Tailored Chemotherapy Information Faxed to General Practitioners Improves Confidence in Managing Adverse Effects and Satisfaction With Shared Care: Results From a Randomized Controlled Trial Michael Jefford, Carl Baravelli, Paul Dudgeon, Adrian Dabscheck, Melanie Evans, Michael Moloney, and Penelope Schofield From the Supportive Care Research Group, Peter MacCallum Cancer Centre; Division of Surgical Oncology, Peter MacCallum Cancer Centre; Phar- macy, Peter MacCallum Cancer Centre; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia. Submitted October 4, 2007; accepted December 12, 2007. Supported by unrestricted educational grant from Roche Products (Australia). Presented in part at the 43rd Annual Meeting of the American Society of Clinical Oncology, June 1-5, 2007, Chicago, IL. Authors’ disclosures of potential con- flicts of interest and author contribu- tions are found at the end of this article. Corresponding author: Michael Jefford, MBBS, MPH, MHlthServMt, PhD, FRACP, Division of Haematology and Medical Oncology, Peter MacCallum Cancer Centre, Locked Bag 1, A’Beckett St, Victoria 8006, Australia; e-mail: Michael.Jefford@petermac.org. © 2008 by American Society of Clinical Oncology 0732-183X/08/2614-2272/$20.00 DOI: 10.1200/JCO.2007.14.7710 A B S T R A C T Purpose General practitioners (GPs) play a critical role in the treatment of patients with cancer; yet often lack information for optimal care. We developed standardized information for GPs about chemotherapy (CT). In a randomized controlled trial we assessed the impact of sending, by fax, information tailored to the particular patient’s CT regimen. Primary end points were: confidence treating patients who were receiving CT (confidence), knowledge of adverse effects and reasons to refer the patient to the treatment center (knowledge), and satisfaction with information and shared care of patients (satisfaction). Methods Focus group work informed the development of the CT information which focused on potential adverse effects and recommended management strategies. GPs of patients due to commence CT were randomly assigned to receive usual correspondence with or without the faxed patient/ regimen-specific information. Telephone questionnaire at baseline and 1 week postintervention assessed knowledge, confidence, and satisfaction. Results Ninety-seven GPs managed 97 patients receiving 23 types of CT. Eighty-one (83.5%) completed the follow-up questionnaire. GPs in the intervention group demonstrated a significantly greater increase in confidence (mean difference, 0.28; 95% CI, 0.10 to 0.47) and satisfaction (mean difference, 0.57; 95% CI, 0.27 to 0.88) compared with usual care, reflecting a 7.1% and 10.5% difference in score, respectively. No differences were detected for knowledge. GPs receiving the CT sheet found correspondence significantly more useful (P  .001) and instructive (P  .001) than GPs who received standard correspondence alone. Conclusion Information about CT faxed to GPs is a simple, inexpensive intervention that increases confidence managing CT adverse effects and satisfaction with shared care. This intervention could have widespread application. J Clin Oncol 26:2272-2277. © 2008 by American Society of Clinical Oncology INTRODUCTION Many patients with cancer receive treatment as out- patients. This is becoming increasingly common, in part due to improved supportive measures and also due to pressure on inpatient resources. A push to- ward greater care in the community places increased demand on primary care doctors (general practitio- ners [GPs] referred to as family physicians in some countries). Many patients have long-established re- lationships with their GP and may consult them for advice regarding current cancer treatments. 1,2 It is therefore vital that GPs have adequate knowledge of cancer treatments and feel confident managing these aspects of their patients’ care. Good communication is vital to ensure effective shared care between cancer treatment centers and community doctors. 3 Unfortunately, many studies suggest that information provided to GPs is grossly inadequate. 4-12 The literature suggests that GPs wish to receive information about proposed treatments, potential adverse effects, and how to manage these effects; however, frequently do not receive this infor- mation. 5,6,10,12 McConnell et al 10 found that 93.4% of GPs wanted information about adverse effects of treatments, 91.5% wished to receive suggestions for JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T VOLUME 26  NUMBER 14  MAY 10 2008 2272 © 2008 by American Society of Clinical Oncology Downloaded from jco.ascopubs.org on May 5, 2016. For personal use only. No other uses without permission. Copyright © 2008 American Society of Clinical Oncology. All rights reserved.