Can current funding mechanisms facilitate the provision of cost-effective models of supportive care for cancer patients in primary care?

Introduction
Individuals living with or beyond cancer have a range of supportive care needs including psychosocial needs, physical needs such as fatigue and nausea and practical needs such as return to work and financial difficulties. The planning and funding of allied health and nursing services have been identified as barriers to meeting these needs. This study aims to assess options for managing cancer supportive care needs in an Australian primary care setting.

Methods
Interviews with GPs and practice nurses were conducted to understand current approaches to managing cancer supportive care needs in primary care. In addition, a review of interventions to address supportive care needs was undertaken. The qualitative analyses, review findings and prevalence data on unmet supportive care needs informed modelling of the costs and benefits of implementing selected interventions. These data will be presented to stakeholders to assess the feasibility and acceptability of implementation in the Australian primary care setting.

Results
GPs and practice nurses reported inadequate consultation time and insufficient funding for allied health referrals as barriers. Over 500 reviews of interventions to address cancer supportive care needs were identified. The reviews identify a range of effective interventions with the potential to be delivered in the Australian primary care setting, including educational and counselling interventions for sexual dysfunction, supervised exercise for fatigue and psychological interventions for anxiety. Modelled estimates of the expected costs and benefits of these interventions quantified funding gaps based on current funding mechanisms.

Implications or key message
Funding issues need to be addressed to meet unmet supportive care needs for cancer patients. The assembled evidence will be shared with a stakeholder group of consumers, GPs, practice nurses and allied health professionals to inform a comprehensive evaluation of intervention and funding options.