14 HCPs (nine FPs, three oncologists and two pharmacists)
involved in care delivery were recruited. In-depth virtual interviews were audio recorded, transcribed
verbatim and analysed using deductive thematic analysis. The value of shared care in relieving the care
strain in tertiary settings was echoed among participants. The central mechanism facilitating perceived
care satisfaction among BCS was the psychological safety provided through a team-based care
approach. Access to HCPs besides oncologists served as an additional source of information and
assistance, empowering BCS to seek help for active symptoms promptly. Implementation strategies
contributing to the trusting survivor–HCP relationship included HCP familiarity, regularity in scheduled
teleconsults and enhanced information transfer using survivorship care plans. However, BCS
continued to ascribe oncologists’ and primary care providers’ exclusive roles in managing their cancer
and chronic conditions, respectively. FPs emphasised the need for additional clinical experience
accrual to build confidence in managing cancer-related issues beyond general and preventive health.
Future work should address the underlying disease segmentation mentality to reinforce cancer
survivorship care as a holistic concept to improve care coordination.
Goals
To examine how results from a pilot trial of a novel care model could be qualitatively mapped to
construct a program logic model by identifying underlying mechanisms and optimising implementation
strategies.
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