Optimising survivorship post-BMT: healthcare professionals' perceptions of long-term care.

Abstract

Survivors who have received a blood or marrow transplant (BMT) require life-long follow-up care and support, however evidence-based assessments of long-term models of care are scarce. This qualitative descriptive study explored the perspectives of blood and marrow transplant (BMT) specialist nurses and physicians, and General Practitioners (GPs) regarding the long-term management and follow-up care of BMT survivors. Semi-structured online interviews were conducted with thirteen purposefully selected BMT Physicians (n = 4), Advanced Practice Nurses (APNs) (n = 6) and GPs (n = 3), experienced in providing long-term care to BMT survivors. Data were analysed using thematic analysis. Both specialist and community-based practitioners identified deficiencies in models of care delivery and in the organisation of long-term care for BMT survivors, particularly in relation to communication, transition and personalisation of care. Two themes were identified that explored (1) Efficiency and quality of current care provision for BMT survivors and (2) Characteristics of optimal care. All participants recognised the need for flexible, patient-centred models of shared care that bring together hospital and community-based healthcare professionals in providing optimal care to BMT survivors. The growing population of survivors of BMT requires an urgent re-evaluation of healthcare models to address their complex long-term care needs. This will require a well-trained primary care-based workforce supported by collaborative relationships with specialist centres and easy access to essential information. Current approaches to post-BMT care that limit provision of care to specialist BMT services are unsustainable, inefficient, and do not support the transition of patients from tertiary to community healthcare services.