Healthcare experiences of people with advanced colorectal cancer: A qualitative study

Purpose: Qualitative research examining healthcare experiences and needs of people with advanced (metastatic or recurrent) colorectal cancer CRC-A is limited. This study aimed to fill this gap in CRC-A survivors treated with surgical or palliative chemotherapy, through a qualitative study. Method: Australian adults treated for CRC-A were recruited 0.5-2 years post-surgery or post-diagnosis of CRC-A (for palliative chemotherapy groups). Semi-structured telephone interviews, analysed via framework analysis, explored healthcare experiences. Demographic, clinical, and quality of life data characterised the sample and informed framework analyses. Data was compared against the Institute of Medicine's framework for quality healthcare. Results: Interviews from 38 participants (22 female) of median age 59 years (range 27-84) revealed six over-arching themes relating to the safety, effectiveness, timeliness, patient-centredness, efficiency, and equity of CRC-A care: 1) Early experiences influence later perceptions; 2) Trusting the system, trusting the professionals; 3) The bene-fits of multidisciplinary care co-ordination; 4) Feeling lost in follow-up; 5) Whose role is it anyway? Gaps in re-sponsibility for survivorship care; and 6) Useful or useless? Perceptions of psychosocial support. Conclusions: Healthcare systems for CRC-A can be improved through delivery of repeated information, upskilling general practitioners and/or implementing written survivorship care plans or survivorship clinics, to ensure quality healthcare.

Automated summary

This study fills a gap in qualitative research regarding the healthcare experiences and needs of people with advanced colorectal cancer (CRC-A) through interviews with 38 participants. The study identifies six key themes relating to the safety, effectiveness, timeliness, patient-centeredness, efficiency, and equity of CRC-A care. The findings highlight the importance of delivering repeated information, upskilling general practitioners, and implementing survivorship care plans or clinics to improve the healthcare system for CRC-A.