What could be the contribution of general practitioners in the management of cancer patients from the central region of tunisia: a retrospective study about 215 physicians.

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Imtinene Belaid
Leila Ben Fatma
Makrem Hochlaf
Soumaya Mnasser
Mohamed Zaher Boudagga
Imene Chabchoub
Faten Zairi
Olfa Gharbi
Slim Ben Ahmed

Abstract

SUMMARY
Background: General practitioners have a major contribution in cancer prevention and screening. However, their contribution in the treatment plan management and in the post treatment follow-up of cancer patients needs to be clarified.
Objective: To evaluate the contribution of general practitioners of the public and private sectors in the management of cancer patients during and after the treatment protocol. To analyze the problems they encounter and find the possible solutions.
Method: A retrospective declarative KAP (Knowledge, Attitudes and Practices) survey was conducted from first September 2010 to 28 February 2011 in the central region of Tunisia among 215 primary care physicians in the public and private sectors. The questionnaire focused on their effective involvement, the role during treatment, follow up and supportive care.
Results: Nearly 80% of physicians who participated in the survey were involved in the management of their patients, primarily by ensuring adherence to their treatment (42.9%), in the follow up care after treatment (42.3%) and in palliative care (29%), however the majority has never prescribed opioid drugs (66.5%). Only 46.6% of the physicians announced the diagnosis of cancer to their patients. The questioned doctors deplored the lack of training in oncology (22.8%) and the feeling of being excluded from the management of their patients once they have addressed them to their specialist peers (48.8%). The interviewed physicians expressed their wish to have a further medical training in oncology (79.5%) and to join a structured cancer network (55.8%).
Conclusion: The majority of interviewed general practitioners of our region were engaged in cancer patients' care. However, gaps were identified especially in palliative care and in prescribing opioid drugs. Promoting continuing education in this field and the establishment of cancer networks will allow extend the scope of general practitioners' intervention in the cancer network.

Keywords:

Survey; Clinical management ; General practitioner ; Malignant tumor

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