The following is a summary of “Adapting and implementing breast cancer follow-up in primary care: protocol for a mixed methods hybrid type 1 effectiveness-implementation cluster randomized study,” published in the November 2023 issue of Primary Care by Fadem, et al.

More people are dealing with serious late and long-term treatment effects of breast cancer because of improvements in how it is found and treated. General care can help take care of people who have had cancer in the past, but there isn’t much information on how to use survival care research in general care. For a study, researchers laid out a multi-phase, mixed-methods, stakeholder-driven research process that focuses on improving primary care in an actionable and evidence-based way. The goal was to improve care for breast cancer survivors by combining the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and the Practice Change Model (PCM). 

Based on in-depth interviews and a 4-round Delphi group with a wide range of partners from cancer and primary care, they will test and apply a type 1 effectiveness-implementation cluster randomized design in 26 primary care practices to see how well the intervention works. Facilitation, audit and feedback, and learning collaboratives will all be part of multi-part execution methods. To get more people to use the tool, data will be collected and analyzed all the time. Comprehensive breast cancer follow-up care is the primary clinical result to measure success.  Mixed methods will be used to evaluate implementation to determine how organizational and environmental factors influence adoption, implementation, and early resilience for follow-up care, symptom management, and risk management tasks six and 12 months after implementation. 

As a result of the study, repeatable, high-impact intervention methods will be created to improve long-term follow-up care for general care patients who have had breast cancer in the past. Working with a national primary care practice-based research network to set up a national marketing study would be the next step if the study was successful. The actions and processes that were found to be useful could also be used to create organizational and care delivery changes for follow-up care at other cancer sites.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02186-3