Coordinating neuro-oncology care from a primary health care perspective: a critical literature review and implications for practice

Primary brain tumours pose a unique concern for health professionals, generally presenting with a rapid and poor prognosis associated with the development of functional and cognitive deficiencies which creates a profound psychosocial impact. Whilst the diagnosis of a primary brain tumour can be associated with medium to long term survival, the majority of patients diagnosed with a high-grade brain tumour will die within 14 months of diagnosis. Given this patient care needs to comprehensive, seamless and individually focused care. The management of patients by specialist neuro-oncological nurses and cancer care coordinators has resulted in an increased focus on cancer care reform. However, despite the aim of these changes there needs to be an increased emphasis on primary health care (PHC) as a strategy for achieving coordination of care. Cost effective PHC initiatives are urgently needed to achieve not only coordination of care but to also balance the biomedical model. Whilst the biomedical model of care focuses on physical wellbeing in the absence of disease. PHC encompasses a more comprehensive and holistic notion of wellness. This critical literature review examines PHC, how it can be applied to the neuro-oncology setting and the implications for practice.