Tailored survivorship care plans for head and neck cancer patients.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 51-51
Author(s):  
Andrew L. Salner ◽  
Shrujal S. Baxi ◽  
Elizabeth Fortier ◽  
Talya Salz
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Primary Care Providers ◽  
Cancer Surveillance ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Providers ◽  
Care Plans ◽  
Patient Reported

51 Background: Survivorship care plans SCPs typically include generic advice for cancer surveillance, management of late effects (LEs), wellness recommendations (WRs), and cancer screening. We developed a platform called HN-STAR that uses electronic patient-reported outcomes (ePROs) and evidence-based management guidelines to generate tailored SCPs for head and neck cancer survivors (HNCSs), a population particularly vulnerable to various LEs. We surveyed HNCSs and their primary care providers (PCPs) regarding the SCP to assess its acceptability and usefulness. Methods: HNCSs at 2 cancer hospitals used HN-STAR. Prior to a routine clinic visit, HNCSs used a validated ePRO measure (PRO-CTCAE) to report 22 physical LEs and other measures to assess wellness. Based on the visit discussion, HN-STAR generated an SCP that included a treatment summary, WRs, and LE management plans. HNCSs indicated their perceptions of the SCP and intentions to adhere to WR and LE management recommendations. PCPs reported on the SCP utility and their comfort in managing WRs and LEs. Results: 47 HNCSs completed surveys (mean 5.4 yrs. from treatment completion). Most were white (89%), male (85%), had an oropharynx tumor (58%), and received multimodality therapy (81%). 51% experienced at least 9 of the 22 LEs in the last month (mean 8.2/person). 91% of HNCSs felt the SCP was easy to follow. 98% intended to follow recommendations for LEs management and 98% reported they would refer back to the SCP. 87% said they plan to share the SCP with a PCP. 23 PCPs completed the survey. 95% were satisfied with the SCP and 95% reported they would like to have one for every cancer patient. PCPs expressed varying levels of comfort in managing specific LEs of head and neck cancer (30-80%). Conclusions: Among HNCSs, an automatically generated SCP that was tailored to their WRs and LEs was acceptable, was trusted, and provided recommendations they intended to follow. PCPs found the SCP useful, and SCPs may help improve their comfort with LE management. Patient-centered SCPs that focus on existing LEs hold promise as a means to help survivors and PCPs manage survivorship issues.

Survivorship needs after head and neck cancer treatment.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10062-10062
Author(s):  
Callie Berkowitz ◽  
Deborah H. Allen ◽  
Jennifer Tenhover ◽  
Leah L. Zullig ◽  
Jonathan E. Fischer ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Head And Neck Cancer ◽  
Cancer Treatment ◽  
Head And Neck ◽  
Neck Cancer ◽  
Primary Care Providers ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

10062 Background: Head and neck cancer (HNC) survivors experience significant sequelae of treatment, including long-term physical side effects and ongoing surveillance for recurrence and secondary malignancy. Given the complicated trajectory of HNC survivors, survivorship care plans educating patients and their caregivers about treatment and recovery may be beneficial. However, little is known about patients’ knowledge gaps related to survivor issues. Methods: Through a prospective anonymous self-administered survey, we evaluated the baseline knowledge of HNC survivors regarding common post-treatment issues and mediating factors. Forty-one HNC patients within 3 months of completing treatment participated between July-November 2016. Descriptive statistics were used to characterize patient responses. Results: Patients had undergone a variety of treatment modalities: radiation (97%), chemotherapy (71%), and surgery (39%). 85% of patients had primary care providers, 56% had regular dental care, and 44% had dental insurance. 78% had caregivers. HNC survivors’ correct responses to side-effect (SE) knowledge questions were lowest for items regarding hearing loss (15%), sleep (33%), tiredness (38%), and anxiety (49%). Only 28% correctly identified cancer risk with alcohol intake. 87% correctly linked tobacco products to cancer recurrence. Patients were most interested in learning via discussions with nurse or doctor (76%) followed by reading written materials (61%), and researching online (32%). Most patients desired to learn more about their cancer (73%), short-term SE (80%), and long-term SE (77%). Conclusions: Our study demonstrated clear gaps in knowledge and healthcare access that may inform targeted, individualized survivorship care plans. Patients had the largest knowledge deficits for alcohol use and recurrence, hearing loss after treatment, and a variety of emotional effects of cancer treatment. These topics should be addressed during delivery of survivorship care plans and surveillance encounters to improve survivorship knowledge.

Survivor feedback on a late effects-oriented survivorship care plan for head and neck cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21596-e21596
Author(s):  
Talya Salz ◽  
Mary S. McCabe ◽  
Kevin C. Oeffinger ◽  
Rebecca B Schnall ◽  
Stacie Corcoran ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Late Effects ◽  
Clinic Visit ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Plans ◽  
Patient Reported

e21596 Background: Survivorship care plans (SCPs) typically include generic advice for the management of late effects (LEs) that can occur, rather than addressing LEs that the survivor actually has. We developed a platform called HN-STAR that uses electronic patient-reported outcomes (ePROs) and evidence-based LE management to generate a personalized SCP for survivors of head and neck cancer (HNC), a population vulnerable to various LEs. We assessed HNC survivors’ experiences with HN-STAR to ensure its acceptability and usefulness. Methods: Disease-free HNC survivors at two cancer hospitals used HN-STAR in conjunction with a routine survivorship visit. Prior to the visit, survivors used a validated ePRO measure (PRO-CTCAE) to report up to 22 physical LEs. Based on clinic visit discussions, HN-STAR generated an SCP that included a treatment summary and LE management plans. Survivors indicated their level of agreement to statements regarding the ease of use of the ePROs, content of the SCP, and intentions to adhere to LE management recommendations. Results: 47 survivors completed surveys (mean 5.4 years from treatment completion). Most were white (89%), male (85%), had an oropharynx tumor (58%), and received multimodality therapy (81%). More than half (51%) experienced at least 9 of the 22 LEs in the last 30 days (mean 8.2 per person). Most survivors reported that completing ePROs improved the discussions with their provider (98%), the quality of their care (96%), and their communication with their provider (98%). 91% agreed the SCP was the right length, and 98% agreed it was easy to follow. 98% intended to follow at least some of the recommendations for LEs management, and 98% reported feeling confident that they could follow the recommendations. The majority agreed that the SCP accurately summarized the clinic visit (98%), they would refer back to the SCP (98%), they trust the SCP (100%), and they plan to share the SCP with a primary care provider (87%). Conclusions: Among HNC survivors, an automatically generated SCP that was tailored to their LEs was acceptable, was trusted, and provided recommendations they intended to follow. Patient-centered SCPs that focus on existing LEs hold promise as a means to help survivors manage LEs.

Utility of standardized letters in assisting primary care providers (PCPs) with the care of cancer survivors (CS).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9593-9593
Author(s):  
Ali Moghaddamjou ◽  
Caroline Speers ◽  
Winson Y. Cheung
Keyword(s):  
Regression Models ◽  
Primary Care Providers ◽  
Cancer Surveillance ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Providers ◽  
Care Plans ◽  
Faculty Appointment ◽  
Essential Components

9593 Background: Survivorship care plans have strong face validity, but individualizing plans to each patient’s needs can be resource intensive. At our institution, a 1-page standardized letter that outlines the essential components of follow-up care is mailed to PCPs at the time of a patient’s discharge. This letter highlights the recommended frequency and interval of tests and physician visits. Our study aims were to 1) characterize PCPs’ attitudes regarding these letters and 2) identify potential strategies to improve this channel of communication with PCPs. Methods: Self-administered surveys were mailed to high-volume PCPs in British Columbia, defined as those whose practices followed >/=5 breast or colorectal CS in the preceding year. The survey asked about practice characteristics and PCPs’ views towards the content and format of these standardized letters. Logistic regression models were constructed to delineate factors associated with follow-up preferences. Results: Among 787 PCPs, 507 (64%) responded: median year since graduation was 27 (range 1-62), 67% were men, 38% had a faculty appointment, 71% practiced in a group, and 92% were paid fee-for-service. When asked about their perspectives regarding the care of CS, 388 (77%) indicated they were comfortable providing follow-up with 299 (74%) reporting that the standardized letter contained adequate information. In regression models, PCPs who were comfortable with cancer surveillance and those who graduated greater than 30 years ago were more likely to view the standardized letter as useful (OR 2.50, 95% CI 1.41-4.43 and OR 2.31, 95% CI 1.24-4.33, respectively) and important (OR 4.07, 95% CI 1.80-9.19 and OR 3.14, 95% CI 1.01-9.74, respectively). Among 103 (26%) PCPs who found the letter to be insufficient, most wanted additional details about the cancer diagnosis (88%), specific information on the toxicities of therapy (88%), and the estimated risk of recurrence (84%). Conclusions: Most PCPS were satisfied with a simple, standardized letter that outlines the necessary components of cancer follow-up. PCPs with less familiarity with cancer surveillance may be a target group that benefits most from individualized survivorship care plans.

Knowledge and Preferences of Primary Care Providers in Delivering Head and Neck Cancer Survivorship Care

2017 ◽  
Vol 33 (6) ◽  
pp. 1323-1327 ◽  
Author(s):  
Callie Berkowitz ◽  
Deborah H. Allen ◽  
Jennifer Tenhover ◽  
Leah L. Zullig ◽  
John Ragsdale ◽  
...  
Keyword(s):  
Primary Care ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Survivorship ◽  
Neck Cancer ◽  
Primary Care Providers ◽  
Survivorship Care ◽  
Care Providers

scholarly journals Assessing Key Stakeholders’ Knowledge, Needs, and Preferences for Head and Neck Cancer Survivorship Care Plans

2018 ◽  
Vol 34 (3) ◽  
pp. 584-591 ◽  
Author(s):  
Leah L. Zullig ◽  
Katherine Ramos ◽  
Callie Berkowitz ◽  
Julie J. Miller ◽  
Rowena J. Dolor ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Survivorship ◽  
Neck Cancer ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Key Stakeholders

scholarly journals Survivorship Care Plans for Patients With Head and Neck Cancer

2012 ◽  
Vol 138 (12) ◽  
pp. 1116 ◽  
Author(s):  
Bruce H. Campbell ◽  
Becky L. Massey ◽  
Katherine B. Myers
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

Use of online survivorship care plans by young adult cancer survivors: Patient characteristics and patient reported outcomes.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 55-55
Author(s):  
Dava Szalda ◽  
Marilyn M. Schapira ◽  
Linda A. Jacobs ◽  
Carolyn Vachani ◽  
James M. Metz ◽  
...  
Keyword(s):  
Young Adult ◽  
Side Effects ◽  
Patient Reported Outcomes ◽  
Adult Survivors ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Providers ◽  
Care Plans ◽  
Adult Cancer Survivors ◽  
Patient Reported

55 Background: Young adult survivors (YAS) are at risk for side effects of cancer therapy and poor post treatment self-management relative to older adult survivors (AS). Survivorship care plans (SCPs) have proved feasible to provide education on symptom management, but the characteristics of YAS who utilize SCPs and patient-reported outcomes (PROs) of YAS via SCPs remains unstudied. Methods: Patient-reported characteristics and outcomes of YAS, age 18 to 39 years, who used a free online SCP generator (OncoLife), between May 2010 and May 2012 are reported. PROs of YAS were compared to AS, age 40-70 years, via frequencies and chi-squared analyses. PROs were queried upon generation of SCP based on diagnosis and treatments received. Results: YAS (n = 1,445, Mage= 31.5 years) and AS (n = 6301, Mage= 56.3 years) were primarily female (69% vs. 78%), Caucasian (76% vs. 86%) and an average of 2.6 years (range 0-20years) vs. 3.2 years (range 0-46 years) since diagnosis and treatment. Most common diagnoses were breast cancer, testicular cancer, lymphoma, thyroid cancer, and sarcomas in YAS vs. breast, colon, lymphoma, prostate, and lung cancer in AS. Three-quarters (75%) of YAS and 70% of AS generated the SCP themselves with the remaining SCPs generated by health care providers. Less than a quarter (22%) of YAS or AS (18%) reported previously receiving a treatment summary. The most commonly endorsed PROs in YAS and AS were neurocognitive changes and fatigue. Fewer YAS than AS endorsed pulmonary concerns and male sexual side effects. The majority of PROs were reported at similar proportions by YAS and AS (see table). Conclusions: In patients who generated an OncoLife SCP, YAS reported similar rates of treatment-related side effects to those reported by AS demonstrating SCPs as a mechanism to capture and address off-therapy issues for all survivors. [Table: see text]

Serious illness communication among patients with head and neck cancer.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 2-2
Author(s):  
Floyd Buen ◽  
Emily J Martin ◽  
Neil Wenger ◽  
Kirsten Buen ◽  
Anne M. Walling
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Retrospective Analysis ◽  
Neck Cancer ◽  
Medical Records ◽  
Primary Care Providers ◽  
Treatment Preferences ◽  
Care Providers ◽  
Goals Of Care ◽  
Serious Illness

2 Background: Head and neck cancer is associated with significant morbidity and mortality, yet little is known about the frequency and content of discussions addressing patients’ values, goals of care, and treatment preferences. Methods: Using an institutional cancer registry, we conducted a retrospective analysis of 70 decedents who underwent surgical treatment for squamous cell carcinoma of the head and neck. We abstracted patients’ medical records using a standardized template. An independent reviewer re-abstracted 20% of the records. For abstracted data pertaining to documented values, goals of care, and/or treatment preferences our inter-rater reliability was greater than 93%. Results: The mean age at diagnosis was 66 years and 69% were male. An enduring advance directive, a completed Physician Order for Life Sustaining Treatment form, and a serious illness conversation documented in the medical record were noted in 27%, 4%, and 49% of the medical records, respectively. Half of the documented goals of care discussions were held in the inpatient setting, over 50% were held in the last month of life, and 25% were held in the last week of life. These conversations involved specialist palliative care providers (47%), hematologist/oncologists (41%), hospitalists (32%), head and neck surgeons (21%), radiation oncologists (19%), and intensivists (18%). None of these discussions involved patients’ primary care providers. Of those with a known location of death, 58% died in the hospital and 4 out of 5 of these patients died during attempted cardiopulmonary resuscitation. Conclusions: In this retrospective analysis, serious illness communication was documented in the minority of patients who died of head and neck cancer. These discussions occurred late in the trajectory of illness. The continuity relationships of teams treating head and neck cancer patients (e.g., head and neck surgeon, radiation/oncologist and hematologist/oncologist) situate these clinicians in the best position to enact serious illness conversations. These data suggest that opportunities to have these discussions upstream are often missed.

scholarly journals Evaluating Primary Care Providers' Views on Survivorship Care Plans Generated by an Electronic Health Record System

2015 ◽  
Vol 11 (3) ◽  
pp. e329-e335 ◽  
Author(s):  
SarahMaria Donohue ◽  
Mary E. Sesto ◽  
David L. Hahn ◽  
Kevin A. Buhr ◽  
Elizabeth A. Jacobs ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Record ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Health Record ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Providers ◽  
Record System ◽  
Care Plans

Survivorship care plans were viewed as useful for coordinating care and making clinical decisions. However primary care physicians desired shorter, clinician-oriented plans that were accessible via EHR and located in a standardized manner.

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