Experiences and expectations of general practitioners in the oncological care of adult patients with cancer on the island of Saint Martin ; Ressentis et attentes des médecins généralistes dans la prise en charge oncologique des patients adultes atteints de pathologies tumorales sur l’île de St Martin

Context: currently, there is no chemotherapy, radiotherapy, or oncological surgery on the Island of Saint Martin. Patients that require specialized care are transferred outside the community, to Guadeloupe, Martinique, or France. There are ongoing efforts to improve the oncological care of these patients. Since January 2017, a standard orientation and care system has been put in place for patients receiving oral treatments, and a medical oncology consultation was created. Nevertheless, the current healthcare offer is far from optimal and raises many difficulties. Objective: based on the experience of general practitioners, to understand the care pathway for patients receiving oncological care in Saint Martin, a territory devoid of specialist proximity and far from regional care offers. Method: qualitative study by semi-structured interviews with nine general practitioners established on the island. Results: the practitioners generally had positive feedback about the oncological care that is being offered. For the most part, established for over three years, they underlined a clear improvement in care since creating the standard referral channel and the arrival of an oncologist. However, our work has made it possible to highlight the obstacles hindering this oncological care from running more efficiently and smoothly. The main difficulties that were raised are the organization of care, the lack of city-hospital coordination, the diversity of the population, and the lack of human and technical resources. The caregivers were in demand of a local network offering comprehensive and multidisciplinary care, increased human resources, and an expanded technical platform. Conclusion: our study shows oncological care's complexity in a remote overseas territory, distant from specialized regional care offers. It highlights the difficulties associated with the care pathway and offers several suggestions and insights to improve the oncology sector. It also suggests improved collaboration between healthcare professionals and ...