Evidence-based care for breast cancer survivors: Communicating the Institute of Medicine Guidelines in medical practice

2009 ◽  
Vol 77 (3) ◽  
pp. 413-420 ◽  
Author(s):  
Renee Royak-Schaler ◽  
Lisa D. Gardner ◽  
Michelle Shardell ◽  
Min Zhan ◽  
Susan Racine Passmore ◽  
...  
2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 49-49
Author(s):  
Eileen Williams ◽  
Andrew Borgert ◽  
Linda Kay Peterson ◽  
Leah L. Dietrich

49 Background: The 2005 Institute of Medicine report recommended providing a cancer TSCP, but barriers including time needed to complete these documents led to limited implementation. In 2014, in order to facilitate delivery, ASCO released a streamlined version of a TSCP. The current prospective, randomized study compares a Breast Cancer ASCO 2014 derived template (concise TSCP) with a facility derived Breast Cancer TSCP template based on the “old” ASCO version and NCCN guideline recommended elements (detailed TSCP). Methods: Female breast cancer survivors who completed therapy at Gundersen Health System were randomized between a concise TSCP and a detailed TSCP. Subjects received a survey prior to their survivorship visit assessing their baseline knowledge of their breast cancer diagnosis and treatment (pre visit knowledge). After the visit, participants completed the same survey (post visit knowledge) and a satisfaction survey. Pre and post visit knowledge survey scores, patient satisfaction scores and time needed to complete the TSCP were compared between the two study groups. Results: Both TSCP groups showed significant improvement in patient-specific disease and treatment knowledge scores (% of applicable knowledge questions answered correctly) after their survivorship visit. There was no significant difference between the concise and detailed groups’ pre-visit knowledge score (mean 78% vs. 79%, p=0.88). Calculated difference between the groups’ post knowledge scores met the pre-determined threshold for non-inferiority (p=0.013). Conclusions: Our study demonstrates the value of a cancer TSCP and Survivorship visit in improving breast cancer survivors’ knowledge of their disease characteristics and treatment. The concise version was found to be non-inferior to the detailed TSCP in terms of patient knowledge and satisfaction and required less time to complete. These results assist us and other institutions in choosing a more streamlined version of TSCP without compromising patient knowledge or satisfaction. [Table: see text]


2015 ◽  
Vol 11 (2) ◽  
pp. 109-119 ◽  
Author(s):  
Karen Meneses ◽  
Silvia Gisiger-Camata ◽  
Yu-Mei Schoenberger ◽  
Robert Weech-Maldonado ◽  
Patrick McNees

Author(s):  
Kathryn H. Schmitz ◽  
Rinad Beidas

Multiple persistent adverse effects of breast cancer treatment are improved with regular exercise. This case study describes a safe and effective exercise program for breast cancer survivors that was adapted into an evidence-based intervention offered through physical therapy (Strength After Breast Cancer). The program was successfully translated and implemented, and it showed equal safety and efficacy as the parent program with regard to lymphedema symptoms, muscular strength, quality of life, and body image. Evaluation of the implementation process revealed multiple facilitators and barriers to implementation. Barriers included the intervention characteristics and challenges with the referral process from oncology. Facilitators included getting the program covered by insurance, a champion in the outpatient clinic, and adaptations to the program and referral process that resulted in successful implementation. Future research is needed to further the goal of ensuring all breast cancer survivors are connected to safe and effective exercise programming.


2018 ◽  
Vol 2 (S1) ◽  
pp. 68-68
Author(s):  
Alejandra Hurtado de Mendoza ◽  
Sara Gómez Trillos ◽  
Marc Schwartz ◽  
Beth Peshkin ◽  
Heidi E. Hamilton ◽  
...  

OBJECTIVES/SPECIFIC AIMS: The overall goal of this project is to enhance the use of GCRA in Latina breast cancer survivors at high risk of hereditary breast and ovarian cancer to reduce disparities in GCRA uptake. The aims of the study are to (1) develop a cultural adaptation of an evidence-based TGC intervention that consists of phone genetic counseling and a booklet, (2) evaluate the impact of TGC Versus Usual Care, and (3) explore the communication patterns in TGC and genetic counseling sessions with an interpreter. METHODS/STUDY POPULATION: We are conducting a 2-phase, mixed methods study. In Phase I we will develop a cultural adaption of an evidence-based intervention (TGC) for high-risk Latina breast cancer survivors using the Learner Verification and Revision Framework (n=15). In Phase II we will use a cluster randomized design with four community sites randomized to Spanish TGC (n=2 sites) or usual care (n=2 sites) (n=60; 15 per site). The primary outcome is genetic counseling uptake. Among women who receive genetic counseling either through TGC (n~30) or with an interpreter (n~15), we will assess counseling quality by reviewing 20 randomly selected audiotaped sessions (10 TGC; 10 interpreters). We will evaluate women’s HBOC knowledge and satisfaction with counseling. Communication processes and outcomes will be assessed using gold standard RIAS quantitative coding system and qualitative discourse analysis. RESULTS/ANTICIPATED RESULTS: We elicited input from transdisciplinary team members to develop an initial adaptation of a TGC print booklet and intervention protocol for use with high-risk Latina breast cancer survivors with limited English proficiency. The booklet contains low-literacy information about HBOC, risk factors, pros and cons of testing, and management strategies. Based on these materials and prior work, we anticipate TGC will consist of one 1 hour or less TGC session by phone. Participants interested in pursuing testing will receive a saliva kit and will participate in a second TGC session (30 min) to discuss test results and management options. DISCUSSION/SIGNIFICANCE OF IMPACT: Given access barriers and the shortage of Spanish-speaking genetic counselors, adapting and translating TGC intervention is a promising strategy that could reduce disparities by broadening the reach and accessibility to genetic counseling while enhancing the quality of the service for Latinas with limited English proficiency.


2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Monira Alwhaibi ◽  
Christa L. Lilly ◽  
Hannah Hazard ◽  
Kimberly M. Kelly

Background. The Institute of Medicine has established Survivorship Care Planning as a critical component of cancer care to ensure that cancer survivors receive the appropriate follow-up care in a timely manner and support cancer survivors in dealing with the risk of recurrence, yet little is known about how cancer survivors think about preventing or controlling future cancer recurrence. This study sought to assess breast cancer women’s perceived prevention and perceived control of future cancer recurrence. Methods. Women with a history of breast cancer (n=114) were surveyed, and data were analyzed using concurrent mixed methods. Binary logistic regression models examined predictors of perceived prevention and perceived control of cancer recurrence. Results. Most women perceived that they could control cancer recurrence (89%); few (30%) perceived that they could prevent cancer recurrence. Women reported components of the timeline (e.g., early diagnosis), identity (e.g., cancer in body), causes (e.g., hereditary), consequences (e.g., witness success), and cure/control (e.g., exercise) or lack of cure/control. Women who reported lack of control were less likely to perceive that they could control cancer recurrence. Women who reported causes were less likely to perceive that they could prevent or control cancer recurrence. Conclusions. Women’s perceptions about the prevention and control of cancer recurrence are important and different factors in the minds of women with breast cancer. Most women believed they could control cancer recurrence; however, few believed they could prevent cancer recurrence. Interventions to focus on control of cancer recurrence, focusing on evidence-based clinical and lifestyle interventions, are needed.


2016 ◽  
Vol 11 (1) ◽  
pp. 41-47 ◽  
Author(s):  
José A. E. Custers ◽  
Marieke F. M. Gielissen ◽  
Johannes H. W. de Wilt ◽  
Aafke Honkoop ◽  
Tineke J Smilde ◽  
...  

2020 ◽  
Vol 22 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Junga Lee ◽  
Florence Vicil

OBJECTIVES The number of breast cancer survivors throughout the world has increased. Breast cancer survivors need to know how to exercise to improve their clinical outcomes. The purpose of this study was to find the effects of an evidence-based combined exercise intervention on the fitness levels of breast cancer survivors.METHODS A total of 38 female breast cancer survivors were randomly assigned to an exercise group (n=19) or a control group who did usual care (n=19). Subjects in the exercise group participated eight weeks of moderate intensity aerobic exercise and bodyweight strength exercise three times per week. Weight, body mass index (BMI), cardiorespiratory fitness, handgrip strength, and flexibility were measured to assess the effects of the exercise intervention.RESULTS Women who completed the exercise intervention had decreased weight and BMI and increased cardiorespiratory fitness, handgrip strength, and flexibility.CONCLUSIONS Breast cancer survivors had improved health outcomes. A combined exercise intervention of moderate intensity three times per week for eight weeks can help breast cancer survivors improve their health. Participating in aerobic exercise and bodyweight strength exercise, which provide dynamic movements and use large muscle groups with no equipment, can help increase physical fitness levels of breast cancer survivors.


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