Psychosocial care for cancer survivors: a systematic literature review on the role of General Practitioners

Objective : To explore the GP's role in providing psychosocial care for cancer survivors through a systematic literature review. Methods : We searched Medline, Embase, PsycINFO, and CINAHL and included studies that complied with the predefined in‐ and exclusion criteria. At least two independent reviewers performed the quality appraisal and data extraction. Results : We included 33 studies (5 qualitative, 19 observational, 9 intervention), the majority of which focussed on care for depression and anxiety (21/33). Cancer survivors were more likely to contact their GP for psychosocial problems compared to non‐cancer controls. Survivors were more likely to use antidepressants compared to controls, although 71% of survivors preferred depression treatment to be ‘talking therapy only'. Overall, GPs and patients mostly agreed that GPs are the preferred healthcare provider to manage psychosocial problems. The major exception is a survivor's fear of recurrence – here, the oncologist was the preferred healthcare provider. Only two interventions effectively decreased depression or anxiety, these studies included patients who had a clinical indication for psychosocial care, were specifically designed for decreasing depression/anxiety, and consisted of a multidisciplinary team approach. The other interventions evaluated GP‐led follow‐up for cancer survivors and found that this did not impact the patients’ levels of anxiety, depression, or distress neither negatively nor positively. Conclusions : Cancer survivors often prefer psychosocial care by their GP, and GPs generally consider they are well‐placed to provide this care. Although evidence on the effectiveness of psychosocial care by GPs is limited, an active multidisciplinary team approach seems key.

Psycho-Oncology

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