Use of remote symptom monitoring with breast cancer survivors using patient-reported outcome (PRO) measures in MyChart.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23125-e23125 ◽  
Author(s):  
Shelby A. Terstriep ◽  
James Wacker ◽  
Charissa Quinlan ◽  
Kiara Pochardt ◽  
Ethan M. Basch
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Patient Reported Outcome ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Symptom Monitoring ◽  
Patient Reported ◽  
Monitoring Group

e23125 Background: Electronic patient-reported outcome monitoring has been found to improve quality of life and overall survival when used with metastatic cancer patients during treatment (Basch, et al., 2017). There has been limited data on using PROs to enhance clinical outcomes in cancer survivorship. This pilot study of breast cancer survivors assessed utilization and satisfaction of electronic proactive symptom and adherence monitoring. Methods: Eighty breast cancer survivors who had completed surgery, chemotherapy, and/or radiation and had received their survivorship care plan were randomized to either usual care or to the PRO monitoring group. The PRO group received questions from the NIH PROMIS toolkit through their patient portal (EPIC) monthly for 6 months. The triage nurse received an alert if the survivor reported on the questionnaire that they had moderate to severe symptoms, had not taken their medication, or would like to speak to a nurse. Participants in the control arm were assessed for sadness, anxiety and satisfaction with provider communication at their usual follow-up visits. Results: Response rates for surveys ranged from 47to 75%. Patients in the PRO monitoring group exhibited no difference in satisfaction at 3 months but had significantly higher scores at 6 months for communication (P=0.005) and monitoring (P= 0.002). Anxiety scores were not significantly different among the usual care group versus the frequent remote monitoring group. Conclusions: Electronic PROs monitoring between clinic visits improved satisfaction with communication and follow-up without increasing anxiety in breast cancer survivors. The pilot data indicate continued development of efficient PROs monitoring can be an important tool to transform the survivorship care plan from a document to an active process of proactively monitoring symptoms and adherence. Support: UG1CA189823. Reference: Basch, E., Deal, A. M., Dueck, A.C., et al. (2017). Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment. Jama, 318 (2), 197. Study Number: A23_Pilot2

Use of remote symptom monitoring with breast cancer survivors using patient reported outcome measures through Epic Mychart.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 208-208
Author(s):  
Shelby A. Terstriep ◽  
James Wacker ◽  
Charissa Quinlan ◽  
Kiara Pochardt ◽  
Ethan M. Basch
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Patient Reported Outcome ◽  
Survivorship Care Plan ◽  
Control Group ◽  
Patient Portal ◽  
Survivorship Care ◽  
Care Plans ◽  
Patient Reported

208 Background: Electronic patient-reported outcome (PRO) monitoring has been found to improve quality of life and overall survival in patients with metastatic cancer patients during active treatment. There has been limited data using PROs to enhance clinical outcomes in cancer survivorship. This pilot study of breast cancer survivors assessed utilization and satisfaction of proactive PRO symptom and adherence monitoring through an EHR patient portal (EPIC MyChart). Methods: Eighty breast cancer survivors who had completed surgery, chemotherapy, and/or radiation and received a survivorship care plan were randomized 1:1 either to usual care or PRO monitoring. The PRO group received questions from the NIH PROMIS toolkit through EPIC MyChart monthly between visits for 6 months. The triage nurse received an EPIC Inbasket alert if the survivor reported moderate to severe symptoms, had not taken their medication(s), or reported they would like to speak to a nurse. Participants in the control group were assessed for sadness, anxiety and satisfaction with provider communication at their usual follow visits. Results: Of 239 surveys sent out, 214 (90%) were completed. Eighty-five (36%) surveys triggered Inbasket alerts to the nurse. The most common nursing response to alerts was calling the patient for counseling/education. Compared to control, the PRO monitoring group exhibited no difference in satisfaction at 3 months, but had significantly higher scores at 6 months for satisfaction with communication (P=0.005) and monitoring (P=0.002). Anxiety scores did not differ between groups. Conclusions: Remote electronic monitoring of symptoms and adherence through the EHR bet was feasible with high completion rates, improved satisfaction, and did not increase anxiety in breast cancer survivors. Follow up work is assessing PRO monitoring to improve efficiency of following cancer survivors, and implementation of survivorship care plans.

scholarly journals Developing a treatment summary and survivorship care plan responsive to African‐American breast cancer survivors

2015 ◽  
Vol 25 (6) ◽  
pp. 729-731 ◽  
Author(s):  
Kimlin Tam Ashing ◽  
Lily Lai ◽  
Shirley Brown ◽  
Kommah McDowell ◽  
DeBorrah Carter ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Treatment Summary

Cost-effectiveness of a survivorship care plan for breast cancer survivors.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 6082-6082 ◽  
Author(s):  
D. Coyle ◽  
E. Grunfeld ◽  
K. Coyle ◽  
J. A. Julian ◽  
G. R. Pond ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care

scholarly journals Survivorship Care Plan Preferences and Utilization Among Asian American Breast Cancer Survivors

2021 ◽  
Vol 48 (5) ◽  
pp. 507-521
Author(s):  
Timiya Nolan ◽  
Elizabeth Arthur ◽  
Ogechi Nwodim ◽  
Amelia Spaulding ◽  
Jennifer Kue
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Asian American ◽  
Breast Cancer Survivors ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care

Improving patient participation in a breast cancer survivorship program at a safety net hospital.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 60-60
Author(s):  
Shakuntala Shrestha ◽  
Pam Khosla ◽  
Janos Molnar ◽  
Maria Eugenia Corona ◽  
Sofia M Garcia
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Breast Cancer Survivors ◽  
Safety Net ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Breast Cancer Survivorship ◽  
Safety Net Hospital

60 Background: To provide comprehensive services and meet Commission on Cancer (CoC) accreditation requirements, we developed and evaluated a customized breast cancer SCP template and delivery model. Objective: To implement and pilot test survivorship care plan (SCP) delivery for breast cancer survivors. Methods: Clinicians at a safety net hospital partnered with investigators at an academic institution to start a breast cancer survivorship care program. We developed an SCP template that is CoC-complaint and responsive to input gathered in 2 focus groups with breast cancer survivors (n = 12) and interviews with staff (n = 8). Oncologists and nurses identified and referred English-speaking women who had completed breast cancer treatment. Participants completed baseline measures prior to receiving individualized SCPs in a survivorship consultation visit with a dedicated APN. In response to high no-show rates, we expanded clinic scheduling to harmonize with participants' other medical appointments. Interim feasibility results for our ongoing study are presented here. Results: A total of 154 patients were screened to reach target enrollment (n= 80) within 20 months. Participant median age was 60 ± 11; 71% were African American, 14% Hispanic; 11% Non-Hispanic White and 92% had household incomes < $20,000. Average times were: 30 ± 13.4 minutes for abstracting patient clinical information in preparation for the survivorship visit; 25 ± 16 minutes for completing individual SCPs; 22±7.65 minutes to review / deliver the SCPs with patients. The difference in no-show rate between first 3-month recruitment period (clinic limited to one day/week) and next 17 months (clinic appointment expanded to accommodate patients' schedule) was statistically significant, p = 0.028. Conclusions: Tailoring SCP templates and delivery models to the needs of a safety net hospital aided the sustainability of a new survivorship clinic. Patient non-adherence to scheduled visits was significantly improved by expanding clinic hours. Significant clinician time was spent preparing SCPs and a level 4 visit (25 minutes) does not adequately reflect this effort. This study is funded by the American Cancer Society, Illinois Division (Grant# 254698).

Implementing a Survivorship Care Plan for Patients With Breast Cancer

2008 ◽  
Vol 26 (5) ◽  
pp. 759-767 ◽  
Author(s):  
Patricia A. Ganz ◽  
Erin E. Hahn
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Late Effects ◽  
Breast Cancer Survivors ◽  
The United States ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Treatment Summary

Breast cancer survivors account for 23% of the more than 10 million cancer survivors in the United States today. The treatments for breast cancer are complex and extend over a long period of time. The post-treatment period is characterized by gradual recovery from many adverse effects from treatment; however, many symptoms and problems persist as late effects (eg, infertility, menopausal symptoms, fatigue), and there may be less frequent long-term effects (eg, second cancers, lymphedema, osteoporosis). There is increasing recognition of the need to summarize the patient's course of treatment into a formal document, called the cancer treatment summary, that also includes recommendations for subsequent cancer surveillance, management of late effects, and strategies for health promotion. This article provides guidance on how oncologists can implement a cancer treatment summary and survivorship care plan for breast cancer survivors, with examples and linkage to useful resources. Providing the breast cancer treatment summary and survivorship care plan is being recognized as a key component of coordination of care that will foster the delivery of high-quality cancer care.

Cost Effectiveness of a Survivorship Care Plan for Breast Cancer Survivors

2014 ◽  
Vol 10 (2) ◽  
pp. e86-e92 ◽  
Author(s):  
Doug Coyle ◽  
Eva Grunfeld ◽  
Kathryn Coyle ◽  
Gregory Pond ◽  
Jim A. Julian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Cost Effectiveness ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Cost Effective ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Effective Use

The authors conclude that this survivorship care plan would be costly to introduce and would not be a cost-effective use of scarce health care resources.

Evaluation of electronic care plan usage and usefulness among breast cancer survivors.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 83-83 ◽  
Author(s):  
Mary Sesto ◽  
William Gray Hocking ◽  
Douglas Wiegmann ◽  
Thomas Y Yen ◽  
Mindy Gribble ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Objective Evaluation ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Patient Portal ◽  
Survivorship Care ◽  
Care Plans ◽  
Treatment Summary

83 Background: Survivorship care plans (SCP) are recommended to improve communication between breast cancer survivors (BCS), primary care, and oncology. Objective evaluation of survivor access of specific care plan content is challenging as commonly-used formats (e.g., paper or electronic file) prevent tracking of usage. This project aimed to evaluate the usage and usefulness of an electronic survivorship care plan (eSCP) that could track access and pages visited. Methods: We recruited 128 BCS from outpatient oncology clinics. 121 BCS received eSCP access via an online secure patient portal; seven received paper copies and are not included in this analysis. The research team customized the portal to track eSCP usage and page visits during the study period (at least 12 weeks of eSCP access). The eSCP consisted of four internal pages (Guide, Treatment Summary, Followup Plan, and Glossary) plus 21 external hyperlinks to survivorship resources. eSCP usefulness and understandability were evaluated using 10-item Likert scales: 1 (not at all useful/very hard to understand to 10 very useful/very easy to understand). Results: 90 out of 121 (74.38%) participants accessed the eSCP. The majority accessed the eSCP within two days of receiving access (N = 70/90, 77.8%) and visited 1 to 3 times (N = 81/90, 90%). Treatment Summary was the most frequently visited internal page (158 visits by 69 participants). Other page usage: Followup Plan (124 visits by 65 participants), Guide (113 visits by 62 participants), and Glossary (46 visits by 31 participants). 34 participants (37.78%) accessed external pages from the eSCP. Participants perceived the overall care plan as useful (8.78, 95% CI [8.38, 9.19]) and easy to understand (8.81, 95% CI [8.47, 9.16]). Conclusions: We found high usage rates among BCS provided an eSCP and the majority perceived the eSCP as useful and easy to understand. Based on favorable assessment and use, it is reasonable for eSCPs to serve as a tool to facilitate communication and care coordination for survivors, especially as access to and use of mobile device technology and electronic patient health portals increase. Minority and rural survivors access and use of such features may require further research.

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