Patient and Provider Preferences for Survivorship Care Plans

If used alone, survivorship care plans are insufficient to ease the transition to follow-up care. Improved communication and care coordination are important for survivorship care that goes beyond what the plan might provide.

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Variations in recommended surveillance in colorectal cancer survivorship care plans.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.13 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 13-13

Author(s):

Alaina Chodoff ◽

Katherine Clegg Smith ◽

Aishwarya Shukla ◽

Amanda L. Blackford ◽

Nita Ahuja ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Controlled Trial ◽

Center Frequency ◽

Cancer Center ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans ◽

Follow Up Care

13 Background: Survivorship care plans (SCPs) outline pertinent information about a cancer survivor’s treatment and follow-up care. We describe the content of colorectal cancer (CRC) SCPs, completed as part of a randomized controlled trial of SCPs, and evaluate whether follow-up recommendations are guideline concordant. Methods: We analyzed 74 CRC SCPs from an academic and community cancer center. Frequency distributions and descriptive statistics were calculated for the entire cohort and separately by recruiting site. Follow-up recommendations were compared to American Cancer Society (ACS), American Society of Clinical Oncology (ASCO) and National Comprehensive Cancer Network (NCCN) guidelines (Table). Results: Content routinely provided in SCPs (>80%) included patient demographics, cancer diagnosis, treatment details (surgery, chemotherapy, radiation therapy) as well as treatment-related side effects. SCP content specified less frequently included cancer stage, cancer risk (predisposing conditions), and recommendations for genetic counseling/testing and health promotion. Nearly all SCPs from the community site provided uniform, guideline-concordant follow-up. At the academic site, on average, more than 15 follow-up recommendations were listed for each surveillance modality, except colonoscopy. Among the SCPs that specified the frequency of follow-up care, the rate of guideline-concordant recommendations was 15/42 (36%) for follow-up visits, 29/43 (67%) for imaging, 12/45 (27%) for laboratory and 39/39 (100%) for colonoscopy. Conclusions: SCPs consistently provided information about CRC diagnosis and treatment, but often omitted information about cancer risk, staging and prognosis. There was considerable variation between cancer centers in the follow-up recommendations suggested for CRC survivors. Future work to improve the consistency of SCP follow-up recommendations with guidelines may be needed. Clinical trial information: NCT03035773 . [Table: see text]

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Survivorship and the chronic cancer patient: Patterns in treatment-related effects, follow-up care, and use of survivorship care plans

Cancer ◽

10.1002/cncr.30862 ◽

2017 ◽

Vol 123 (21) ◽

pp. 4268-4276 ◽

Cited By ~ 10

Author(s):

Melissa A. Frick ◽

Carolyn C. Vachani ◽

Christina Bach ◽

Margaret K. Hampshire ◽

Karen Arnold-Korzeniowski ◽

...

Keyword(s):

Cancer Patient ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans ◽

Follow Up Care

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Use of telemedicine in the delivery of survivorship care plans among breast cancer survivors: Lessons learned at Kaiser Permanente East Bay.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.77 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 77-77 ◽

Cited By ~ 1

Author(s):

Pamela Kim Washington ◽

Heather Tews ◽

Dan-Thanh Nguyen ◽

Leeina Wade ◽

Trang Phan ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Lessons Learned ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Breast Cancer Patients ◽

Kaiser Permanente ◽

Care Plans ◽

Follow Up Care

77 Background: Beginning in 2015, the National Accreditation Program for Breast Centers (NAPBC) requires accredited facilities to provide Survivorship Care Plans (SCP) to breast cancer patients treated with curative intent. Here we describe lessons learned with the use of telemedicine in the delivery of SCPs at Kaiser Permanente East Bay. Methods: SCP implementation followed a two-step process: patients who are diagnosed and complete treatment in 2016 are given a SCP at their last surgical or medical oncology appointment (YTD, n=8); 2) patients diagnosed in 2015 who completed treatment in 2015-2016 were contacted by a physician assistant and offered an appointment by telephone or in-person to deliver the care plan (n=152). Both clinic and telemedicine appointments consist of a detailed review of treatment received, post-treatment follow-up care, discussion of health education resources, and provision of referrals as appropriate. Patients also have the opportunity to ask questions about treatment and follow-up care. Results: Among patients diagnosed in 2015 who were offered a TAV or in-person visit, 44.0% preferred a telephone appointment. Actual appointment duration ranged from 10 to 30 minutes. Lack of co-payment and fees associated with transportation as well as loss of income due to taking time off work were the primary factors cited choosing telemedicine over in-person clinic appointments. Interestingly, no differences in member satisfaction scores for in-person vs. telephone visits were observed. Conclusions: Findings suggest telemedicine may be effective in the delivery of SCPs. Similar to rural settings, use of telemedicine in urban settings has a unique capacity to increase service to breast cancer patients.

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Provision and Discussion of Survivorship Care Plans Among Cancer Survivors: Results of a Nationally Representative Survey of Oncologists and Primary Care Physicians

Journal of Clinical Oncology ◽

10.1200/jco.2013.51.7540 ◽

2014 ◽

Vol 32 (15) ◽

pp. 1578-1585 ◽

Cited By ~ 104

Author(s):

Danielle Blanch-Hartigan ◽

Laura P. Forsythe ◽

Catherine M. Alfano ◽

Tenbroeck Smith ◽

Larissa Nekhlyudov ◽

...

Keyword(s):

Cancer Survivors ◽

Primary Care Physicians ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Factors Associated ◽

Care Plans ◽

Follow Up Care ◽

Nationally Representative ◽

Survivorship Care Planning

Purpose Survivorship care planning should involve discussions between providers and cancer survivors to address survivors' needs and optimize adherence. We examined the frequency and factors associated with oncologists' and primary care physicians' (PCPs) reports of provision of written survivorship care plans (SCPs) and discussion of survivorship care recommendations with survivors. Methods A nationally representative sample of 1,130 oncologists and 1,020 PCPs was surveyed about survivorship care practices with survivors. Logistic regression models predicted multilevel factors associated with providing SCPs or discussing recommendations with survivors. Results Although a majority of oncologists (64%) reported always/almost always discussing survivorship care recommendations with survivors, fewer also discussed who survivors should see for cancer-related and other follow-up care (32%); fewer still also provided a written SCP to the survivor (< 5%). Survivorship care recommendations and provider responsibility were not regularly discussed by PCPs and survivors (12%). Oncologists who reported detailed training about late and long-term effects of cancer were more likely to provide written SCPs (odds ratio [OR], 1.73; 95% CI, 1.22 to 2.44) and discuss survivorship care planning with survivors (OR, 2.02; 95% CI, 1.51 to 2.70). PCPs who received SCPs from oncologists were 9× more likely (95% CI, 5.74 to 14.82) to report survivorship discussions with survivors. Conclusion A minority of both PCPs and oncologists reported consistently discussing and providing SCPs to cancer survivors. Training and knowledge specific to survivorship care and coordinated care between PCPs and oncologists were associated with increased survivorship discussions with survivors. These nationally representative data provide a useful benchmark to assess implementation of new efforts to improve the follow-up care of survivors.

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Moving survivorship care plans forward: focus on care coordination

Cancer Medicine ◽

10.1002/cam4.733 ◽

2016 ◽

Vol 5 (7) ◽

pp. 1717-1722 ◽

Cited By ~ 16

Author(s):

Talya Salz ◽

Shrujal Baxi

Keyword(s):

Care Coordination ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans

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Effects of Survivorship Care Plans on patient reported outcomes in ovarian cancer during 2-year follow-up – The ROGY care trial

Gynecologic Oncology ◽

10.1016/j.ygyno.2017.02.041 ◽

2017 ◽

Vol 145 (2) ◽

pp. 319-328 ◽

Cited By ~ 23

Author(s):

Belle H. de Rooij ◽

Nicole P.M. Ezendam ◽

Kim A.H. Nicolaije ◽

M. Caroline Vos ◽

Johanna M.A. Pijnenborg ◽

...

Keyword(s):

Ovarian Cancer ◽

Patient Reported Outcomes ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans ◽

Patient Reported

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Use of Survivorship Care Plans to Re-Engineer Breast Cancer Follow-Up

The Open Breast Cancer Journal ◽

10.2174/1876817201305010023 ◽

2013 ◽

Vol 5 (1) ◽

pp. 23-26 ◽

Cited By ~ 3

Author(s):

Grace Makari-Judson

Keyword(s):

Breast Cancer ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans

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

JMIR Research Protocols ◽

10.2196/23414 ◽

2020 ◽

Vol 9 (12) ◽

pp. e23414

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 Identifier (IRRID) PRR1-10.2196/23414

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Integration of survivorship care plans into standard care: A quality improvement project.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.70 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 70-70

Author(s):

Patricia Deslauriers ◽

Shanmuga Subbiah ◽

Jane M. Fall-Dickson

Keyword(s):

Quality Of Life ◽

Standard Care ◽

Patient Knowledge ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Improvement Project ◽

Care Plans ◽

Sf 36

70 Background: American College of Surgeons’ Commission on Cancer accredited programs are required to provide Survivorship Care Plans (SCPs) to cancer survivors after initial cancer treatment. A critical need exists to evaluate SCP patient outcomes. The primary purpose of this quality improvement project was to integrate SCP into standard care for adult stage I, II, and III breast and colon cancer patients. Secondary aims were to examine the hypothesis that the SCP will improve participants’ knowledge base regarding their cancer, health promotion and disease prevention, satisfaction with delivery of health care, quality of life, and adherence to follow-up and surveillance testing. Methods: The IRB approved study was conducted at a hospital-based Medical Oncology Clinic (MOC) in the Western US. A pre/post design was used. Sociodemographic, Medical Outcomes Study Form-36 (MOS-SF-36), Patient Satisfaction Questionnaire Short Form-PSQ-18 (PSQ-SF-18), and Patient Knowledge of Disease Questionnaire (PKDQ) data were collected pre/post SCP. At the follow-up visit, MOS-SF-36, PSQ-SF-18, PKDQ, and open-ended evaluative questionnaire (OEEQ) data were collected. Results: Forty-two subjects were enrolled. The sample is primarily female (n = 36; 86%), Caucasian (n = 41; 97.6%), Hispanic (n = 36; 85.7%), non-high school graduates (n = 26; 61%), and unemployed/retired (n = 32; 78%). Annual incomes were primarily less than $20K (n = 32; 78%). Paticipants were post-treatment for breast cancer (n = 36) or colon cancer (n = 6). 100% of the participants returned for follow-up visits with only 2 (4.8%) delayed. There were significant increases in knowledge (p < 0.001). There were no statistically significant changes in the MOS-SF-36 ant the PSQ-SF-18. Themes in the OEEQ captured satisfaction with the provision of the SCP, changes in health promotion and disease prevention habits. Conclusions: This pilot study supports the hypothesis that SCPs improve adherence to follow-up and patient knowledge, especially in a unique setting of a low socio-economic, ethnically diverse population. A larger study is needed to show statistically significant improvements in health-related quality of life and satisfaction with delivery of health care.

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