scholarly journals Identifying Key Questions to Advance Research and Practice in Cancer Survivorship Follow-Up Care: A Report From the ASPO Survivorship Interest Group

2009 ◽  
Vol 18 (7) ◽  
pp. 2152-2154 ◽  
Author(s):  
Shawna V. Hudson ◽  
Jessica Chubak ◽  
Elliot J. Coups ◽  
Lyla Blake-Gumbs ◽  
Paul B. Jacobsen ◽  
...  
Keyword(s):  
Cancer Survivorship ◽  
Interest Group ◽  
Research And Practice ◽  
Follow Up Care ◽  
Advance Research ◽  
Key Questions

Guideline-concordant surveillance and follow-up care among low-income patients with breast cancer: The role of primary care medical homes.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 171-171
Author(s):  
Stephanie B. Wheeler ◽  
Racquel Elizabeth Kohler ◽  
Ravi K. Goyal ◽  
Kristen Hassmiller Lich ◽  
Alexis Moore ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Low Income ◽  
Breast Cancer Survivors ◽  
Breast Cancer Survivorship ◽  
Medical Homes ◽  
Follow Up Care

171 Background: Community Care of North Carolina (CCNC) initiated an innovative medical home (MH) program in the 1990s to improve primary care in Medicaid-insured populations. CCNC has been successful in improving asthma, diabetes, and cardiovascular outcomes, but has not been evaluated in the context of cancer care. We sought to determine whether MH enrollment was associated with guideline-concordant surveillance and follow-up care among breast cancer survivors. Methods: Using state cancer registry records matched to Medicaid claims, we identified women ages 18-64 diagnosed with stage 0, I, or II breast cancer from 2003-2007 and tracked their CCNC enrollment. Using published American Society for Clinical Oncology breast cancer survivorship guidelines to define our outcomes, we employed multivariate logistic regressions to examine correlates of receipt of surveillance mammogram and at least two physical exams within 15 months post-diagnosis. Results: In total, 840 women were included in our sample. Approximately half were enrolled in a CCNC MH during the study period, 38% were enrolled for more than 7 months post-diagnosis. Enrollment in a MH for at least 7 months post-diagnosis was strongly associated with receiving guideline-recommended surveillance mammogram (p<0.01) and at least 2 physical exams (p<0.01) within 15 months post-diagnosis. Conclusions: Results suggest that MH enrollment is associated with higher quality breast cancer survivorship care among women insured by Medicaid. Given the growing population of cancer survivors and increased emphasis on primary care MH, more research is needed to explore how medical homes can enhance and ensure the provision of guideline-recommended care during cancer survivorship.

scholarly journals Virtual care for prostate cancer survivorship: protocol for an evaluation of a nurse-led algorithm-enhanced virtual clinic implemented at five cancer centres across Canada

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045806
Author(s):  
Quynh Pham ◽  
Jason Hearn ◽  
Jacqueline L Bender ◽  
Alejando Berlin ◽  
Ian Brown ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Survivorship ◽  
Site Specific ◽  
Virtual Care ◽  
Follow Up Care ◽  
Specific Implementation ◽  
Triage Algorithm ◽  
The Impact ◽  
Virtual Clinic

IntroductionProstate cancer (PCa) is the most common cancer in Canadian men. Current models of survivorship care are no longer adequate to address the chronic and complex survivorship needs of patients today. Virtual care models for cancer survivorship have recently been associated with comparable clinical outcomes and lower costs to traditional follow-up care, with patients favouring off-site and on-demand visits. Building on their viability, our research group conceived the Ned Clinic—a virtual PCa survivorship model that provides patients with access to lab results, collects patient-reported outcomes, alerts clinicians to emerging issues, and promotes patient self-care. Despite the promise of the Ned Clinic, the model remains limited by its dependence on oncology specialists, lack of an autonomous triage algorithm, and has only been implemented among PCa survivors living in Ontario.Methods and analysisOur programme of research comprises two main research objectives: (1) to evaluate the process and cost of implementing and sustaining five nurse-led virtual PCa survivorship clinics in three provinces across Canada and identify barriers and facilitators to implementation success and (2) to assess the impact of these virtual clinics on implementation and effectiveness outcomes of enrolled PCa survivors. The design phase will involve developing an autonomous triage algorithm and redesigning the Ned Clinic towards a nurse-led service model. Site-specific implementation plans will be developed to deploy a localised nurse-led virtual clinic at each centre. Effectiveness will be evaluated using a historical control study comparing the survivorship outcomes of 300 PCa survivors enrolled in the Ned Clinic with 300 PCa survivors receiving traditional follow-up care.Ethics and disseminationAppropriate site-specific ethics approval will be secured prior to each research phase. Knowledge translation efforts will include diffusion, dissemination, and application approaches to ensure that knowledge is translated to both academic and lay audiences.

Patient experiences and preferences for survivorship care.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 110-110
Author(s):  
Kelly Westbrook Mitchell ◽  
Kevin Houck ◽  
Gretchen Genevieve Kimmick ◽  
Kathy J. Trotter ◽  
Jeffrey M. Peppercorn
Keyword(s):  
Breast Cancer ◽  
Cancer Survivorship ◽  
Breast Cancer Survivors ◽  
Care Plan ◽  
Survivorship Care ◽  
Optimal Method ◽  
Follow Up Care ◽  
Cancer Specialist ◽  
White Patients

110 Background: The optimal method for delivery of care to over 2 million breast cancer survivors in the U.S. remains unclear, with multiple models currently in practice. This study involved a patient-centered investigation of experiences and preferences for breast cancer survivorship care. Methods: We conducted a single-institution, cross-sectional, self-administered survey of needs, experiences, and interests following initial breast cancer care at an academic multidisciplinary breast clinic. For 4 weeks, all patients presenting for routine oncology care were provided a survey at appointment check-in. Analysis is descriptive, with chi square testing used to evaluate demographic correlates of response. Results: 612 surveys were distributed, with a response rate of 66.8%. Median age of respondents was 56 (range 26-93); 71% were white, and 18% identified themselves as black. Over 55% had a college degree. Regarding ongoing care, 63% preferred to see a cancer specialist at least annually, and 30% wanted access to a cancer specialist as needed. Less than 15% preferred referral to a local practice, and less than 15% favored follow-up care from a specialized cancer survivorship clinic. Regarding visit content, over 90% felt assessment for disease recurrence was a priority on follow-up. A majority were interested in emotional and psychological support (52%). Nearly 40% of patients felt that assistance with non-cancer related health issues was very important in oncology clinic follow-up, but only 25% wanted a cancer specialist to provide general medical care. 42% reported receiving a summary of their cancer treatment. 37% reported receiving awritten plan or list of recommendations regarding care needed as a cancer survivor. White patients were less likely than non-white patients to receive a treatment summary (p < 0.02) or a care plan (p<0.005). Age and education were not correlated with receipt of these materials. Conclusions: Patients’ experiences and preferences regarding long-term management of breast cancer are varied. Many patients desire ongoing follow-up with their primary oncology team. Further evaluation of patients’ goals, needs, and an evidence-based approach to follow-up care is needed to guide optimal program design.

Breast cancer survivorship: A model for risk assessment and follow-up care.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e21576-e21576
Author(s):  
Jodie Ann Barr ◽  
Anne O'Dea ◽  
Lori Ranallo ◽  
Carol J. Fabian ◽  
Jennifer R. Klemp
Keyword(s):  
Breast Cancer ◽  
Risk Assessment ◽  
Cancer Survivorship ◽  
Breast Cancer Survivorship ◽  
Follow Up Care

Looking Beyond Survival: How Are We Looking at Survivorship?

2006 ◽  
Vol 24 (32) ◽  
pp. 5166-5169 ◽  
Author(s):  
Eva Grunfeld
Keyword(s):  
Cancer Survivorship ◽  
Cancer Care ◽  
Cancer Survival ◽  
Control Strategies ◽  
Cancer Control ◽  
International Perspective ◽  
Access To Treatment ◽  
Follow Up Care

Background The prevalence of cancer survivors is increasing worldwide. This creates the imperative to look beyond cancer survival to cancer survivorship. This review explores cancer survivorship from an international perspective in two ways: from a cancer control perspective through a review of cancer control strategies and from a cancer care perspective through a review of clinical practice guidelines and research on cancer follow-up care. Results Many national cancer control strategies or cancer charities consider survivorship obliquely, primarily under the umbrellas of quality of life and rehabilitation. Few have well-developed policies or plans specifically directed at survivorship. Cancer follow-up care is recognized internationally as a pressing health care issue. Many countries have tested new and innovative models to deliver follow-up care. Similarly, many countries have developed guidelines that specifically address follow-up care. Few studies or guidelines address the broader, multifaceted aspects of cancer survivorship. Discussion This review suggests that research and recognition of cancer survivorship as a unique phase of the cancer care trajectory need to be improved. In many of the poorer countries of the world, the imperative remains the basics of cancer care: timely diagnosis, access to treatment, and alleviation of suffering.

Associations Among Cancer Survivorship Discussions, Patient and Physician Expectations, and Receipt of Follow-Up Care

2010 ◽  
Vol 28 (15) ◽  
pp. 2577-2583 ◽  
Author(s):  
Winson Y. Cheung ◽  
Bridget A. Neville ◽  
Craig C. Earle
Keyword(s):  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Primary Care Providers ◽  
Survivorship Care ◽  
Care Providers ◽  
Follow Up Care ◽  
Physical Examinations ◽  
Survivorship Care Planning ◽  
Influenza Vaccinations

Purpose To explore the associations among cancer survivorship discussions, patient-physician expectations, and receipt of follow-up care in cancer survivors. Patients and Methods We surveyed cancer survivors about various aspects of their care, including expectations of their providers' roles, whether discussions with a physician had occurred, and self-reported patterns of follow-up. Primary care providers (PCPs) and oncologists were also surveyed for their own perceived roles. We developed a scoring system to evaluate the level of agreement in expectations between patients and physicians and between PCPs and oncologists (where 0 = most discordant and 4 = most concordant). Regression and stratified analyses were conducted to examine the relationships among expectations, discussions, and follow-up. Results In total, 535 patients (54%) and 378 physicians (62%) responded. Survivorship care expectations were most discrepant between PCPs and oncologists (mean score, 1.78), moderate between patients and oncologists (mean score, 1.97), and most similar between patients and PCPs (mean score, 2.82). Having a conversation specifically about cancer follow-up was associated with better concordance between patients and oncologists, but not for patients and their PCPs or between physicians. Better concordance in patient-oncologist expectations also correlated with greater odds of receiving certain aspects of follow-up care, such as influenza vaccinations and physical examinations, but only if a discussion about cancer follow-up had occurred. Conclusion A discussion about cancer follow-up may affect survivorship care through its primary influence on patient-oncologist expectations. Further work is required to clarify the aspects of survivorship discussions that are important for optimal cancer survivorship care planning.

scholarly journals Development and usability testing of the e‐EXCELS tool to guide cancer survivorship follow‐up care

2019 ◽  
Vol 29 (1) ◽  
pp. 123-131 ◽  
Author(s):  
Denalee M. O'Malley ◽  
Stacy N. Davis ◽  
Katie A. Devine ◽  
Brittany Sullivan ◽  
Alicja Bator ◽  
...  
Keyword(s):  
Cancer Survivorship ◽  
Usability Testing ◽  
Follow Up Care
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