Assessment of Quality of Cancer-Related Follow-Up Care From the Cancer Survivor's Perspective

Purpose We assessed cancer survivors' perceptions of the quality of their follow-up care. Methods We surveyed a population-based cohort of leukemia, bladder, and colorectal cancer survivors diagnosed 2 to 5 years previously in northern California (N = 623; participation rate, 69.2%; overall response rate, 49.2%). Data were collected between April 2003 and November 2004. Ten scales assessed survivors' perceptions of different aspects of care in the last 12 months, and an eleventh scale measured their overall ratings of care. Results On nine of the 11 scales, mean scores ranged from 88 to 97 on a 0 to 100 response format, indicating very positive experiences. The two areas where quality perceptions were lower were discussions about health promotion and the physician's knowledge of the whole patient. In adjusted analyses, those without private health insurance (P = .02) and Hispanic and Asian survivors compared with whites (P < .001) reported worse timeliness of care. Survivors who had multiple comorbidities reported better scores on timeliness of care (P < .01) and physicians' knowledge (P = .05) than survivors without any comorbidity. Length of the patient-physician relationship was the variable most consistently found to be significantly associated with survivors' quality assessments. Physicians' information exchange had the strongest relationship with overall ratings of care, followed by physicians' affective behavior, their knowledge of the survivor, and survivors' perceptions of coordination of care (P < .001 for all). Conclusion Delivery of quality follow-up care to cancer survivors may require efforts to improve patient-centered communication and coordination. Special emphasis may need to be placed on health promotion discussions and adoption of a whole-person orientation.

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Quality of Patient-Provider Communication Among Cancer Survivors: Findings From a Nationally Representative Sample

Journal of Oncology Practice ◽

10.1200/jop.2015.006999 ◽

2016 ◽

Vol 12 (12) ◽

pp. e964-e973 ◽

Cited By ~ 15

Author(s):

Neetu Chawla ◽

Danielle Blanch-Hartigan ◽

Katherine S. Virgo ◽

Donatus U. Ekwueme ◽

Xuesong Han ◽

...

Keyword(s):

Cancer Survivors ◽

Social Needs ◽

Provider Communication ◽

Communication Quality ◽

Follow Up Care ◽

Patient Provider Communication ◽

Lifestyle Recommendations

Purpose: Although patient-provider communication is an essential component of health care delivery, little is known about the quality of these discussions among patients with cancer. Methods: Data are from the 2011 Medical Expenditure Panel Survey Experiences with Cancer survey among 1,202 adult cancer survivors. We evaluated discussions with any provider after a cancer diagnosis about: (1) follow-up care; (2) late or long-term treatment effects; (3) lifestyle recommendations, such as diet, exercise, and quitting smoking; and (4) emotional or social needs. Using a response scale ranging from “did not discuss” to “discussed in detail,” a summary score was constructed to define communication quality as high, medium, or low. Patient factors associated with the quality of provider discussions were examined using multivariable polytomous logistic regression analyses. Results: At the time of the survey, approximately one half of the patients (46%) were either within 1 year (24.1%) or between 1 and 5 years (22.0%) of treatment. More than one third of cancer survivors reported that they did not receive detailed communication about follow-up care, and more than one half reported that they did not receive detailed communication regarding late or long-term effects, lifestyle recommendations, or emotional and social needs. Only 24% reported high-quality communication for all four elements, indicating that the vast majority experienced suboptimal communication. In multivariable analysis, survivors reporting a high communication quality with providers included those who were within 1 year of treatment, between the ages of 18 and 64 years, non-Hispanic black or other ethnicity, and married. Conclusion: Study findings demonstrate gaps in the communication quality experienced by cancer survivors in the United States and help identify survivors for targeted interventions.

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Quality of cancer follow-up care: a focus on Latina breast cancer survivors

Journal of Cancer Survivorship ◽

10.1007/s11764-014-0343-9 ◽

2014 ◽

Vol 8 (3) ◽

pp. 364-371 ◽

Cited By ~ 7

Author(s):

Monica Rosales ◽

Kimlin Ashing ◽

Anna Napoles

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Follow Up Care

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Physical activity, ethnicity, and quality of life among breast cancer survivors and population-based controls: the long-term quality of life follow-up study

Breast Cancer Research and Treatment ◽

10.1007/s10549-021-06261-0 ◽

2021 ◽

Author(s):

Kate E. Dibble ◽

Richard N. Baumgartner ◽

Stephanie D. Boone ◽

Kathy B. Baumgartner ◽

Avonne E. Connor

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Physical Activity ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Population Based ◽

Follow Up Study

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Patients’ perspective on the quality of prostate cancer follow-up care.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.175 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 175-175

Author(s):

Barbara M. Wollersheim ◽

Henk G. van der Poel ◽

Kristel M. van Asselt ◽

Floris J. Pos ◽

Emine Akdemir ◽

...

Keyword(s):

Prostate Cancer ◽

Health Promotion ◽

Cancer Patients ◽

Symptom Management ◽

Background Information ◽

Survivorship Care ◽

Follow Up Care ◽

Patients Perspective

175 Background: Information about prostate cancer patients’ perspective on the quality of their follow-up care in the hospital is important to optimize survivorship care. This study assessed the quality of prostate cancer follow-up care as experienced by cancer patients and its association with patients’ sociodemographic and clinical characteristics, and treatment-related symptom burden. Methods: We surveyed 385 (response rate, 100%) patients with localized prostate cancer participating in a randomized controlled trial comparing the (cost)effectiveness of specialist- versus primary care-based prostate cancer follow-up. For this study, we used baseline data that were collected during patients’ first follow-up visit at the hospital (2-34 weeks) after primary treatment (radical prostatectomy or radiotherapy) prior to randomization. We assessed patients’ ratings of the quality of follow-up care using the Assessment of Patient Experiences of Cancer Care survey. This survey consists of thirteen scales: getting needed care, timeliness of care, waiting time in physician’s office, information exchange, physician’s affective behavior, physicians’ knowledge about patients’ life, interaction with nurses, interaction with office staff, symptom management, symptom information provision, health promotion, coordination of care, and overall rating of care. Logistic regression analysis was used to identify factors associated with perceived quality of follow-up care. Results: Patients reported positive experiences with follow-up care for 10 of 13 scales, with mean scores ranging from 72 to 97 (on a 0-100 response scale). The three scales where patients reported suboptimal follow-up care were symptom management (mean score of 43), health promotion (mean score of 45), and physicians’ knowledge about patients’ life (mean score of 66). Overall, patients’ report of suboptimal quality of follow-up care was associated significantly with being more highly educated, not having a partner, being older, having multiple comorbidities, and experiencing symptoms (urinary, bowel, and hormonal symptoms). Conclusions: Prostate cancer patients were generally positive about their initial, hospital-based follow-up care after primary surgery or radiation. However, physicians’ knowledge about patients’ lives, symptom management, and health promotion was rated as suboptimal. The findings point to areas where prostate cancer survivorship care can be improved.

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Developing a cultural and socioecological patient-centered survivorship care plan template for African American survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.34_suppl.40 ◽

2012 ◽

Vol 30 (34_suppl) ◽

pp. 40-40

Author(s):

Kimlin T. Ashing-Giwa ◽

Carlyn Tapp ◽

Shirley Brown ◽

June Smith ◽

Eudora Mitchell ◽

...

Keyword(s):

African American ◽

Cancer Survivors ◽

Medical Care ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Patient Centered ◽

Community Based ◽

Follow Up Care

40 Background: Cancer and its treatments bring added health and life challenges. Cancer survivors require ongoing surveillance and medical care. To facilitate best practice in follow-up care, the Institute of Medicine, the American Society of Clinical Oncology and advocacy organizations advise that cancer survivors be provided with treatment summaries and Survivorship Care Plan (SCP). African-American breast cancer survivors (AABCS) have poorer outcomes characterized by greater morbidity and mortality, hence warranting their careful surveillance and follow-up medical care. SCP investigations are urgently needed to improve follow-up care and cancer outcomes in AABCS. Methods: The study embraced a community-based participatory research framework, building upon a series of research projects conducted by the African American Cancer Coalition, a partnership of scientific researchers and community-based advocates. Three informative focus groups were conducted with AABCS (N=25) and advocates (N=3) to obtain input on cultural and socio-ecological SCP contents to increase patient responsiveness. Results: AABCS believed that increased mortality may be due to comorbidities and inadequate surveillance and follow-up care. Participants recommended that the SCP attend to and document all comorbidities and medications; allow for participation of primary care providers; referrals for providers especially surgeons who are familiar with treating AABCS to the reduce keloid, and health advisories on nutrition, exercise and stress management. Quality-of-life related components and community referrals should be included because they are important for overall health. AABCS noted the importance of spirituality in life, and the disproportionately high levels of socioecological stress in the community. Conclusions: Participants infused cultural and socioecologic relevance towards the development of a patient centered SCP template to increase acceptability and utilization among AABCS. Participants underscored that developing the SCP responsive to AABCS and facilitating adherence to SCP recommendations, are areas warranting increased intervention and research.

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Communication with cancer survivors: Disparities by education level but not race in a majority-minority community

10.21203/rs.3.rs-1054249/v1 ◽

2021 ◽

Author(s):

Marci Chock ◽

Sharon Tamashiro ◽

Kristy Fujinaga ◽

Ryon Nakasone ◽

Jared Acoba

Keyword(s):

High School ◽

Cancer Survivors ◽

Education Level ◽

Response Scale ◽

Optimal Care ◽

Race And Education ◽

Follow Up Care ◽

The Impact

Abstract Purpose Patient-provider communication (PPC) is an important component of optimal patient care. Many factors influence the quality of PPC among cancer patients, however, there are conflicting data on the impact of patient race and education level on PPC. We sought to assess the effect of race and education level on PPC among a multiracial cohort of cancer survivors. Methods We conducted a survey of 360 cancer survivors. Data were collected on age, race, income, and education level. The survey assessed satisfaction with PPC and follow-up with cancer physician. Questions were answered on a 5-point response scale. We evaluated PPC using nonparametric analyses and built logistic regression models for satisfaction with follow-up care. Results Patients with a high school or lower education consistently rated questions of PPC more poorly than those who attained a higher level of education. No significant associations were detected between PPC and race. Results for perceived quality of care showed a similar disparity by education level. High school educated patients reported significantly lower satisfaction with quality of follow-up care compared with patients who attained Graduate level education (OR 3.50, 95% CI 1.37-8.94). Conclusion Our study demonstrated that education level, but not race, is associated with perception of communication and satisfaction with follow-up care. Patients who attained higher levels of education had higher PPC ratings and satisfaction with follow-up care. Our findings identify an opportunity for improvement in PPC through individualizing the delivery of health-related information with the goal of achieving optimal care of long-term cancer survivors.

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Breast and prostate cancer survivors’ experiences of patient-centered cancer follow-up care from primary care physicians and oncologists

Journal of Cancer Survivorship ◽

10.1007/s11764-016-0537-4 ◽

2016 ◽

Vol 10 (5) ◽

pp. 906-914 ◽

Cited By ~ 12

Author(s):

Shawna V. Hudson ◽

Pamela A Ohman-Strickland ◽

Alicja Bator ◽

Denalee O’Malley ◽

Daniel Gundersen ◽

...

Keyword(s):

Prostate Cancer ◽

Primary Care ◽

Cancer Survivors ◽

Primary Care Physicians ◽

Patient Centered ◽

Prostate Cancer Survivors ◽

Follow Up Care ◽

Breast And Prostate Cancer

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Quality of care indicators and their related outcomes: A population-based study in prostate cancer patients treated with radical prostatectomy

Canadian Urological Association Journal ◽

10.5489/cuaj.1649 ◽

2014 ◽

Vol 8 (7-8) ◽

pp. 572 ◽

Cited By ~ 1

Author(s):

Colleen Webber ◽

David Robert Siemens ◽

Michael Brundage ◽

Patti A Groome

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Quality Indicators ◽

Hospital Volume ◽

A Priori ◽

Population Based ◽

Follow Up Care ◽

Cause Specific Survival

Introduction: We evaluated the validity of 8 quality of care indicators for prostate cancer patients treated curatively with radical prostatectomy (RP) by examining their association with indicator relevant outcomes.Methods: We conducted a population-based retrospective cohort study of 646 prostate cancer patients diagnosed between 1990 and 1998 who received RP within 6 months of diagnosis. Data were collected from treating charts and linked to registry and administrative data. Quality indicators included: hospital volume, pre-treatment risk assessment, consultation with a radiation oncologist, appropriate follow-up care, nerve-sparing surgery, units of blood transfused, surgical margin status, and pelvic lymph node dissection during RP. Indicator-relevant outcomes were selected a priori by clinical members of the research team. The associations between indicators and their relevant outcomes were analyzed using regression techniques, to control for potential confounders.Results: Of the quality indicators evaluated, only hospital volume was statistically significantly associated with the gradient in the expected direction. Patients treated in the lowest-volume hospitals (<1 RP/month) had lower cause-specific survival rates compared to patients treated in the highest-volume hospitals (≥7 RP/month) (HR=4.71 95%; CI 1.06-20.82). Completeness of follow-up care was associated with cause-specific survival but in the opposite direction to our hypothesis.Conclusion: The structural indicator of hospital volume was associated with cause-specific survival in accordance with our a priori hypothesis. Our negative findings for completeness of follow-up care call its validity into question. Issues of statistical power and measurement accuracy may have affected our validation of the remaining indicators underscoring the challenges in assessing the impact of accepted quality indicators.

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