Survivorship care plan outcomes for primary care physicians, cancer survivors, and systems: a scoping review

Purpose Cancer survivors have many medical and psychosocial needs that are unaddressed in the post-treatment period. Qualitative research was carried out to assess how a survivorship care plan created by oncologists could improve the quality of survivorship care. Participants and Methods Focus groups and interviews conducted with cancer survivors, nurses, primary care physicians, and oncologists provide insights into post-treatment follow-up practices and the acceptability and feasibility of providing survivors and referring physicians with a cancer survivorship care plan. Results Cancer survivors reported satisfaction with post-treatment medical care, but felt that their psychosocial needs were not met. Survivors expressed enthusiastic support for receipt of a follow-up care plan. Primary care physicians viewed themselves as playing an important role during the post-treatment period and indicated that a written care plan for follow-up would help them improve their survivorship practices. Nurses recognized the need to improve the care of cancer survivors and suggested that they could play an active role in creating and implementing cancer survivorship plans. Physicians providing oncology care acknowledged the value of survivorship care plans, but were not inclined to complete them because such plans would not reduce other reporting and communication requirements and would be burdensome to complete given their busy schedules. Conclusion Survivorship care planning is viewed favorably by consumers, nurses, and physicians, however there are several barriers to its adoption. Barriers may be overcome with: electronic medical records, changes in reporting requirements of insurers, advocacy on the part of patients, and incorporation of care planning in education and training programs.

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Rural Primary Care Offices and Cancer Survivorship Care: Part of the Care Trajectory for Cancer Survivors

Health Services Research and Managerial Epidemiology ◽

10.1177/2333392818822914 ◽

2019 ◽

Vol 6 ◽

pp. 233339281882291 ◽

Cited By ~ 1

Author(s):

Maresi Berry-Stoelzle ◽

Kim Parang ◽

Jeanette Daly

Keyword(s):

Primary Care ◽

Cancer Survivors ◽

Cancer Survivorship ◽

Research Network ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Female Physicians ◽

Skin Changes ◽

Care Plans

Background: A cancer diagnosis is a monumental event in a patient’s life and with the number of cancer survivors increasing; most of these patients will be taken care of by a primary care provider at some point after their cancer therapy. The purpose of this study is to identify primary care physician’s needs to care for a patient who has had cancer. Methods: A cross-sectional survey of the physician members of the Iowa Research Network was conducted. The survey was designed to measure physician confidence in cancer survivor’s care, office strategies regarding cancer survivorship care, and resources available for patients with cancer. Two hundred seventy-four Iowa Research Network members were invited to participate in this survey. Results: Eighty-two physicians (30%) completed the questionnaire with 96% reporting that they are aware of their patient’s cancer survivorship status. Seventy-one physicians reported they were aware of cancer survivorship status by an oncologist sending a note to the office, 68 being diagnosed in their office, 61 by the patient keeping the office apprised, and 15 receiving a survivorship care plan. Physicians reported the top changes in a cancer survivor’s physical health as fatigue (81%) and pain (59%). Sixty-two physicians reported not feeling confident for managing chemobrain, cardiotoxicity (71%), and skin changes (35%). Male physicians were significantly more confident managing patients’ skin changes ( P = .049) and musculoskeletal disturbances than female physicians ( P = .027), while female physicians were significantly more confident managing early-onset menopause than male physicians ( P = .027). Conclusion: Most respondents are aware of their patients who are cancer survivors and are mostly confident in the care they provide for them related to long-term effects and side effects of cancer therapies with limited receipt of cancer survivorship care plans.

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A model for delivering survivorship care: Integrating the oncology and the primary care setting—An Italian experience.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.e275 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. e275-e275

Author(s):

Elena Lorenzi ◽

Lucia Morello ◽

Rita Mazza ◽

Isabella Garassino ◽

Raffaele Cavina ◽

...

Keyword(s):

Primary Care ◽

Cancer Survivors ◽

Early Stage ◽

Care Delivery ◽

Care Plan ◽

Disease Stage ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Early Stage Disease

e275 Background: The population of cancer-survivors faces different lifetime health risk. Thus, models for high-quality and personalized care delivery are strongly needed. ASCO provides different models for survivorship care delivery but there is not an agreement on what is the best in meeting patients’ needs and in terms of cost-effectiveness. In our institution we started a program that tries to integrate survivors’ health care provided by the oncologist and by the Primary Care Physician (PCP). Methods: We included patients (pts) aged more than 18 yrs-old at the time of diagnosis, affected by hematologic or solid tumors. Pts had no evidence of disease from at least 5 yrs from the diagnosis. They are referred to the PCP with the following documents: Survivorship Care-Plan, Survivorship Care-Program, letter to the PCP. Recurrence rate, death rate, treatment related serious clinical events will be calculated after 12 months from the start of the project. Results: We includedin our program 269 cancer-survivors (60% of pts referred to our survivorship-clinic from April to July 2015). The median age was 67 yrs, they were mainly females. The different cancer types were: breast (157), colorectal (36), hematologic (30), gynecologic (11), gastric (9), melanoma (6) lung (5), genitourinary (5), head/neck (3), sarcoma (3) and others (4). 189 of pts had an early stage disease (stage I-II) at diagnosis. 234 of pts underwent surgical treatment and 161 received chemotherapy with different schedules based on tumor types. 59% of pts received anthracycline-based-chemotherapy, 78% at a cumulative dose > 240 mg/m2 . 154 of pts underwent radiation therapy (90% in thoracic field) with a median dose of 60 Gy. We observed 11 cases of secondary cancer after a median of 2.7 yrs from the first diagnosis. The median observation time from the diagnosis to the inclusion in our program was 10 yrs (range 2-31). Conclusions: The observation period from the beginning of the program is too short to provide follow-up data. A high percentage of pts present a high risk of cardiologic late toxicities, therefore they need a more intensive cardiologic follow-up. We will present the first follow-up analysis of this cohort of pts in April 2016.

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Primary care providers' awareness and utilization of survivorship care plans.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.94 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 94-94

Author(s):

Alicia R. Rosales ◽

Tina Schaal ◽

Shelby Darland ◽

Dan Sayam Zuckerman

Keyword(s):

Primary Care ◽

Cancer Survivors ◽

Care Coordination ◽

Primary Care Providers ◽

Comfort Level ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Care Providers ◽

Care Plans

94 Background: The Commission on Cancer (CoC) standard 3.3 requires that all patients who complete cancer treatment receive a survivorship care plan (SCP). To aid in care coordination, the standard also requires that the SCP be provided to the patient’s primary care provider (PCP). St. Luke’s Mountain States Institute (MSTI) has been providing patients and PCPs with SCPs for more than 5 years. Other local accredited cancer centers also provide SCPs for their patients. Methods: In partnership with the local chapter of the American Cancer Society, MSTI created an online survey aimed at assessing the utilization of the SCP in primary care clinics and the PCP’s comfort level carrying out the recommended surveillance. The survey link was distributed through email to approximately 300 PCPs across a large geographical area in varying sized practices. Results: Sixty three responses were received in 3 weeks with 46 responses from physicians and 17 responses from advanced practice providers. All of the respondents said they care for cancer survivors in their practice but 54% have never received a SCP. Twenty nine reported having received a SCP and answered 8 questions related to how they use the SCP in practice. The majority refer to the SCP to monitor for recurrence and 52% use it as a tool for coordination of care. Forty eight percent use the SCP to manage co-morbid conditions. Ninety-five percent of all respondents indicated they feel comfortable carrying out a surveillance plan provided by the oncologist for patients 2 years out from treatment. Sixty-four percent indicated they would like additional education about caring for cancer survivors. A common theme in comments included the desire for improved communication between the oncologists and PCPs. Conclusions: This standard was created in part to improve care coordination between oncologists and PCPs. More than have of the PCPs in the MSTI service area have not seen a SCP for their patients. Most indicated they are comfortable providing surveillance if they have a clear follow-up care plan from the oncologist. More than half want additional information about caring for cancer survivors. Future exploration could include assessment of barriers to communication and utilizing the SCP in practice.

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Survivorship care plan preferences of cancer survivors and health care providers: a systematic review and quality appraisal of the evidence

Journal of Cancer Survivorship ◽

10.1007/s11764-015-0452-0 ◽

2015 ◽

Vol 10 (1) ◽

pp. 71-86 ◽

Cited By ~ 39

Author(s):

Dori L. Klemanski ◽

Kristine K. Browning ◽

Jennifer Kue

Keyword(s):

Systematic Review ◽

Health Care ◽

Cancer Survivors ◽

Health Care Providers ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Care Providers ◽

Quality Appraisal

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Colorectal Cancer Survivors' Needs and Preferences for Survivorship Information

Journal of Oncology Practice ◽

10.1200/jop.2013.001312 ◽

2014 ◽

Vol 10 (4) ◽

pp. e277-e282 ◽

Cited By ~ 20

Author(s):

Talya Salz ◽

Shrujal S. Baxi ◽

Victoria S. Blinder ◽

Elena B. Elkin ◽

Margaret M. Kemeny ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Survivors ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Cancer History ◽

Colorectal Cancer Survivors

In the absence of a survivorship care plan, colorectal cancer survivors still generally understood their cancer history; however, many lacked knowledge of ongoing risks and prevention.

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