Randomized trial assessing the impact of survivorship care plans on the quality of care for childhood cancer survivors.

Background Breast cancer is the most common form of cancer among American women, accounting for 23% of all cancer survivors nationally. Yet, the availability of adequate resources and tools for supporting breast cancer survivors has not kept up with the rapid advancement in treatment options, resulting in unmet supportive care needs, particularly among low-income and minority populations. This study explores an alternative means of delivering breast cancer survivorship care plans (SCPs), with the aim of improving survivor morbidity, patient knowledge, and self-management of treatment-related symptoms, as well as addressing inconsistencies in follow-up care visits. Objective The overall goal of this study is to improve the uptake of SCP recommendations via an educational intervention for breast cancer survivors, to improve treatment-related morbidity, patient knowledge, self-management, and adherence to follow-up visits. The specific aims of the study are to (1) evaluate the feasibility of the online SCP, and (2) assess the impact of the online SCP on survivorship outcomes. Methods We will enroll 50 breast cancer survivors who have completed initial breast cancer treatment into a 2-armed, randomized, waitlist-controlled pilot trial, and collect data at baseline and 6 months. For the first aim, we will use mixed methods, including surveys and personal interviews among the intervention group, to determine the feasibility of providing an online, interactive SCP (called ACESO) based on the survivors’ online user experience and their short-term adoption. For the secondary aim, we will compare the 2 groups to assess the primary outcomes of survivor knowledge, self-efficacy for self-management, perceived peer support, and adherence to SCP-recommended posttreatment follow-up visits to oncology and primary care; and the secondary outcomes of treatment-related morbidity (body weight, fatigue, depression, anxiety, sexual function, distress, and sleep quality). We assess these outcomes by using measurements from validated instruments with robust psychometric properties. Results We have developed and refined the online breast cancer survivorship plan, ACESO, with consultation from breast cancer oncologists, nurses, and survivors. Approval for the study protocol has been obtained from the Institutional Review Board. An advisory board has also been established to provide oversight and recommendations on the conduct of the study. The study will be completed over a period of 2 years. Conclusions The results of this pilot study will inform the feasibility and design of a larger-scale pragmatic trial to evaluate the impact of an online breast cancer SCP on treatment-related morbidity and self-efficacy for self-management. International Registered Report Identifier (IRRID) PRR1-10.2196/23414

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Accelerated Aging among Cancer Survivors: From Pediatrics to Geriatrics

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2014.34.e423 ◽

2014 ◽

pp. e423-e430 ◽

Cited By ~ 50

Author(s):

Tara O. Henderson ◽

Kirsten K. Ness ◽

Harvey Jay Cohen

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Aging Process ◽

Intervention Studies ◽

Accelerated Aging ◽

Childhood Cancer Survivors ◽

The United States ◽

Care Plans ◽

The Impact ◽

Multiple Morbidities

There are almost 14-million cancer survivors in the United States and the population is growing. Almost two-thirds of these survivors are age 65 or older. Given this, it is imperative to understand the impact of cancer and its therapies on the aging process. Childhood cancer survivors, diagnosed with cancer at age 21 or younger, particularly females, have rates of frailty similar to rates in older adults. This phenomenon appears to start early, suggesting an aging phenotype. Frailty among childhood cancer survivors increases risk for chronic disease and mortality. Adults diagnosed with cancer are faced with the effects of cancer and its therapies compounded by the issues of multiple morbidities that occur with the typical aging process. Intervention studies to date have focused on smoking cessation, diet, and exercise, as well as improving rates of late effects surveillance in childhood cancer survivors. No intervention studies have specifically addressed the issue of frailty or multiple morbidities in cancer survivors. Concerted efforts must continue to create and disseminate survivorship care plans to all cancer survivors.

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Enhancing Research on Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2006.06.7207 ◽

2006 ◽

Vol 24 (32) ◽

pp. 5149-5153 ◽

Cited By ~ 57

Author(s):

John Z. Ayanian ◽

Paul B. Jacobsen

Keyword(s):

Quality Of Life ◽

Quality Of Care ◽

Cancer Survivors ◽

Cancer Registries ◽

The United States ◽

Institute Of Medicine ◽

Survivorship Care ◽

Care Plans ◽

And Performance

The United States devotes substantial resources to understanding the etiologies of cancer and improving treatments, but much less research has focused on the needs of cancer survivors after they have completed active treatment. This article augments findings from the Institute of Medicine about cancer survivorship research and ways to enhance quality of life and quality of care. Studies of cancer survivors should focus on mechanisms and risk factors for impaired quality of life and evaluate interventions to improve this domain. Research to improve quality of care should concentrate on survivorship care plans, surveillance tests, respective roles of primary and specialty care, and performance measures related to survivorship care. Opportunities to expand research on cancer survivors include clinical trials, large cohort studies, cancer registries, and national surveys. Research to understand the needs of cancer survivors will provide a foundation for effective programs to meet these needs.

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Exploring Interactive Survivorship Care Plans to Support Breast Cancer Survivors: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.23414 ◽

2020 ◽

Author(s):

Akshat Kapoor ◽

Priya Nambisan

Keyword(s):

Breast Cancer ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Self Management ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Breast Cancer Survivorship ◽

Care Plans ◽

The Impact

BACKGROUND Breast cancer is the most common form of cancer among American women, accounting for 23% of all cancer survivors nationally. Yet, the availability of adequate resources and tools for supporting breast cancer survivors has not kept up with the rapid advancement in treatment options, resulting in unmet supportive care needs, particularly among low-income and minority populations. This study explores an alternative means of delivering breast cancer survivorship care plans (SCPs), with the aim of improving survivor morbidity, patient knowledge, and self-management of treatment-related symptoms, as well as addressing inconsistencies in follow-up care visits. OBJECTIVE The overall goal of this study is to improve the uptake of SCP recommendations via an educational intervention for breast cancer survivors, to improve treatment-related morbidity, patient knowledge, self-management, and adherence to follow-up visits. The specific aims of the study are to (1) evaluate the feasibility of the online SCP, and (2) assess the impact of the online SCP on survivorship outcomes. METHODS We will enroll 50 breast cancer survivors who have completed initial breast cancer treatment into a 2-armed, randomized, waitlist-controlled pilot trial, and collect data at baseline and 6 months. For the first aim, we will use mixed methods, including surveys and personal interviews among the intervention group, to determine the feasibility of providing an online, interactive SCP (called ACESO) based on the survivors’ online user experience and their short-term adoption. For the secondary aim, we will compare the 2 groups to assess the primary outcomes of survivor knowledge, self-efficacy for self-management, perceived peer support, and adherence to SCP-recommended posttreatment follow-up visits to oncology and primary care; and the secondary outcomes of treatment-related morbidity (body weight, fatigue, depression, anxiety, sexual function, distress, and sleep quality). We assess these outcomes by using measurements from validated instruments with robust psychometric properties. RESULTS We have developed and refined the online breast cancer survivorship plan, ACESO, with consultation from breast cancer oncologists, nurses, and survivors. Approval for the study protocol has been obtained from the Institutional Review Board. An advisory board has also been established to provide oversight and recommendations on the conduct of the study. The study will be completed over a period of 2 years. CONCLUSIONS The results of this pilot study will inform the feasibility and design of a larger-scale pragmatic trial to evaluate the impact of an online breast cancer SCP on treatment-related morbidity and self-efficacy for self-management. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/23414

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Quality of Care, Including Survivorship Care Plans

Improving Outcomes for Breast Cancer Survivors - Advances in Experimental Medicine and Biology ◽

10.1007/978-3-319-16366-6_17 ◽

2015 ◽

pp. 255-269 ◽

Cited By ~ 4

Author(s):

Dawn L. Hershman ◽

Patricia A. Ganz

Keyword(s):

Quality Of Care ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans

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Survivorship Care Plans and Telehealth Education for the Improvement of Access to Cancer Survivorship, the IMPACT Study

Case Medical Research ◽

10.31525/ct1-nct04081779 ◽

2019 ◽

Author(s):

Keyword(s):

Cancer Survivorship ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Impact Study ◽

Care Plans ◽

The Impact

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Exploring the impact of pharmacist comprehensive annual care plans on perceived quality of chronic illness care by patients in Alberta, Canada

Canadian Pharmacists Journal / Revue des Pharmaciens du Canada ◽

10.1177/17151635211020340 ◽

2021 ◽

pp. 171516352110203

Author(s):

Candace Necyk ◽

Jeffrey A. Johnson ◽

Ross T. Tsuyuki ◽

Dean T. Eurich

Keyword(s):

Quality Of Care ◽

Chronic Illness ◽

Care Plan ◽

Short Version ◽

Chronic Illness Care ◽

Online Questionnaire ◽

Care Plans ◽

Funding Program ◽

The Impact

Background: In 2012, the Government of Alberta introduced a funding program to remunerate pharmacists to develop a comprehensive annual care plan (CACP) for patients with complex needs. The objective of this study is to explore patients’ perceptions of the care they received through the pharmacist CACP program in Alberta. Methods: We invited 3442 patients who received a pharmacist-billed CACP within the previous 3 months and 6888 matched controls across Alberta to complete an online questionnaire. The questionnaire consisted of the short version Patient Assessment of Chronic Illness Care (PACIC-11), with 3 additional pharmacy-specific assessment questions added. Additional questions related to health status and demographics were also included. Results: Overall, most patients indicated a low level of chronic illness care by pharmacists, with few differences noted between CACP patients and non-CACP controls. Of note, controls reported higher quality of care for 5 domains within the adapted PACIC-like tool compared with CACP patients ( p < 0.05 for all). Interestingly, only 79 (44%) of CACP patients reported that they had received a CACP, whereas only 192 (66%) of control patients reported that they did not receive a care plan. In a sensitivity analysis including only these respondents, individuals who received a CACP perceived a significantly higher quality of chronic illness care across all PACIC domains. Conclusion: Overall, chronic illness care incentivized by the pharmacist CACP program in Alberta is perceived to be moderate to low. When limited to respondents who explicitly recognized receiving the service or not, the perceptions of quality of care were more positive. This suggests that better implementation of CACP by pharmacists may be associated with improved quality of care and that some redesign is needed to engage patients more. Can Pharm J (Ott) 2021;154:xx-xx.

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