scholarly journals The Potential of Survivorship Care Plans in Primary Care Follow-up of Minority Breast Cancer Patients

2009 ◽  
Vol 24 (S2) ◽  
pp. 467-471 ◽  
Author(s):  
Mary Ann Burg ◽  
Ellen D. S. Lopez ◽  
Amy Dailey ◽  
Mary Elspeth Keller ◽  
Brendan Prendergast
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Patients ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Care Plans

Use of telemedicine in the delivery of survivorship care plans among breast cancer survivors: Lessons learned at Kaiser Permanente East Bay.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 77-77 ◽  
Author(s):  
Pamela Kim Washington ◽  
Heather Tews ◽  
Dan-Thanh Nguyen ◽  
Leeina Wade ◽  
Trang Phan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Lessons Learned ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Kaiser Permanente ◽  
Care Plans ◽  
Follow Up Care

77 Background: Beginning in 2015, the National Accreditation Program for Breast Centers (NAPBC) requires accredited facilities to provide Survivorship Care Plans (SCP) to breast cancer patients treated with curative intent. Here we describe lessons learned with the use of telemedicine in the delivery of SCPs at Kaiser Permanente East Bay. Methods: SCP implementation followed a two-step process: patients who are diagnosed and complete treatment in 2016 are given a SCP at their last surgical or medical oncology appointment (YTD, n=8); 2) patients diagnosed in 2015 who completed treatment in 2015-2016 were contacted by a physician assistant and offered an appointment by telephone or in-person to deliver the care plan (n=152). Both clinic and telemedicine appointments consist of a detailed review of treatment received, post-treatment follow-up care, discussion of health education resources, and provision of referrals as appropriate. Patients also have the opportunity to ask questions about treatment and follow-up care. Results: Among patients diagnosed in 2015 who were offered a TAV or in-person visit, 44.0% preferred a telephone appointment. Actual appointment duration ranged from 10 to 30 minutes. Lack of co-payment and fees associated with transportation as well as loss of income due to taking time off work were the primary factors cited choosing telemedicine over in-person clinic appointments. Interestingly, no differences in member satisfaction scores for in-person vs. telephone visits were observed. Conclusions: Findings suggest telemedicine may be effective in the delivery of SCPs. Similar to rural settings, use of telemedicine in urban settings has a unique capacity to increase service to breast cancer patients.

Systematic development of a a breast cancer survivorship program at a small independent oncology practice.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 52-52 ◽  
Author(s):  
Cynthia Rogers ◽  
Shailesh R. Satpute
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Data Entry ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care Plans ◽  
Full Time ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Care Plans

52 Background: It is widely accepted that providing survivorship care plans leads to improvements in outcomes for cancer survivors. Treatment summaries are now part of ASCO and NCCN survivorship guidelines. We faced a unique challenge of implementing the survivorship care plan at the Jones Clinic as a small independent practice. The Jones Clinic consists of three full time physicians and two full time nurse practitioners. We see approximately 850 new patients per year. Methods: As a part of ASCO’s quality training program, we focused on the stage I – III (early stage) breast cancer patients who completed their initial therapy. We formed a team, identified the barriers, created a flow diagram of the process, assigned roles for each individual member and finally implemented the process. Results: The major issues identified were lack of provision in the electronic medical record (EMR) system for survivorship and lack of standardized data entry process. We created a system in the EMR for survivorship data entry and extraction of such data in a document. Since July 2015, one hundred percent of breast cancer patients completing adjuvant therapy at the Jones Clinic have received a survivorship treatment summary and a plan of care. The care plan is also shared with their primary care provider. Importantly, creating a survivorship document required less than 10 minutes of the provider’s time. Conclusions: We are now able to provide our patients with a survivorship care plan and address survivorship issues within thirty days of completion of therapy. Creating the care plan requires minimal time from the providers. Our new process meets ASCO guidelines for survivorship care plans and no additional staffing was needed. We now plan to provide a survivorship care plan to all oncology patients treated with curative intent.

Using Canadian administrative data to evaluate primary and oncology care of breast cancer patients post-treatment: Subset of the CanIMPACT Study.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 5-5 ◽  
Author(s):  
Mary L McBride ◽  
Patti Groome ◽  
Donna Turner ◽  
Margaret Jorgensen ◽  
Cynthia Kendell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Patients ◽  
Administrative Data ◽  
Cancer Care ◽  
Data Access ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Oncology Care

5 Background: CanIMPACT is a multi-provincial Canadian research team funded to identify and address key issues faced by cancer patients and providers at the intersection of primary and specialist oncology care. Canada has national healthcare standards, but provincial/territorial healthcare delivery systems. One facet will use administrative data from the population-based, publicly-funded healthcare system to evaluate issues during pre-diagnosis, treatment, and post-treatment survivorship for breast cancer patients. For the survivorship phase, we aim to conduct the following analyses and compare across provinces: 1) Utilization of physician services overall and by specialty, including oncologists, non-oncology specialists, and primary care; 2) Assessment of adherence to ASCO and Canadian follow-up guideline for breast cancer care, use of surveillance breast imaging, and metastatic investigations; 3) Assessment of adherence to recommended care of chronic illness and preventive care; 4) Quantification of the cost of follow-up overall and by specialty; 5) Comparison of inter- and intra-provincial variation for all outcomes by health administrative region and for vulnerable groups (age ≥ 75 at diagnosis, northern/rural/remote, low income, immigrants), and examine the effect of continuity of primary care and chronic disease on post-treatment care. Methods: Patients will be identified from provincial cancer registries and linked to data extracted from: outpatient physician service claims, hospital inpatient and outpatient data, and cancer facility medical records. Results: Participating provinces have finalized the core questions and detailed protocols, and assessed data comparability. They are in the process of obtaining the required ethics and data access approvals, and data acquisition for processing and analysis. Conclusions: Results will address existing information gaps that can be used to improve transition and care across the cancer care trajectory. Importantly, results will be combined with those of a CanIMPACT qualitative study to inform design of a pragmatic randomized trial focused on improving coordination and quality of care.

scholarly journals Survivorship care plans for breast cancer patients: understanding the quality of the available evidence

2017 ◽  
Vol 24 (6) ◽  
pp. 446 ◽  
Author(s):  
V. D'Souza ◽  
H. Daudt ◽  
A. Kazanjian
Keyword(s):  
Breast Cancer ◽  
Stress Reduction ◽  
Knowledge Synthesis ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Emotional Challenges ◽  
Care Plans ◽  
Methodologic Quality

Aim The overall goal of the present study was to contribute to consistency in the provincial approach to survivorship care planning through knowledge synthesis and exchange. Our review focused on the research concerning the physical and emotional challenges of breast cancer (bca) patients and survivors and the effects of the interventions that have been used for lessening those challenges.Methods The psychosocial topics identified in bca survivorship care plans created by two different initiatives in our province provided the platform for our search criteria: quality of life (qol), sexual function, fatigue, and lifestyle behaviours. We conducted an umbrella review to retrieve the best possible evidence, and only reviews investigating the intended outcomes in bca survivors and having moderate-to-high methodologic quality scores were included.Results Of 486 reports retrieved, 51 reviews met the inclusion criteria and form part of the synthesis. Our results indicate that bca patients and survivors experience numerous physical and emotional challenges and that interventions such as physical activity, psychoeducation, yoga, and mindfulness-based stress reduction are beneficial in alleviating those challenges.Conclusions Our study findings support the existing survivorship care plans in our province with respect to the physical and emotional challenges that bca survivors often face. However, the literature concerning cancer risks specific to bca survivors is scant. Although systematic reviews are considered to be the “gold standard” in knowledge synthesis, our findings suggest that much remains to be done in the area of synthesis research to better guide practice in cancer survivorship.

scholarly journals Exploring Interactive Survivorship Care Plans to Support Breast Cancer Survivors: Protocol for a Randomized Controlled Trial

10.2196/23414 ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. e23414
Author(s):  
Akshat Kapoor ◽  
Priya Nambisan
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Self Management ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Breast Cancer Survivorship ◽  
Care Plans ◽  
The Impact

Background Breast cancer is the most common form of cancer among American women, accounting for 23% of all cancer survivors nationally. Yet, the availability of adequate resources and tools for supporting breast cancer survivors has not kept up with the rapid advancement in treatment options, resulting in unmet supportive care needs, particularly among low-income and minority populations. This study explores an alternative means of delivering breast cancer survivorship care plans (SCPs), with the aim of improving survivor morbidity, patient knowledge, and self-management of treatment-related symptoms, as well as addressing inconsistencies in follow-up care visits. Objective The overall goal of this study is to improve the uptake of SCP recommendations via an educational intervention for breast cancer survivors, to improve treatment-related morbidity, patient knowledge, self-management, and adherence to follow-up visits. The specific aims of the study are to (1) evaluate the feasibility of the online SCP, and (2) assess the impact of the online SCP on survivorship outcomes. Methods We will enroll 50 breast cancer survivors who have completed initial breast cancer treatment into a 2-armed, randomized, waitlist-controlled pilot trial, and collect data at baseline and 6 months. For the first aim, we will use mixed methods, including surveys and personal interviews among the intervention group, to determine the feasibility of providing an online, interactive SCP (called ACESO) based on the survivors’ online user experience and their short-term adoption. For the secondary aim, we will compare the 2 groups to assess the primary outcomes of survivor knowledge, self-efficacy for self-management, perceived peer support, and adherence to SCP-recommended posttreatment follow-up visits to oncology and primary care; and the secondary outcomes of treatment-related morbidity (body weight, fatigue, depression, anxiety, sexual function, distress, and sleep quality). We assess these outcomes by using measurements from validated instruments with robust psychometric properties. Results We have developed and refined the online breast cancer survivorship plan, ACESO, with consultation from breast cancer oncologists, nurses, and survivors. Approval for the study protocol has been obtained from the Institutional Review Board. An advisory board has also been established to provide oversight and recommendations on the conduct of the study. The study will be completed over a period of 2 years. Conclusions The results of this pilot study will inform the feasibility and design of a larger-scale pragmatic trial to evaluate the impact of an online breast cancer SCP on treatment-related morbidity and self-efficacy for self-management. International Registered Report Identifier (IRRID) PRR1-10.2196/23414

Do nurse-navigated TSSCPs improve treatment and follow up compliance in underserved populations?

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 72-72
Author(s):  
Camille Manoukian ◽  
Maria Altamirano ◽  
Kimlin Tan Ashing ◽  
Ann Falor Callahan ◽  
Virginia Sun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Underserved Populations ◽  
Statistical Significance ◽  
Clinic Visit ◽  
Treatment Recommendations ◽  
Breast Cancer Patients ◽  
Care Plans ◽  
Number Of Patients

72 Background: Multiple cancer organizations advocate for the use of treatment summaries and survivorship care plans (TSSCPs) in cancer patients. To better quantify the benefits of a nurse-navigated, culturally and linguistically responsive TSSCP in underserved breast cancer patients, we compared rates of compliance with treatment and follow up in 26 patients who were treated with TSSCPs to 38 similar controls who were treated without TSSCPs. Methods: We prospectively enrolled 26 consecutive, newly-diagnosed breast cancer patients who were given nurse-navigated TSSCPs under an IRB-approved protocol. At their first clinic visit, a trained nurse educated and assisted the patient in the use and completion of the TSSCP. Nurse-navigated TSSCPs were completed at each subsequent visit through 12 months of surveillance. Rates of compliance with treatment and follow up guidelines were compared to 38 similar control patients using a two group Fisher’s exact chi-square test. Statistical significance was set at p-value < 0.05. Results: All patients were treated under Medicaid insurance and 47% were racial and/or ethnic minorities. Time from diagnosis to treatment and time from initial clinic visit to treatment were similar across groups. The rate of compliance with first treatment recommendations was 96% (25/26) in the TSSCP group compared to 79% (30/38) in the non-TSSCP group (p = 0.07). The number of patients compliant with all follow up visits was similar: 22/25 (88%) of TSSCP patients and 22/30 (73%) in non-TSSCP patients (p = 0.31). Of the recommended total follow up appointments, 6/67 in the TSSCP group and 25/120 in the no TSSCP group were “no shows” (p = 0.04). Conclusions: Although the use of nurse-navigated TSSCPs may not improve time to treatment in medically underserved patients, adherence to first treatment recommendations and follow up appointment attendance shows some improvement in patients who participate in nurse-navigated TSSCPs. Further study is needed to fully assess the role of nurse-navigated TSSCPs in improving treatment and surveillance compliance rates and how these rates impact clinical outcomes. Acknowledgement: Funded by a Community Grant from the Los Angeles County Affiliate of Susan G. Komen.

Shared Care For Hematologic Malignancy Survivors: Challenges Between Primary Care Physicians and Hematologist/Oncologists

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2958-2958
Author(s):  
Haleh Kadkhoda ◽  
Clare Karten ◽  
Emily Van Laar ◽  
Elisa Weiss ◽  
Kevin C. Oeffinger ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Primary Care Physicians ◽  
Clinical Information ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Effective Management ◽  
Treatment Summaries ◽  
Care Plans

Abstract Background Many cancer patients are cured, or have a series of remissions interspersed with periods of re-treatment. In 2006, the Institute of Medicine's From Cancer Patient to Cancer Survivor: Lost in Transition recommended comprehensive treatment summaries and follow-up care plans for all cancer survivors. [Parry 2013] There were about 14 million cancer survivors in the US as of January 2012; this population is expected to be 18 million by 2022. [Siegel 2012] Among survivors, 64% have survived 5 years or more; 40% have survived 10 years or more; and 15% have survived 20 years or more after diagnosis. [de Moor 2013] Many survivors in this growing population experience physical, psychological, and/or financial long-term/ late effects. The complexities of managing cancer survivors suggest their care should not be conceived as a transition from the hematologist/oncologist to the primary care provider, but rather as an ongoing, flexible collaboration determined by individual survivor needs. Methods Polling surveys were conducted within the 2012 online education activity Sharing Care for Survivors of Hematologic Malignancies, developed by The Leukemia & Lymphoma Society and Medscape Oncology. Case-based education was delivered by an expert panel of hematologist/oncologists (Hem/Oncs) and primary care physicians (PCPs) to illustrate effective communication methods and critical communication points between (Hem/Oncs) and (PCPs). Results As of June 30, 116 Hem/Oncs and 171 PCPs overall responded to the polling surveys, which address current practices and barriers in shared care of cancer survivors. Responses were analyzed to identify gaps in continuity of care among specialties. A summary of responses shows the most significant barrier in effective management is the lack of survivorship care plans and treatment summaries (41% Hem/Oncs vs 51% PCPs). Only 8% and 5% of Hem/Oncs and PCPs, respectively, use survivorship care plans, although both Hem/Oncs and PCPs agreed that such plans and summaries are the most useful communication vehicle among professionals (73% Hem/Oncs vs 67% PCPs). PCPs used patient self-reported data more frequently to document cancer treatment, compared with Hem/Oncs (21% vs 7%, respectively); Hem/Oncs used caregiver reports more often than did PCPs (12% vs 3%, respectively). Similar numbers of Hem/Oncs and PCPs estimated that PCPs spend more than 4 hours of non-reimbursed time weekly researching issues related to patient care (47% Hem/Oncs vs 41% PCPs). Despite progress in electronic health records and widespread Internet access, these physicians most typically use the phone to communicate about the management of cancer survivors (64% Hem/Oncs vs 74% PCPs), followed by faxed/mailed letters, with email ranking as least used. Lack of prompt communication between Hem/Oncs and PCPs was the second highest barrier listed by respondents to effective management (22% and 27%, respectively). Conclusion Analysis of the Hem/Onc and PCP learner responses to the polling surveys point to clinical complexities and persistent challenges in the co-management of survivors of hematologic cancers. The challenges relate to communication, technological, healthcare system and healthcare coverage issues.Timely, ongoing communication of the right clinical information between Hem/Oncs and PCPs is essential for optimal management of the growing number of cancer survivors. Hem/Oncs and PCPs devote significant time each week to addressing the cancer survivors' needs; the lack of reimbursed time for PCPs may be an impediment to optimal care. Hem/Oncs and PCPs place a high value on the utility of survivorship care plans; however, they are not widely used. Phone calls are the current preferred communication mode. Until other technological solutions are more widely used to share clinical information, it is important to employ practical solutions, such as providing PCPs with information to help prioritize cancer survivors' follow-up care needs and providing patients/caregivers with brief cancer treatment summaries. Communication strategies to address potentially preventable causes of death, such as cardiac disease and second cancers, as well as acknowledgment and treatment for anxiety and depression related issues [Harrington 2010], which often accompany the uncertainty many cancer survivors live with, are critical. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Views of family physicians about survivorship care plans to provide breast cancer follow-up care: exploration of results from a randomized controlled trial

2015 ◽  
Vol 22 (4) ◽  
pp. 252 ◽  
Author(s):  
M.A. O'Brien ◽  
E. Grunfeld ◽  
J. Sussman ◽  
G. Porter ◽  
M. Hammond Mobilio
Keyword(s):  
Breast Cancer ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Family Physicians ◽  
Survivorship Care Plan ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Randomized Controlled

Background The U.S. Institute of Medicine recommends that cancer patients receive survivorship care plans, but evaluations to date have found little evidence of the effectiveness of such plans. We conducted a qualitative follow-on study to a randomized controlled trial (rct) to understand the experiences of family physicians using survivorship care plans to support the follow-up of breast cancer patients.MethodsA subset of family physicians whose patients were enrolled in the parent rct in Ontario and Nova Scotia were eligible for this study. In interviews, the physicians discussed survivorship care plans (intervention) or usual discharge letters (control), and their confidence in providing follow-up cancer care.Results Of 123 eligible family physicians, 18 (10 intervention, 8 control) were interviewed. In general, physicians receiving a survivorship care plan found only the 1-page care record to be useful. Physicians who received only a discharge letter had variable views about the letter’s usefulness; several indicated that it lacked information about potential cancer- or treatment-related problems. Most physicians were comfortable providing care 3–5 years after diagnosis, but desired timely and informative communication with oncologists. Conclusions Although family physicians did not find extensive survivorship care plans useful, discharge letters might not be sufficiently comprehensive for follow-up breast cancer care. Effective strategies for two-way communication between family physicians and oncologists are still lacking.

Sign in / Sign up

Export Citation Format

Share Document