What Do Primary Care Providers Think About Implementing Breast Cancer Survivorship Care?

Purpose: As cancer centres move forward with earlier discharge of stable survivors of early-stage breast cancer (BCA) to primary care follow-up, it is important to address known knowledge and practice gaps among primary care providers (PCPS). In the present qualitative descriptive study, we examined the practice context that influences implementation of existing clinical practice guidelines for providing such care. The purpose was to determine the challenges, strengths, and opportunities related to implementing comprehensive evidence-based BCA survivorship care guidelines by PCPS in southeastern Ontario. Methods: Semi-structured interviews were conducted with 19 PCPS: 10 physicians and 9 nurse practitioners. Results: Thematic analysis revealed 6 themes within the broad categories of knowledge, attitudes, and resources. Participants highlighted 3 major challenges related to providing BCA survivorship care: inconsistent educational preparation, provider anxieties, and primary care burden. They also described 3 major strengths or opportunities to facilitate implementation of survivorship care guidelines: tools and technology, empowering survivors, and optimizing nursing roles. Conclusions: We identified several important challenges to implementation of comprehensive evidence-based survivorship care for bca survivors, as well as several strengths and opportunities that could be built upon to address those challenges. Findings from our research could inform targeted knowledge translation interventions to provide support and education for PCPS and bca survivors.