In collaboration with Stacey Marjerrison in the Department of Pediatrics, Lawrence Grierson and his team are leading provincial efforts to examine a Pediatric Oncology Group of Ontario initiative aimed at increasing the role of primary care in childhood cancer survivorship. Using a pragmatic, multi-perspective approach, the researchers are engaging survivors and families, AfterCare clinic clinicians, and family physicians to understand current survivorship care models and identify factors that support effective integration of community-based primary care providers. The findings to date highlight the value of family physicians in providing comprehensive relational care for these patients.
AfterCare clinics describe shared-care models for survivors with complex needs, and “graduation” pathways for survivors at lower risk of cancer-related late effects to engage with family physicians. These models are understood to support continuity of care and the long-term sustainability of survivorship care. Furthermore, survivors report confidence in their family physicians based on strong therapeutic relationships. The team has also identified barriers to integration, including unclear communication pathways, uncertainty about roles and responsibilities, and limited transparency regarding information shared between AfterCare clinics and primary care providers. Survivors further reported gaps in understanding of their medical history, often relying on family members or clinicians to fill in missing information.
In the next steps, the team plans to engage family physicians caring for survivors of childhood cancer to further explore how to support collaborative, sustainable, and patient-centred survivorship care in community practice. To learn more or share your experiences, please contact Trish Nayiager.
Project Leads: Stacey Marjerrison, Lawrence Grierson Contact: Trish Nayiager (nayiagt@mcmaster.ca)
Research Project Update