scholarly journals 137P Survivorship care plan for breast cancer patients: An intensive follow-up is still useless?

2021 ◽  
Vol 32 ◽  
pp. S81
Author(s):  
G. Cortesi ◽  
F. Piacentini ◽  
L. Moscetti ◽  
M. Barbolini ◽  
C. Nasso ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
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.

scholarly journals Survivorship Care Plan Information Needs: Perspectives of Safety-Net Breast Cancer Patients

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0168383 ◽  
Author(s):  
Nancy J. Burke ◽  
Tessa M. Napoles ◽  
Priscilla J. Banks ◽  
Fern S. Orenstein ◽  
Judith A. Luce ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Information Needs ◽  
Safety Net ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Breast Cancer Patients

Improving the delivery of team-based survivorship care after primary breast cancer treatment through a multi-level intervention.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7056-7056
Author(s):  
Lauren P. Wallner ◽  
Paul Abrahamse ◽  
Archana Radhakrishnan ◽  
Lawrence C. An ◽  
Jennifer J. Griggs ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Medical Oncology ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Multi Level ◽  
Oncology Providers

7056 Background: The delivery of team-based survivorship care after primary cancer treatment remains challenging, in part due to a lack of effective interventions. We developed a multi-level intervention for breast cancer patients and their primary care and medical oncology providers to improve the delivery of team-based survivorship care called ConnectedCancerCare (CCC). CCC includes a patient-facing, personalized mobile website, and tailored feedback letters to providers. Methods: We conducted a pilot randomized controlled trial in a breast oncology clinic to establish the feasibility and acceptability of CCC. Women within one year of completing primary treatment for stages 0-II breast cancer were randomized to CCC (intervention) or a static online survivorship care plan (control). Participants completed online surveys at baseline and 3 months, ascertaining their knowledge about PCP roles in their survivorship care, their communication with their PCP about team-based care, and whether they scheduled a follow-up visit with their PCP. Multiple measures of acceptability were collected among women in the intervention arm (n = 28). Qualitative interviews were conducted at the completion of the study with 5 PCPs, 6 oncology providers, and 10 intervention patients to identify barriers and facilitators to implementing CCC. Results: Among 160 eligible women invited to participate, 66 women completed the baseline survey and were randomized (41% participation rate), and 54 completed the 3-month follow-up survey (83% response rate). Women in the intervention arm found the content of the CCC website to be highly acceptable, with 82% reporting it was easy to use, and 86% reporting they would recommend it to other patients. A greater proportion of women randomized to CCC (vs. control) reported scheduling a PCP follow-up visit (64% vs. 42%) and communicating with their PCP about provider roles (67% vs. 18%). Women in the CCC arm also reported higher mean knowledge scores regarding team-based cancer care (3.7 vs. 3.4). Providers noted challenges to implementing CCC, including integration into electronic medical records, and supporting sustained engagement with CCC over time. Conclusions: Our findings suggest deploying CCC in medical oncology practices is feasible, and the intervention content is acceptable among breast cancer patients. CCC shows promise for improving understanding and communication about provider roles in survivorship care, and facilitating patients to follow up with their PCP early in the survivorship period. Clinical trial information: NCT03618017 .

Integrating the primary care physician into cancer follow-up.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 102-102 ◽  
Author(s):  
Andrew L. Salner ◽  
Deborah Walker ◽  
Amanda Seltzer ◽  
SarahLena Panzer ◽  
Carrie Stricker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Primary Care Physician ◽  
Care Physician ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Plans ◽  
Follow Up Care

102 Background: After a diagnosis of breast cancer, it can be difficult for patients to understand the role their primary care physician (PCP) should play in their follow up care. Methods: 65 women (mean age 60 years, SD = 10) with breast cancer (stage 0-III) were seen by a nurse practitioner for a 60-90 minute consultative survivorship visit and received a treatment summary and personalized survivorship care plan (SCP) utilizing Carevive Care Planning Systems software. The Carevive system incorporates patient-reported and clinical data to create tailored care plans with personalized recommendations for follow up care and supportive referrals, including direction to follow up with primary care for specific care and health maintenance activities. Approximately 6 weeks following their survivorship care visit, patients completed a survey assessing their use of and satisfaction with the SCP. Patients were advised that the SCP would be mailed to their referring oncologist and primary care physician. Results: Out of 65 sent, 35 surveys have been completed to date. Survivors were diagnosed approximately 10 months prior, and all were within 6 months following completion of treatment. All patients (100%) reported that they read, or planned to read, their survivorship care plan packet carefully. While all care plans included a recommendation to follow up with their PCP, only (71%) of survivors remembered receiving this recommendation. Of those who did, most (74%) had either seen or scheduled an appointment with their PCP. Patients who reported higher anxiety at the time of the survivorship visit were more likely to report that the follow up care plan helped them take action about seeing their PCP (p = .03). Conclusions: Coordination between primary and oncology care providers has previously been shown to improve the quality of care for cancer survivors. SCPs that emphasize the importance of and activities to be undertaken in primary care may help to improve this coordination. Continuation of this research will help to better understand how to integrate the primary care physician into cancer follow up care. Updated data will be shared at time of presentation.

Survivorship care after breast cancer: Follow-up practices of Australian health professionals and attitudes to a survivorship care plan

2010 ◽  
Vol 6 (2) ◽  
pp. 116-125 ◽  
Author(s):  
Meagan E BRENNAN ◽  
Phyllis BUTOW ◽  
Andrew J SPILLANE ◽  
Frances M BOYLE
Keyword(s):  
Breast Cancer ◽  
Health Professionals ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Australian Health

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.

Implementing survivorship care planning in a large integrated cancer program.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 69-69
Author(s):  
Jamie Cairo ◽  
Carol Huibregtse ◽  
Adam Ferry ◽  
James L. Weese
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cancer Care ◽  
Breast Cancer Survivors ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Care Planning ◽  
Survivorship Care ◽  
Care Plans ◽  
Survivorship Care Planning

69 Background: Aurora Health Care is comprised of 15 hospitals and 22 oncology clinics. Aurora Cancer Care (ACC), a Commission on Cancer (CoC) accredited program, diagnoses and treats 7,000 adult cancer patients annually, more than any other healthcare system in Wisconsin. The CoC’s Survivorship Standard 3.3 requires accredited cancer programs to provide cancer patients with survivorship counseling and a written care plan. ACC was challenged to develop a consistent model of survivorship care that can work at multiple sites across the system. Methods: Workflow planning and education began at all oncology clinics in fourth quarter of 2014. Thirteen disease specific survivorship care plan templates were built into the EMR with some-auto population functionality. A system wide delivery plan was launched in first quarter of 2015 with the goal of targeting 10% of eligible patients. Initial focus was on breast cancer patients with some sites also including other cancers. The model of survivorship care is an “embedded consultation” in medical or surgical oncology with an advanced practice provider (APP) completing the care plan and meeting with the patient at the end of first line treatment. Results: Initial required volumes were estimated based on 2013 registry data with a goal of completing approximately 700 care plans in 2015 to meet the 10% CoC standard. During Q1 & Q2 of 2015, 444 care plans were generated and given to patients, mostly for breast cancer survivors. The most significant barrier surrounded retrieving data from the EMR. Conclusions: Data from the first half of 2015 demonstrates success with the approach. Aurora Cancer Care will exceed the benchmark of 700 care plans. There has been a high level of engagement with the APPs who have taken ownership of survivorship care planning, contributing to the success of the program thus far. Because of difficulty retrieving data from the EMR, manual tracking was still required. Future modifications will address this and other barriers.

Evaluating a clinically and culturally informed survivorship care plan trial for African American breast cancer survivors (AABCS).

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 71-71
Author(s):  
Kimlin Tan Ashing ◽  
Kommah McDowell ◽  
Shirley Brown ◽  
Mayra Serrano ◽  
Lily L. Lai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Self Report ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Trial Participation ◽  
Survivorship Care ◽  
Culturally Informed ◽  
The Impact

71 Background: This randomized control study was designed to evaluate the impact of trial participation on access to survivorship care planning (SCP) and adherence to surveillance recommendations among AABCS. Methods: AABCS were recruited from the State Cancer Registry and support groups. This trial consisted of 1:1 randomization into two conditions: 1) peer navigation + clinically- and culturally-informed breast cancer (BC) materials, and 2) clinically- and culturally-informed BC materials, only. AABCS (N= 29) from advocacy groups were trained as peer navigators, with on-going supervision and monitoring by the research team. The ASCO-SCP template was modified based on input from survivor-advocates to increase clinical, cultural and socio-ecological relevance. The study was implemented using community based-participatory approach. Mailed, self-report assessments were taken at baseline and at 6- and 12-month follow-up. Results: In total, 112 AABCS who were 6-18 months post initial primary treatment for stage 0-3 BC participated in the study. There was a 74% participation rate and a 64% completion rate. At 6- and 12-month follow-up, 65% and 73% reported access to a SCP, respectively. Improvements from baseline in adherence to SCP surveillance recommendations were observed at 6- and 12- month follow-up assessments regarding physical exam (45.6%, 71.2%, 71.0%, respectively), pelvic exam (39.7%, 45.2%, 46.5%, respectively), breast self-exam (45.0%, 79.0%, 81.2%, respectively), and breast imaging (31.1%, 75.6%, 81.1%, respectively) (p< 0.05). There we no significant demographic, medical or study outcome differences by study condition. Conclusions: Our study findings demonstrate the effectiveness of trial participation in facilitating access to SCP and improved adherence to recommended surveillance. Participation of survivor-advocates in developing culturally-informed BC informational and survivorship care strategies can enhance acceptability and sustainability, especially in community and primary care settings. Untapped opportunities exist for survivor-advocate engagement in survivorship research and practice to address inequities. Clinical trial information: NCT01824745.

Empowering breast cancer survivors: Results of a community-based survivorship clinic.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 29-29
Author(s):  
Heather Thompson Mackey ◽  
Stacy Wentworth
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Side Effects ◽  
Cancer Patients ◽  
Fear Of Recurrence ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Health Maintenance

29 Background: Based on advances in detection and treatment, survival for breast cancer patients has increased over the past decade with 5-year survival rates approaching 90%. Survivors remain at risk for treatment related side effects, which can profoundly impact their quality of life. The Breast Cancer Survivorship Clinic (BCSC) was established in January 2016 to provide patient-centered care to survivors with the intent to maximize quality of life, empower decision making, and facilitate care coordination in order to pursue a life of wellness and overall health in patients’ lives after cancer. Methods: A Survivorship Nurse Practitioner (SNP) meets newly diagnosed breast cancer patients to introduce survivorship as part of the treatment course for those treated with curative intent. Upon completion of active treatment, survivors are scheduled to see the SNP to review their Survivorship Care Plan (SCP) outlining treatment history, surveillance schedule, side effects of treatment, and recommendations for cancer screening and health maintenance. Survivors are surveyed to assess symptoms and concerns at the end of treatment, as well as assess patient empowerment after meeting with the SNP. Results: Over the first nine months of BCSC, 95 patients have been seen. The most common concerns related to physical side effects include fatigue (57%), hormone changes (39%), and insomnia (39%). Survivors report fear of recurrence (58%), finances (47%), and anxiety (35%) to be among their greatest psychosocial concerns. 86% said they would appreciate reviewing a SCP with the SNP. After meeting with the SNP, 93% felt better or much better able to understand their illness, cope with illness, and keep themselves healthy. After meeting with the SNP, 92% felt more confident in their health and felt as though they can better help themselves. Conclusions: The first months of the BCSC have been a success with excellent reported empowerment via validated survey measure. Continued refinement in program development will ensure the initial successes of the program will continue in order to provide all survivors with late/long-term side effect management, physical/emotional support, and survivorship care planning at the completion of cancer treatments.

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