The association between patients’ perceived continuity of care and beliefs about oral anticancer treatment

  • Orit Cohen CastelEmail author
  • Efrat Shadmi
  • Lital Keinan–Boker
  • Tal Granot
  • Khaled Karkabi
  • Efrat Dagan
Original Article



To explore factors associated with necessity beliefs and concerns among patients receiving oral anticancer therapy (OACT) and, specifically, to examine the relationship between continuity of care (COC) and patients’ beliefs about OACT.


A cross-sectional study was conducted among patients from four oncology centers receiving OACT (either targeted, hormonal, or chemotherapy). Two months after OACT initiation, patients were asked to participate in a face-to-face or telephone survey. The Beliefs about Medicines Questionnaire was used to examine patients’ perceptions of their personal necessity for OACT and concerns about potential adverse effects. The Nijmegen Continuity Questionnaire was used to assess patients’ perceived COC. Data on clinical characteristics were collected from medical records.


Participants’ beliefs about OACT necessity (n = 91) were found to be associated with COC within the oncology team, and with COC between the oncology specialist and the primary care physicians (β = 0.27, p = 0.003; β = 0.22, p = 0.02, respectively), beyond age, depression, and cancer type (ΔR2 = 0.14, p < 0.001). Additionally, the difference between participants’ beliefs about OACT necessity and their OACT-related concerns was associated with COC within the oncology team (β = 0.30, p = 0.001), beyond age, income, family status, and cancer type (ΔR2 = 0.09, p = 0.001).


This study shows that cancer patients’ perceptions about the COC between care providers are related to their beliefs about OACT necessity, thus providing evidence for the importance of health care delivery approaches that support COC within the oncology team and between the oncology specialist and the primary care physician.


Oral anticancer treatment Continuity of care Beliefs about Medicines Questionnaire Nijmegen Continuity Questionnaire 



The authors express their gratitude to patients who participated in this study and made this research possible.


This study was supported by grants from the Israel Cancer Association (grant no. (20140089, the National Institute for Health Policy Research (IL) (grant no. (2015/84, and Maccabi Institute for Health Services Research (grant no.28/2016).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interests.

Supplementary material

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ESM 1 (DOCX 20 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health SciencesUniversity of HaifaHaifaIsrael
  2. 2.School of Public Health, Faculty of Social Welfare and Health SciencesUniversity of HaifaHaifaIsrael
  3. 3.Davidoff Cancer Treatment and Research CenterRabin Medical CenterPetah TikvaIsrael
  4. 4.Department of Family Medicine, Clalit Health Services, Haifa & Western Galilee District, Ruth & Bruce Rappaport Faculty of MedicineTechnion - Israel Institute of TechnologyHaifaIsrael

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