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Brant J, Blaseg K, Aders K, Oliver D, Gray E, Dudley W. Navigating the Transition From Cancer Care to Primary Care: Assistance of a Survivorship Care Plan. Oncol Nurs Forum 2016; 43:710-719. [DOI: 10.1188/16.onf.710-719] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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O'Hea E, Wu J, Dietzen L, Harralson T, Boudreaux ED. The Polaris Oncology Survivorship Transition (POST) System: A Patient- and Provider-Driven Cancer Survivorship Planning Program. JOURNAL OF ONCOLOGY NAVIGATION & SURVIVORSHIP 2016; 7:11-24. [PMID: 28845364 PMCID: PMC5568840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND It is strongly recommended that individuals ending treatment for cancer have a "survivorship plan," and new standards require survivorship planning for accreditation, However, a comprehensive plan is often neglected. OBJECTIVE To present the development and field test results of a web-based, breast cancer survivorship care planning system. METHODS The Polaris Oncology Survivorship Transition (POST) blends input from the electronic health record (EHR), oncology care providers (OCPs), and patients to create a survivorship care plan (SCP). The content of the POST program was created with the assistance of end-user input (patients, oncologists, and primary care providers (PCPs)) and the full program was piloted on women ending treatment for breast cancer. This paper presents the pilot study that field-tested the POST In a clinical setting. Patients were recruited from outpatient care clinics and chemotherapy units in a comprehensive care center. The study included 25 women ending treatment for breast cancer in the past year, 4 OCPs, and PCPs. Patients received the POST computeπzed assessment and a tailored SCP. RESULTS The POST assists providers in crafting efficient and comprehensive SCPs and was rated highly satisfactory by all end-users. DISCUSSION The POST program can be used as a cancer survivorship planning program to assist OCPs in care planning for their patients ending treatment for breast cancer. CONCLUSION This study provides support for Incorporating computerized SCP programs into clinical practice. Use of the POST in clinical practice has the potential to improve survivorship planning.
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Affiliation(s)
- Erin O'Hea
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | - Juliet Wu
- Departments of Emergency Medicine and Psychiatry, University of Massachusetts Medical School, Worcester, MA
| | | | | | - Edwin D Boudreaux
- Departments of Emergency Medicine, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
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Selove R, Birken SA, Skolarus TA, Hahn EE, Sales A, Proctor EK. Using Implementation Science to Examine the Impact of Cancer Survivorship Care Plans. J Clin Oncol 2016; 34:3834-3837. [PMID: 27621409 PMCID: PMC5477985 DOI: 10.1200/jco.2016.67.8060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Rebecca Selove
- Rebecca Selove, Tennessee State University, Nashville, TN; Sarah A. Birken, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Ted A. Skolarus, University of Michigan; Veterans Affairs Health Services Research and Development Center for Clinical Management Research; and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Erin E. Hahn, Kaiser Permanente Southern California, Pasadena, CA; Anne Sales, University of Michigan, Ann Arbor, MI; and Enola K. Proctor, Washington University in St Louis, St Louis, MO
| | - Sarah A Birken
- Rebecca Selove, Tennessee State University, Nashville, TN; Sarah A. Birken, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Ted A. Skolarus, University of Michigan; Veterans Affairs Health Services Research and Development Center for Clinical Management Research; and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Erin E. Hahn, Kaiser Permanente Southern California, Pasadena, CA; Anne Sales, University of Michigan, Ann Arbor, MI; and Enola K. Proctor, Washington University in St Louis, St Louis, MO
| | - Ted A Skolarus
- Rebecca Selove, Tennessee State University, Nashville, TN; Sarah A. Birken, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Ted A. Skolarus, University of Michigan; Veterans Affairs Health Services Research and Development Center for Clinical Management Research; and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Erin E. Hahn, Kaiser Permanente Southern California, Pasadena, CA; Anne Sales, University of Michigan, Ann Arbor, MI; and Enola K. Proctor, Washington University in St Louis, St Louis, MO
| | - Erin E Hahn
- Rebecca Selove, Tennessee State University, Nashville, TN; Sarah A. Birken, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Ted A. Skolarus, University of Michigan; Veterans Affairs Health Services Research and Development Center for Clinical Management Research; and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Erin E. Hahn, Kaiser Permanente Southern California, Pasadena, CA; Anne Sales, University of Michigan, Ann Arbor, MI; and Enola K. Proctor, Washington University in St Louis, St Louis, MO
| | - Anne Sales
- Rebecca Selove, Tennessee State University, Nashville, TN; Sarah A. Birken, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Ted A. Skolarus, University of Michigan; Veterans Affairs Health Services Research and Development Center for Clinical Management Research; and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Erin E. Hahn, Kaiser Permanente Southern California, Pasadena, CA; Anne Sales, University of Michigan, Ann Arbor, MI; and Enola K. Proctor, Washington University in St Louis, St Louis, MO
| | - Enola K Proctor
- Rebecca Selove, Tennessee State University, Nashville, TN; Sarah A. Birken, The University of North Carolina at Chapel Hill, Chapel Hill, NC; Ted A. Skolarus, University of Michigan; Veterans Affairs Health Services Research and Development Center for Clinical Management Research; and Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Erin E. Hahn, Kaiser Permanente Southern California, Pasadena, CA; Anne Sales, University of Michigan, Ann Arbor, MI; and Enola K. Proctor, Washington University in St Louis, St Louis, MO
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de Rooij BH, Ezendam NPM, Nicolaije KAH, Vos MC, Pijnenborg JMA, Boll D, Kruitwagen RFPM, van de Poll-Franse LV. Factors influencing implementation of a survivorship care plan-a quantitative process evaluation of the ROGY Care trial. J Cancer Surviv 2016; 11:64-73. [PMID: 27480883 PMCID: PMC5266782 DOI: 10.1007/s11764-016-0562-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 07/09/2016] [Indexed: 11/24/2022]
Abstract
Purpose The aim of this study is to investigate the factors that influence implementation of Survivorship Care Plans (SCPs) in the intervention arm of the ROGY Care trial by (1) assessing the level of SCP receipt in the ROGY Care trial and (2) identifying patient- and provider-level factors that influence SCP receipt. Methods Between 2011 and 2015, a pragmatic cluster randomized-controlled-trial was conducted on the effects of automatically generated SCPs. Endometrial (N = 117) and ovarian (N = 61) cancer patients were allocated to ‘SCP care’, as provided by their SCP care providers (N = 10). Associations between SCP receipt (self-reported SCP receipt and actually generated SCPs), patient-factors (socio-demographic-, clinical-, and personality factors), and care provider factors (profession and a-priori motivation regarding SCP provision) were tested in univariate analysis. The odds ratios of factors influencing self-reported SCP receipt were estimated with a multivariate regression model. Results Of all patients in the SCP care arm (N = 178), SCPs were generated by the care provider for 90 % of the patients and 70 % of the patients reported that they had received an SCP. Patients with older age, ovarian cancer, type D (distressed) personality, and patients that completed the questionnaire a longer period of time after the SCP consult were more likely to report no SCP receipt. Conclusions SCP receipt was influenced by patient- but not care-provider factors. Implications for cancer survivors Certain patient groups were less likely to report SCP receipt. Whether all patients are in need of an SCP, requires further investigation. If they do, more efforts need to be made towards the implementation of SCPs.
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Affiliation(s)
- Belle H de Rooij
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. .,The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
| | - Nicole P M Ezendam
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Kim A H Nicolaije
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - M Caroline Vos
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center South, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, The Netherlands
| | - Johanna M A Pijnenborg
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center South, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, The Netherlands
| | - Dorry Boll
- Department of Obstetrics and Gynecology, Catharina Hospital, Eindhoven, The Netherlands
| | - Roy F P M Kruitwagen
- Department of Gynecology and GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Lonneke V van de Poll-Franse
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Nicolaije KA, Ezendam NP, Pijnenborg JM, Boll D, Vos MC, Kruitwagen RF, van de Poll-Franse LV. Paper-Based Survivorship Care Plans May be Less Helpful for Cancer Patients Who Search for Disease-Related Information on the Internet: Results of the Registrationsystem Oncological Gynecology (ROGY) Care Randomized Trial. J Med Internet Res 2016; 18:e162. [PMID: 27392550 PMCID: PMC4958141 DOI: 10.2196/jmir.4914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 11/26/2015] [Accepted: 01/19/2016] [Indexed: 11/16/2022] Open
Abstract
Background The Institute of Medicine recommends Survivorship Care Plans (SCPs) for all cancer survivors. However, it is unclear whether certain patient groups may or may not benefit from SCPs. Objective The aim was to assess whether the effects of an automatically generated paper SCP on patients’ satisfaction with information provision and care, illness perceptions, and health care utilization were moderated by disease-related Internet use. Methods Twelve hospitals were randomized to either SCP care or usual care in the pragmatic cluster randomized Registrationsystem Oncological GYnecology (ROGY) Care trial. Newly diagnosed endometrial cancer patients completed questionnaires after diagnosis (N=221; response: 74.7%, 221/296), 6 months (n=158), and 12 months (n=147), including patients’ satisfaction with information provision and care, illness perceptions, health care utilization (how many times patients visited a medical specialist or primary care physician about their cancer in the past 6 months), and disease-related Internet use (whether patients used the Internet to look for information about cancer). Results In total, 80 of 221 (36.2%) patients used the Internet to obtain disease-related information. Disease-related Internet use moderated the SCP care effect on the amount of information received about the disease (P=.03) and medical tests (P=.01), helpfulness of the information (P=.01), and how well patients understood their illness (P=.04). All stratified analyses were not statistically significant. However, it appeared that patients who did not seek disease-related information on the Internet in the SCP care arm reported receiving more information about their disease (mean 63.9, SD 20.1 vs mean 58.3, SD 23.7) and medical tests (mean 70.6, SD 23.5 vs mean 64.7, SD 24.9), finding the information more helpful (76.7, SD 22.9 vs mean 67.8, SD 27.2; scale 0-100), and understanding their illness better (mean 6.6, SD 3.0 vs mean 6.1, SD 3.2; scale 1-10) than patients in the usual care arm did. In addition, although all stratified analyses were not significant, patients who did seek disease-related information on the Internet in the SCP care arm appeared to receive less information about their disease (mean 65.7, SD 23.4 vs mean 67.1, SD 20.7) and medical tests (mean 72.4, SD 23.5 vs mean 75.3, SD 21.6), did not find the information more helpful (mean 78.6, SD 21.2 vs mean 76.0, SD 22.0), and reported less understanding of their illness (mean 6.3, SD 2.8 vs mean 7.1, SD 2.7) than patients in the usual care arm did. Conclusions Paper SCPs appear to improve the amount of information received about the disease and medical tests, the helpfulness of the information, and understanding of the illness for patients who do not search for disease-related information on the Internet. In contrast, paper SCPs do not seem beneficial for patients who do seek disease-related information on the Internet. Trial Registration ClinicalTrials.gov NCT01185626; https://clinicaltrials.gov/ct2/show/NCT01185626 (Archived by WebCite at http://www.webcitation.org/6fpaMXsDn)
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Affiliation(s)
- Kim Ah Nicolaije
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.
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Kvale EA, Huang CHS, Meneses KM, Demark-Wahnefried W, Bae S, Azuero CB, Rocque GB, Bevis KS, Ritchie CS. Patient-centered support in the survivorship care transition: Outcomes from the Patient-Owned Survivorship Care Plan Intervention. Cancer 2016; 122:3232-3242. [PMID: 27387096 DOI: 10.1002/cncr.30136] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND To the authors' knowledge, few studies to date have evaluated the effects of survivorship care planning on the care transition process from specialty cancer care to self-management and primary care, patient experience, or health outcomes. The Patient-owned Survivorship Transition Care for Activated, Empowered survivors (POSTCARE) is a single coaching encounter based on the Chronic Care Model that uses motivational interviewing techniques to engage survivors of breast cancer. The current study examined the effects of the POSTCARE intervention on patient outcomes and care coordination. METHODS A total of 79 survivors of American Joint Commision on Cancer TNM System stage 0 to IIIB breast cancer were randomized to POSTCARE (40 patients) or usual care (39 patients). Patient outcomes were assessed using the 36-Item Short Form Health Survey (SF-36), Social/Role Activities Limitations, Self-Efficacy for Managing Chronic Disease 6-Item Scale, the Patient Activation Measure-Short Form, and Patient Health Questionnaire depression scale at baseline and at 3-month follow-up. Care coordination was assessed using confirmed primary care physician visits and reported discussion of the survivorship care plan at the 3-month follow-up. Logistic and linear regression analyses were conducted to examine the effect of POSTCARE on selected outcomes. RESULTS Participants in the intervention group versus those receiving usual care demonstrated significantly higher self-reported health (F-statistic (3,71), 3.63; P =.017) and lower social role limitations (F (3,70), 3.82; P =.014) and a trend toward greater self-efficacy (F (3,69), 2.51; P = .07). Three quality-of-life domains reached clinically meaningful improvement at the 3-month follow-up, including physical role (P =.0009), bodily pain (P =.03), and emotional role (P =.04). CONCLUSIONS The POSTCARE intervention appeared to have a positive impact on patient outcomes and demonstrated promise as a strategy with which to improve survivors' experience, care coordination, and health outcomes. Cancer 2016;122:3232-42. © 2016 American Cancer Society.
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Affiliation(s)
| | | | - Karen M Meneses
- School of Nursing, University of Alabama, Birmingham, Alabama
| | | | - Sejong Bae
- Department of Medicine, University of Alabama, Birmingham, Alabama
| | - Casey B Azuero
- Department of Psychology, University of Alabama, Tuscaloosa, Alabama
| | | | - Kerri S Bevis
- Department of Obstetrics and Gynecology, University of Alabama, Birmingham, Alabama
| | - Christine S Ritchie
- Department of Medicine, University of California San Francisco, San Francisco, California
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Salz T, Baxi S. Moving survivorship care plans forward: focus on care coordination. Cancer Med 2016; 5:1717-22. [PMID: 27075650 PMCID: PMC4944899 DOI: 10.1002/cam4.733] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/19/2016] [Accepted: 03/18/2016] [Indexed: 11/08/2022] Open
Abstract
After completing treatment for cancer, the coordination of oncology and primary care presents a challenge for cancer survivors. Many survivors need continued oncology follow-up, and all survivors require primary care. Coordinating the shared care of a cancer survivor, or facilitating an informed handoff from oncology to primary care, is essential for cancer survivors. Survivorship care plans are personalized documents that summarize cancer treatment and outline a plan of recommended ongoing care, with the goal of facilitating the coordination of post-treatment care. Despite their face validity, five trials have failed to demonstrate the effectiveness of survivorship care plans. We posit that these existing trials have critical shortcomings and do not adequately address whether survivorship care plans improve care coordination. Moving forward, we propose four criteria for future trials of survivorship care plans: focusing on high-needs survivor populations, tailoring the survivorship care plan to the care setting, facilitating implementation of the survivorship care plan in clinical practice, and selecting appropriate trial outcomes to assess care coordination. When trials meet these criteria, we can finally assess whether survivorship care plans help cancer survivors receive optimal oncology and primary care.
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Affiliation(s)
- Talya Salz
- Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Shrujal Baxi
- Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Weil Medical College of Cornell University, New York, New York
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Wagner RW, Pritzker S. Cancer survivorship care-planning: Practice, research, and policy implications for social work. SOCIAL WORK IN HEALTH CARE 2016; 55:181-194. [PMID: 26933764 DOI: 10.1080/00981389.2015.1115800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Increasing numbers of cancer survivors are living longer than 5 years from their diagnosis date. This has resulted in a growing population of cancer survivors, expected to reach 19 million by 2024. Survivors frequently experience late effects caused by cancer and its treatment, reducing survivors' quality of life in multiple domains. Survivorship care-plans may aid the many physical, psychosocial, and financial needs that emerge posttreatment. However, the lack of reimbursement mechanisms, the limited amount of effectiveness research, and minimal guidelines for content and delivery are barriers to the widespread provision of survivorship care-plans. Challenges and opportunities for social work practice, research, and policy are identified and discussed.
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Affiliation(s)
- Richard W Wagner
- a Graduate College of Social Work , University of Houston , Houston , Texas , USA
| | - Suzanne Pritzker
- a Graduate College of Social Work , University of Houston , Houston , Texas , USA
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Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte SJ, Warner E, Lyman GH, Ganz PA. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol 2016; 34:611-35. [PMID: 26644543 DOI: 10.1200/jco.2015.64.3809] [Citation(s) in RCA: 542] [Impact Index Per Article: 67.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1,073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made. This guideline was developed through a collaboration between the American Cancer Society and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both CA: A Cancer Journal for Clinicians and Journal of Clinical Oncology. Copyright © 2015 American Cancer Society and American Society of Clinical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by the American Cancer Society or the American Society of Clinical Oncology.
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Affiliation(s)
- Carolyn D. Runowicz
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Corinne R. Leach
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - N. Lynn Henry
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Karen S. Henry
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Heather T. Mackey
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Rebecca L. Cowens-Alvarado
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Rachel S. Cannady
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Mandi L. Pratt-Chapman
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Stephen B. Edge
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Linda A. Jacobs
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Arti Hurria
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Lawrence B. Marks
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Samuel J. LaMonte
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Ellen Warner
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Gary H. Lyman
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
| | - Patricia A. Ganz
- Carolyn D. Runowicz, Herbert Wertheim College of Medicine, Florida International University; Karen S. Henry, Sylvester Cancer Center at the University of Miami, Miami, FL; Corinne R. Leach, Rebecca L. Cowens-Alvarado, Rachel S. Cannady, and Samuel J. LaMonte, American Cancer Society, Atlanta, GA; N. Lynn Henry, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI; Heather T. Mackey, Oncology Nursing Society, Pittsburgh; Linda A. Jacobs, Abramson Cancer Center, University of Pennsylvania,
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Palmer SC, Stricker CT, Panzer SL, Arvey SA, Baker KS, Casillas J, Ganz PA, McCabe MS, Nekhlyudov L, Overholser L, Partridge AH, Risendal B, Rosenstein DL, Syrjala KL, Jacobs LA. Outcomes and satisfaction after delivery of a breast cancer survivorship care plan: results of a multicenter trial. J Oncol Pract 2016; 11:e222-9. [PMID: 25784579 DOI: 10.1200/jop.2014.001404] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Survivorship care plans (SCPs) have been suggested to reduce fragmentation of care experienced by cancer survivors. Acceptance of SCPs is high, but trials in the United States are few. This pilot study used a quasiexperimental design to examine the outcomes achieved by breast cancer survivors receiving a standardized SCP visit at one of seven comprehensive cancer centers. MATERIALS AND METHODS Outcomes were assessed before and again 3 months after delivery of an SCP and included survivors' use of and satisfaction with SCPs, perceived knowledge about survivorship, and assessment of the quality and coordination of survivorship care. RESULTS One hundred thirty-nine survivors of breast cancer completed baseline and follow-up measures and received a standardized SCP visit. Participants most commonly used SCP materials to make decisions about exercise (64%), which tests to receive and when (62%), and dietary changes (62%). Only 21% shared the SCP with their primary care provider during that time. Satisfaction with the SCP was high, with 90% of participants reporting being at least satisfied with the SCP. Perceived knowledge about survivorship improved after SCP delivery, as did perceived care coordination and the provider's knowledge of the effects of cancer on survivors (all P < .001). Individuals closer to the time of diagnosis reported greater satisfaction with and use of SCPs. CONCLUSION This study demonstrates improvements in perceived knowledge and quality of survivorship care after receipt of a comprehensive SCP. Survivors were satisfied with their SCP, and those closer to diagnosis reported greater satisfaction with and use of the materials.
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Affiliation(s)
- Steven C Palmer
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Carrie Tompkins Stricker
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - SarahLena L Panzer
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Sarah A Arvey
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - K Scott Baker
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Jackie Casillas
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Patricia A Ganz
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Mary S McCabe
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Larissa Nekhlyudov
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Linda Overholser
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Ann H Partridge
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Betsy Risendal
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Donald L Rosenstein
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Karen L Syrjala
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Linda A Jacobs
- Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; LIVESTRONG, Austin, TX; Fred Hutchinson Cancer Research Center, Seattle, WA; University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, CA; Memorial Sloan Kettering Cancer Center, New York, NY; Dana-Farber Cancer Institute, Boston, MA; University of Colorado Cancer Center, Denver, CO; and University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
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Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, Cannady RS, Pratt-Chapman ML, Edge SB, Jacobs LA, Hurria A, Marks LB, LaMonte SJ, Warner E, Lyman GH, Ganz PA. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. CA Cancer J Clin 2016; 66:43-73. [PMID: 26641959 DOI: 10.3322/caac.21319] [Citation(s) in RCA: 441] [Impact Index Per Article: 55.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Answer questions and earn CME/CNE The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made.
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Affiliation(s)
- Carolyn D Runowicz
- Executive Associate Dean for Academic Affairs and Professor, Department of Obstetrics and Gynecology, Herbert Wertheim College of Medicine Florida International University, Miami, FL
| | - Corinne R Leach
- Director, Cancer and Aging Research, Behavioral Research Center, American Cancer Society, Atlanta, GA
| | - N Lynn Henry
- Associate Professor, Division of Hematology/Oncology, University of Michigan, Comprehensive Cancer Center, Ann Arbor, MI
| | - Karen S Henry
- Nurse Practitioner, Oncology/Hematology Sylvester Cancer Center at the University of Miami, Miami, FL
| | | | | | - Rachel S Cannady
- Behavioral Scientist, Behavioral Research Center/National Cancer Survivorship Resource Center, American Cancer Society, Atlanta, GA
| | | | | | - Linda A Jacobs
- Clinical Professor of Nursing, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Arti Hurria
- Associate Professor and Director, Cancer and Aging Research Program, City of Hope, Duarte, CA
| | - Lawrence B Marks
- Sidney K. Simon Distinguished Professor of Oncology Research and Chairman, Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - Samuel J LaMonte
- Retired Head and Neck Surgeon, Survivorship Workgroup Member and Volunteer, American Cancer Society, Atlanta, GA
| | - Ellen Warner
- Professor of Medicine, University of Toronto, Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Toronto, ON
| | - Gary H Lyman
- Co-Director Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Patricia A Ganz
- Distinguished Professor of Medicine and Health Policy & Management, Schools of Medicine and Public Health, University of California, Los Angeles, CA
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Lee Smith J, Hall IJ. Advancing Health Equity in Cancer Survivorship: Opportunities for Public Health. Am J Prev Med 2015; 49:S477-82. [PMID: 26590642 PMCID: PMC4658651 DOI: 10.1016/j.amepre.2015.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/03/2015] [Accepted: 08/13/2015] [Indexed: 01/18/2023]
Affiliation(s)
- Judith Lee Smith
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
| | - Ingrid J Hall
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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Nicolaije KA, Ezendam NP, Vos MC, Pijnenborg JM, Boll D, Boss EA, Hermans RH, Engelhart KC, Haartsen JE, Pijlman BM, van Loon-Baelemans IE, Mertens HJ, Nolting WE, van Beek JJ, Roukema JA, Zijlstra WP, Kruitwagen RF, van de Poll-Franse LV. Impact of an Automatically Generated Cancer Survivorship Care Plan on Patient-Reported Outcomes in Routine Clinical Practice: Longitudinal Outcomes of a Pragmatic, Cluster Randomized Trial. J Clin Oncol 2015; 33:3550-9. [DOI: 10.1200/jco.2014.60.3399] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose This study was conducted to longitudinally assess the impact of an automatically generated survivorship care plan (SCP) on patient-reported outcomes in routine clinical practice. Primary outcomes were patient satisfaction with information and care. Secondary outcomes included illness perceptions and health care use. Methods Twelve hospitals were randomly assigned to SCP care or usual care in a pragmatic, cluster randomized trial. Newly diagnosed patients with endometrial cancer completed questionnaires after diagnosis (n = 221; 75% response), 6 months (n = 158), and 12 months (n = 147). An SCP application was built in the Web-based ROGY (Registration System Oncological Gynecology). By clicking the SCP button, a patient-tailored SCP was generated. Results In the SCP care arm, 74% of patients received an SCP. They reported receiving more information about their treatment (mean [M] = 57, standard deviation [SD] = 20 v M = 47, SD = 24; P = .03), other services (M = 35, SD = 22 v M = 25, SD = 22; P = .03), and different places of care (M = 27, SD = 25 v M = 23, SD = 26; P = .04) than the usual care arm (scales, 0 to 100). However, there were no differences regarding satisfaction with information or care. Patients in the SCP care arm experienced more symptoms (M = 3.3, SD = 2.0 v M = 2.6, SD = 1.6; P = .03), were more concerned about their illness (M = 4.4, SD = 2.3 v M = 3.9, SD = 2.1; P = .03), were more affected emotionally (M = 4.0, SD = 2.2 v M = 3.7, SD = 2.2; P = .046), and reported more cancer-related contact with their primary care physician (M = 1.8, SD = 2.0 v M = 1.1, SD = 0.9; P = .003) than those in the usual care arm (scale, 1 to 10). These effects did not differ over time. Conclusion The present trial showed no evidence of a benefit of SCPs on satisfaction with information and care. Furthermore, SCPs increased patients' concerns, emotional impact, experienced symptoms, and the amount of cancer-related contact with the primary care physician. Whether this may ultimately lead to more empowered patients should be investigated further.
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Affiliation(s)
- Kim A.H. Nicolaije
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Nicole P.M. Ezendam
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - M. Caroline Vos
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Johanna M.A. Pijnenborg
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Dorry Boll
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Erik A. Boss
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Ralph H.M. Hermans
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Karin C.M. Engelhart
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Joke E. Haartsen
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Brenda M. Pijlman
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Ingrid E.A.M. van Loon-Baelemans
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Helena J.M.M. Mertens
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Willem E. Nolting
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Johannes J. van Beek
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Jan A. Roukema
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Wobbe P. Zijlstra
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Roy F.P.M. Kruitwagen
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
| | - Lonneke V. van de Poll-Franse
- Kim A.H. Nicolaije, Nicole P.M. Ezendam, Wobbe P. Zijlstra, and Lonneke V. van de Poll-Franse, Tilburg University, Tilburg; Kim A.H. Nicolaije, Nicole P.M. Ezendam, and Lonneke V. van de Poll-Franse, Comprehensive Cancer Center the Netherlands, Eindhoven; M. Caroline Vos and Dorry Boll, Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk; Erik A. Boss, Maxima Medical Center, Veldhoven and Eindhoven, the Netherlands; Ralph H.M. Hermans, Catharina Hospital, Eindhoven; Karin C.M. Engelhart, St Anna Hospital
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Mayer DK, Birken SA, Chen RC. Avoiding Implementation Errors in Cancer Survivorship Care Plan Effectiveness Studies. J Clin Oncol 2015; 33:3528-30. [DOI: 10.1200/jco.2015.62.6937] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Deborah K. Mayer
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Sarah A. Birken
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Ronald C. Chen
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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Chen RC, Hoffman KE, Sher DJ, Showalter TN, Morrell R, Chen AB, Benda R, Nguyen PL, Movsas B, Hardenbergh P. Development of a standard survivorship care plan template for radiation oncologists. Pract Radiat Oncol 2015; 6:57-65. [PMID: 26778795 DOI: 10.1016/j.prro.2015.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 10/01/2015] [Accepted: 10/01/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE In response to a need expressed by members of the American Society for Radiation Oncology (ASTRO), the ASTRO Board of Directors approved an initiative to create a radiation oncology-specific survivorship care plan (SCP) template. METHODS AND MATERIALS Members of the ASTRO Health Services Research Committee (which was subsequently renamed the Clinical, Translational, and Basic Science Advisory Committee) were charged with this task. Creation of the ASTRO SCP template was informed by existing SCP templates published by other organizations and modified to add radiation treatment details felt to be important by committee members. An emphasis was placed on describing diagnostic and treatment details in ways that patients and referring physicians can understand. The resulting template subsequently underwent ASTRO committee review, public comment, and was ultimately approved by the ASTRO Board of Directors. RESULTS The standardized template includes 2 components: the first 2 pages represent an SCP that is to be given to the patient and referring physicians, whereas page 3 includes additional technical radiation therapy details which are usually included in a traditional radiation treatment summary. That is, the template serves two purposes - obviating the need for radiation oncologists to create an SCP for patients and a separate treatment completion note. CONCLUSIONS The standardized ASTRO SCP template serves an immediate need of practicing radiation oncologists to have a template that is radiation-specific and meets current requirements for SCP and radiation treatment summary. Potential future work may include development of disease-specific templates that will include more granular details regarding expected toxicities and follow-up care recommendations and working with electronic medical record system vendors to facilitate autocreation of SCP documents to reduce the burden on physicians and other staff. These future developments can make this intervention more helpful to patients, and further reduce the burden of creating SCPs.
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Rubin G, Berendsen A, Crawford SM, Dommett R, Earle C, Emery J, Fahey T, Grassi L, Grunfeld E, Gupta S, Hamilton W, Hiom S, Hunter D, Lyratzopoulos G, Macleod U, Mason R, Mitchell G, Neal RD, Peake M, Roland M, Seifert B, Sisler J, Sussman J, Taplin S, Vedsted P, Voruganti T, Walter F, Wardle J, Watson E, Weller D, Wender R, Whelan J, Whitlock J, Wilkinson C, de Wit N, Zimmermann C. The expanding role of primary care in cancer control. Lancet Oncol 2015; 16:1231-72. [PMID: 26431866 DOI: 10.1016/s1470-2045(15)00205-3] [Citation(s) in RCA: 355] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/25/2015] [Accepted: 07/27/2015] [Indexed: 12/21/2022]
Abstract
The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise—from epidemiologists, psychologists, policy makers, and cancer specialists—has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to effect change are outlined. The strengths of primary care—its continuous, coordinated, and comprehensive care for individuals and families—are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.
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Affiliation(s)
- Greg Rubin
- School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK.
| | - Annette Berendsen
- Department of General Practice, University of Groningen, Groningen, Netherlands
| | | | - Rachel Dommett
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Craig Earle
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Jon Emery
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - Tom Fahey
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luigi Grassi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Eva Grunfeld
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Sumit Gupta
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | | | - David Hunter
- School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK
| | | | - Una Macleod
- Hull-York Medical School, University of Hull, Hull, UK
| | - Robert Mason
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Geoffrey Mitchell
- Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Richard D Neal
- North Wales Centre for Primary Care Research, Bangor University, Bangor, Wales
| | | | - Martin Roland
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Bohumil Seifert
- Department of General Practice, Charles University, Prague, Czech Republic
| | - Jeff Sisler
- Department of Family Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Stephen Taplin
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Peter Vedsted
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Teja Voruganti
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Fiona Walter
- Department of General Practice, University of Groningen, Groningen, Netherlands
| | - Jane Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Eila Watson
- Department of Clinical Health Care, Oxford Brookes University, Oxford, UK
| | - David Weller
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Jeremy Whelan
- Research Department of Oncology, University College London, London, UK
| | - James Whitlock
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Clare Wilkinson
- North Wales Centre for Primary Care Research, Bangor University, Bangor, Wales
| | - Niek de Wit
- Department of General Practice, University Medical Center Utrecht, Utrecht, Netherlands
| | - Camilla Zimmermann
- Division of Medical Oncology and Haematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Andersen BL, Dorfman CS. Evidence-based psychosocial treatment in the community: considerations for dissemination and implementation. Psychooncology 2015; 25:482-90. [PMID: 27092813 DOI: 10.1002/pon.3864] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 04/05/2015] [Accepted: 05/10/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND In psycho-oncology care, steps toward dissemination and implementation of evidence-based treatments (EBTs) have not been made. For this to change, factors associated with real-world dissemination and implementation must be identified. In the community, providers, their organizations, and patients are key stakeholders. METHOD A focused review of literatures in continuing education, dissemination, and implementation of mental health services is provided. RESULTS Early-career providers are most ready to implement as they have greater openness and more positive attitudes toward EBTs. Current continuing education practices to teach EBTs have limited effectiveness. Instruction using interactive strategies tailored to therapists' clinical needs and the provision of post-education consultation is needed. There is tension between EBT delivery with fidelity and the necessity for adaptation. EBT service provision is the key outcome of implementation, and documenting such is important to patients, providers, and organizations. CONCLUSION A multilevel conceptual framework, Setting, Therapist, Education, imPlementation, and Sustainability, is offered and provides directions for dissemination and sustainable implementation. Guidelines from the Commission on Cancer of the American College of Surgeons and the American Society of Clinical Oncology underscore the timeliness of the proposed framework to move EBTs from the research settings where they were developed to the practice settings where they are needed.
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Klemanski DL, Browning KK, Kue J. Survivorship care plan preferences of cancer survivors and health care providers: a systematic review and quality appraisal of the evidence. J Cancer Surviv 2015; 10:71-86. [DOI: 10.1007/s11764-015-0452-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/09/2015] [Indexed: 10/23/2022]
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Mayer DK, Birken SA, Check DK, Chen RC. Summing it up: an integrative review of studies of cancer survivorship care plans (2006-2013). Cancer 2015; 121:978-96. [PMID: 25252164 PMCID: PMC4948720 DOI: 10.1002/cncr.28884] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 04/14/2014] [Accepted: 04/29/2014] [Indexed: 11/06/2022]
Abstract
In 2006, the Institute of Medicine recommended that cancer survivors who are completing primary treatment receive a survivorship care plan (SCP) based on face validity. The state of scientific knowledge regarding the SCP is unclear. The authors conducted an integrative review of existing evidence regarding SCPs. The MEDLINE/PubMed database, the Excerpta Medica Database (EMBASE), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) database were searched for relevant studies published between 2006 and 2013 using a combination of keywords: "survivors," "survivorship," "care plans," "care planning," "treatment summaries," and "cancer." Articles were included if they 1) reported results from an empirical study, 2) included cancer survivors who were diagnosed at age ≥ 18 years, 3) related to SCP, and 4) were published in English. In total, 781 records were retrieved; 77 were identified as duplicates, and 665 were abstracts or presentations that did not relate to SCPs for adults or were not empirical, which left 42 articles for inclusion in this review. Studies regarding SCP fell into 3 categories: 1) content (n=14), 2) dissemination and implementation (n=14), and 3) survivor and provider outcomes (n=14). SCPs have been endorsed and are associated with improved knowledge, but SCP use remains sporadic. Only 4 studies were randomized controlled trials (RCTs) that avoided many biases associated with observational studies. Other limitations included cross-sectional or pre-SCP-post-SCP ("pre-post") designs, limited generalizability caused by a lack of sample diversity, and a lack of systematic testing of data-collection tools. The quantity and quality of SCP research are limited. SCPs have been endorsed, but evidence of improved outcomes associated with SCP is limited. Future research that addresses the methodological concerns of extant studies is needed regarding SCP use, content, and outcomes.
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Affiliation(s)
- Deborah K. Mayer
- School of Nursing, University of North Carolina, Chapel Hill, NC 27599
- UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599
| | - Sarah A. Birken
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599
| | - Devon K. Check
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599
| | - Ronald C. Chen
- Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC 27599
- UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599
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Jabson JM. Treatment summaries, follow-up care instructions, and patient navigation: could they be combined to improve cancer survivor’s receipt of follow-up care? J Cancer Surviv 2015; 9:692-8. [DOI: 10.1007/s11764-015-0444-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/24/2015] [Indexed: 11/29/2022]
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Chrischilles EA, McDowell BD, Rubenstein L, Charlton M, Pendergast J, Juarez GY, Arora NK. Survivorship care planning and its influence on long-term patient-reported outcomes among colorectal and lung cancer survivors: the CanCORS disease-free survivor follow-up study. J Cancer Surviv 2014; 9:269-78. [PMID: 25354481 DOI: 10.1007/s11764-014-0406-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/30/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aims to evaluate the relationship between survivorship care planning (SCP) and survivorship care and health outcomes reported by long-term lung and colorectal cancer survivors. METHODS Participants (n = 832) were diagnosed and enrolled during 2003-2005. In 2012, patient-reported outcomes (survivorship care and health outcomes) and two patient-reported SCP measures (receipt of written summary of cancer treatment and receipt of instructions on who to see for routine cancer follow-up) were collected. Analyses controlled for SCP predictors collected from medical records and an interview 1 year after diagnosis. RESULTS One in four survivors reported receiving both SCP elements. Those receiving both were more certain which doctor was in charge (odds ratio (OR) 7.0; 95 % confidence intervals (95 % CI) 3.9-12.5), more likely to report follow-up checkup (OR 5.1; 95 % CI 3.3-8.0), and had an MRI/PET/CT scan in the past 2 years (OR 2.8; 95 % CI 1.7-4.7) compared to those receiving neither. Physician communication experiences were significantly more positive and having physical exams (OR 2.0; 95 % CI 1.2-3.4) and meeting exercise guidelines (OR 1.6; 95 % CI 1.004-2.4) more likely. Physical health (p = 0.012) and good-to-excellent self-perceived health status (OR 2.2; 95 % CI 1.3-3.9) were better for those receiving both elements. CONCLUSION SCP may lead to better cancer follow-up care, long-term physical health, and physician-patient communication experiences. IMPLICATIONS FOR CANCER SURVIVORS The positive association between outcomes and SCP suggests that efforts to implement SCP should be fruitful.
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Hebdon M, Abrahamson K, McComb S, Sands L. Transitioning Patients to Survivorship Care: A Systematic Review. Oncol Nurs Forum 2014; 41:615-25. [DOI: 10.1188/14.onf.615-625] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Poplack DG, Fordis M, Landier W, Bhatia S, Hudson MM, Horowitz ME. Childhood cancer survivor care: development of the Passport for Care. Nat Rev Clin Oncol 2014; 11:740-50. [PMID: 25348788 DOI: 10.1038/nrclinonc.2014.175] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Survivors of childhood cancer are at risk of long-term adverse effects and late effects of the disease and/or its treatment. In response to national recommendations to improve evidence-based follow-up care, a web-based support system for clinical decision making, the Passport for Care (PFC), was developed for use at the point of care to produce screening recommendations individualized to the survivor. To date, the PFC has been implemented in over half of the nearly 200 clinics affiliated with the Children's Oncology Group across the USA. Most clinician users report that the PFC has been integrated into clinic workflows, and that it fosters improved conversations with survivors about the potential late effects a survivor might experience and about the screening and/or behavioural interventions recommended to improve health status. Furthermore, clinicians using the PFC have indicated that they adhered more closely to follow-up care guidelines. Perspectives on the challenges encountered and lessons learned during the development and deployment of the PFC are reviewed and contrasted with other nationwide approaches to the provision of guidance on survivor follow-up care; furthermore, the implications for the care of childhood cancer survivors are discussed.
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Affiliation(s)
- David G Poplack
- Hematology-Oncology Section, Department of Paediatrics, Texas Children's Cancer Center, Baylor College, One Baylor Plaza, Houston, TX 77030, USA
| | - Michael Fordis
- Center for Collaborative and Interactive Technologies, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Wendy Landier
- Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Smita Bhatia
- Department of Population Sciences, City of Hope, 1500 East Duarte Road, Duarte, CA 91010, USA
| | - Melissa M Hudson
- Cancer Survivorship Division, Departments of Oncology and Epidemiology, and Cancer Control, St Jude's Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA
| | - Marc E Horowitz
- Hematology-Oncology Section, Department of Paediatrics, Texas Children's Cancer Center, Baylor College, One Baylor Plaza, Houston, TX 77030, USA
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Survivorship care plans in cancer: a systematic review of care plan outcomes. Br J Cancer 2014; 111:1899-908. [PMID: 25314068 PMCID: PMC4229639 DOI: 10.1038/bjc.2014.505] [Citation(s) in RCA: 165] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/28/2014] [Accepted: 08/18/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Eight years after the Institute of Medicine recommended survivorship care plans (SCPs) for all cancer survivors, this study systematically reviewed the evidence for their use. METHODS Studies evaluating outcomes after implementation of SCPs for cancer survivors were identified by searching databases (MEDLINE, EMBASE and Cochrane). Data were extracted and summarised. RESULTS Ten prospective studies (2286 survivors) met inclusion criteria (5 randomised controlled trials (RCTs)). Study populations included survivors of breast, gynaecological, colorectal and childhood cancer. Several models of SCP were evaluated (paper based/on-line, oncologist/nurse/primary-care physician-delivered and different templates). No significant effect of SCPs was found on survivor distress, satisfaction with care, cancer-care coordination or oncological outcomes in RCTs. Breast cancer survivors with SCPs were better able to correctly identify the clinician responsible for their follow-up care. One study suggested a positive impact on reducing unmet needs. Levels of survivor satisfaction with, and self-reported understanding of, their SCP were very high. Feasibility was raised by health professionals as a significant barrier, as SCPs took 1-4 h of their time to develop. CONCLUSIONS Emerging evidence shows very few measurable benefits of SCPs. Survivors reported high levels of satisfaction with SCPs. Resource issues were identified as a significant barrier to implementation.
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Brennan ME, Butow P, Spillane AJ, Boyle F. Patient-reported quality of life, unmet needs and care coordination outcomes: Moving toward targeted breast cancer survivorship care planning. Asia Pac J Clin Oncol 2014; 12:e323-31. [PMID: 25244662 DOI: 10.1111/ajco.12254] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2014] [Indexed: 11/27/2022]
Abstract
AIM Survivorship care plans (SCPs) have been proposed for universal use with the aim of addressing the many unmet needs of cancer survivors. Trials have failed to find a significant impact of SCPs on quality of life outcomes. This study evaluated quality of life, unmet needs, satisfaction with health care and perception of cancer care coordination at the end of treatment in a cohort of women at the end of treatment for early breast cancer. The aim was to identify specific needs to assist in the design of a tailored SCP. METHODS Women completed patient-reported measures of health-related quality of life (FACT-B [ES]), unmet needs (CaSUN), satisfaction with medical care and cancer care coordination. Total scores and subscale scores for the whole cohort and results of analysis comparing three age groups were reported. RESULTS Sixty-eight women (mean age 56) participated. Mean score for FACT-B = 108 and FACT-B (ES) = 167.4. Younger women (<51 years) reported a significantly lower quality of life (P = 0.001 for FACT-B, TOI and FACT-B [ES]). Using CaSUN, 76.1% of participants reported at least one unmet need; mean number of unmet needs = 6.2. Younger women reported more unmet needs than older women. The most frequently reported unmet need was fear of cancer recurrence. Overall, participants were very satisfied with medical care and cancer care coordination. CONCLUSION Younger women reported poorer quality of life and more unmet needs. SCPs should specifically target younger women and must include strategies to address fear of cancer recurrence if they are to lead to a measureable difference in outcomes.
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Affiliation(s)
- Meagan Elizabeth Brennan
- Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,The Patricia Ritchie Centre for Cancer Care and Research, The Mater Hospital, North Sydney, New South Wales, Australia
| | - Phyllis Butow
- Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, New South Wales, Australia
| | - Andrew John Spillane
- Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
| | - Frances Boyle
- Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,The Patricia Ritchie Centre for Cancer Care and Research, The Mater Hospital, North Sydney, New South Wales, Australia
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O'Brien M, Stricker CT, Foster JD, Ness K, Arlen AG, Schwartz RN. Navigating the Seasons of Survivorship in Community Oncology. Clin J Oncol Nurs 2014; 18 Suppl:9-14. [DOI: 10.1188/14.cjon.s1.9-14] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Nicolaije KAH, Ezendam NPM, Vos MC, Pijnenborg JMA, van de Poll-Franse LV, Kruitwagen RFPM. Oncology providers’ evaluation of the use of an automatically generated cancer survivorship care plan: longitudinal results from the ROGY Care trial. J Cancer Surviv 2013; 8:248-59. [DOI: 10.1007/s11764-013-0327-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 11/11/2013] [Indexed: 12/21/2022]
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Salani R. Survivorship planning in gynecologic cancer patients. Gynecol Oncol 2013; 130:389-97. [DOI: 10.1016/j.ygyno.2013.05.022] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 05/13/2013] [Accepted: 05/16/2013] [Indexed: 01/01/2023]
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