Correspondentie tussen eerste en tweede lijn over patiënten met kanker*

Objective

To explore the correspondence between primary and secondary healthcare providers about patients with lung, breast or colorectal cancer.

Design

Qualitative research.

Method

We collected the medical files of 50 patients with lung, breast or colorectal cancer by purposive sampling and selected the correspondence-related items from them. These concerned referral letters from primary to secondary caregivers and letters from specialists. A qualitative content analysis of these documents was performed. In addition, 4 general practitioners, 4 oncologists and 1 nurse specialist were interviewed.

Results

We analysed 50 referral letters and 369 letters from specialists. Content could be divided into 6 main themes in the referral letters, and it was noticeable that highly relevant information regarding the past medical history was often mixed with less relevant information. The same was true for the medication list and case history to a certain extent. We could distinguish 9 themes in the letters from specialists. All the letters from specialists did include information about the current treatment, but information about treatment intent (curative or palliative) or alternative treatment options was rarely available. Interviews with the healthcare providers confirmed these findings.

Conclusion

The study findings indicate that referral letters and specialist correspondence are not sufficiently tailored to the needs of the recipient.

Conflict of interest and financial support: no conflict of interest declared. The study was financially supported by a grant from the Stichting Stoffels-Hornstra (a foundation providing funding for medical research). ICMJE forms provided by the authors are available online along with the full text of this article.