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Torreggiani M, Maselli D, Costi S, Guberti M. Models of Care in Providing Comprehensive Healthcare on Cancer Survivors: A Scoping Review with a TIDieR Checklist Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:122. [PMID: 38397613 PMCID: PMC10888265 DOI: 10.3390/ijerph21020122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The study's aim is to identify the models of care used to provide survivorship care plans (SCPs) to cancer survivors in healthcare services, describing what kind of professionals are involved, in which settings and timings, and their feasibility. METHODS The Joanna Briggs Institute methodology for scoping reviews is followed. Studies that considered the SCPs applying different models of care, in any healthcare setting on any adult cancer survivors who completed oncological treatments, have been included. Pubmed, Embase, Cochrane Library, Scopus, and Cinahal were searched from 2013 to 2023 with these keywords: "Survivorship Care Plan", "Oncology", and "Program". The study selection process was reported with the PRISMA-ScR. A total of 325 records were identified, 42 were screened, and, ultimately, 23 articles were included. RESULTS The models of care include: SCP standardization in hospitals; self-support oriented; consultation-based; primary or specialist direct referral; shared care; a multimodal approach. Multidisciplinary teams were involved in the SCP models of care. The settings were private clinics or cancer centers. One-hour SCP interventions were most frequently delivered through in-person visits, by telephone, or online. CONCLUSIONS Implementing SCPs is feasible in healthcare contexts, but with challenges, like time and resource management. Patient-centered programs promoting coordinated care are promising models of care.
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Affiliation(s)
- Martina Torreggiani
- Health Professions Department, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Deborah Maselli
- International Doctorate School in Clinical and Experimental Medicine, Università degli Studi di Modena e Reggio Emilia, 41125 Reggio Emilia, Italy;
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Monica Guberti
- Research and EBP Unit, Health Professions Department, Azienda USL-IRCCS of Reggio Emilia, 42123 Reggio Emilia, Italy;
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2
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Cracchiolo JR, Arafat W, Atreja A, Bruckner L, Emamekhoo H, Heinrichs T, Raldow AC, Smerage J, Stetson P, Sugalski J, Tevaarwerk AJ. Getting ready for real-world use of electronic patient-reported outcomes (ePROs) for patients with cancer: A National Comprehensive Cancer Network ePRO Workgroup paper. Cancer 2023; 129:2441-2449. [PMID: 37224181 DOI: 10.1002/cncr.34844] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Electronic patient‐reported outcome (ePRO) programs may offer advantages for patients with cancer, clinicians, health care systems, payors, and society in general; but developing and maintaining an ePRO program will require cancer centers to navigate defining meaningful problems, collecting ePROs, implementing action when those ePROs require intervention without over‐burdening clinicians, and monitoring the successes and failures of their ePRO programs. Physician informaticists from the National Comprehensive Cancer Network Electronic Health Record Advisory Group offer 10 guiding principles to consider when contemplating, building, or refining an ePRO program for patients with cancer.
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Affiliation(s)
| | - Waddah Arafat
- Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ashish Atreja
- University of California-Davis Comprehensive Cancer Center, Sacramento, California, USA
| | - Lauren Bruckner
- Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Hamid Emamekhoo
- University of Wisconsin Carbone Cancer Center, Madison, Wisconsin, USA
| | - Tricia Heinrichs
- National Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania, USA
| | - Ann C Raldow
- University of California-Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Jeffrey Smerage
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
| | - Peter Stetson
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jessica Sugalski
- National Comprehensive Cancer Network, Plymouth Meeting, Pennsylvania, USA
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3
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Mikles SP, Griffin AC, Chung AE. Health information technology to support cancer survivorship care planning: A systematic review. J Am Med Inform Assoc 2021; 28:2277-2286. [PMID: 34333588 PMCID: PMC8449616 DOI: 10.1093/jamia/ocab134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/13/2021] [Accepted: 06/23/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE The study sought to conduct a systematic review to explore the functions utilized by electronic cancer survivorship care planning interventions and assess their effects on patient and provider outcomes. MATERIALS AND METHODS Based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, studies published from January 2000 to January 2020 were identified in PubMed, CINAHL, EMBASE, PsychINFO, Scopus, Web of Science, and the ACM Digital Library . The search combined terms for cancer, survivorship, care planning, and health information technology (HIT). Eligible studies evaluated the effects of a HIT intervention on usability, knowledge, process, or health-related outcomes. A total of 578 abstracts were reviewed, resulting in 60 manuscripts describing 40 studies. Thematic analyses were used to define meta-themes of system functions, and Fisher's exact tests were used to examine associations between functions and outcomes. RESULTS Patients were the target end users for 18 interventions, while 12 targeted providers and 10 targeted both groups. Interventions used patient-reported outcomes collection (60%), automated content generation (58%), electronic sharing (40%), persistent engagement (28%), and communication features (20%). Overall, interventions decreased the time to create survivorship care plans (SCPs) and supported care planning knowledge and abilities, but results were mixed for effects on healthcare utilization, SCP sharing, and provoking anxiety. Persistent engagement features were associated with improvements in health or quality-of-life outcomes (17 studies, P = .003). CONCLUSIONS Features that engaged users persistently over time were associated with better health and quality-of-life outcomes. Most systems have not capitalized on the potential of HIT to share SCPs across a care team and support care coordination.
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Affiliation(s)
- Sean P Mikles
- Lineberger Comprehensive Cancer Outcomes Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashley C Griffin
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Arlene E Chung
- Lineberger Comprehensive Cancer Outcomes Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, UNC School of Medicine, Chapel Hill, North Carolina, USA
- Program on Health and Clinical Informatics, UNC School of Medicine, Chapel Hill, North Carolina, USA
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4
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Utilization of an audit tool to evaluate accuracy of treatment summary and survivorship care plans. J Cancer Surviv 2019; 13:890-898. [DOI: 10.1007/s11764-019-00804-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 08/23/2019] [Indexed: 10/26/2022]
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5
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Xiang S, Zhang K, Yang G, Gao D, Zeng C, He M. Mitochondria-Targeted and Resveratrol-Loaded Dual-Function Titanium Disulfide Nanosheets for Photothermal-Triggered Tumor Chemotherapy. NANOSCALE RESEARCH LETTERS 2019; 14:211. [PMID: 31227943 PMCID: PMC6588667 DOI: 10.1186/s11671-019-3044-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/07/2019] [Indexed: 05/04/2023]
Abstract
A subcellular organelle-targeted delivery of anti-cancer drugs is a promising strategy to maximize the anti-cancer effects and minimize the adverse effects. Herein, we prepared a mitochondria-targeted drug delivery nanoplatform based on IR780 iodide (IR780) and titanium disulfide (TiS2) nanosheets. Due to the large specific surface area of TiS2 nanosheets, the nanoplatform could highly load anti-cancer drug resveratrol (RV). The as-prepared nanocomposite (IR780-TiS2/RV) was used for an efficacious photothermal-triggered tumor chemotherapy. IR780-TiS2/RV showed satisfactory stability and biocompatibility, and the loading ratio of RV and IR780 was about 112% and 56%, respectively. Upon the near-infrared (NIR) irradiation, the heat generated by IR780-TiS2/RV could trigger the RV release. Due to the conjugation with the mitochondria-specific IR780, IR780-TiS2/RV could target and accumulate in mitochondria and release RV when triggered by NIR to decrease the mitochondrial membrane potential, rapidly induce the upregulation of key intrinsic apoptotic factors such as cytochrome c, and initiate the caspase cascade, thereby achieving the chemotherapeutic effect. The IR780-TiS2/RV nanocomposite was demonstrated to have a high anti-tumor efficacy in vitro and in vivo as well as no remarkable tissue toxicity. We believe our study demonstrates that the NIR-triggered IR780-TiS2/RV nanoplatform could be a promising chemotherapeutic agent in clinical practice.
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Affiliation(s)
- Sen Xiang
- The First Department of Oncology, Zhumadian Central Hospital, 747 Zhumadian Zhonghua Road, Zhumadian, 463000 China
| | - Kaifang Zhang
- The First Department of Oncology, Zhumadian Central Hospital, 747 Zhumadian Zhonghua Road, Zhumadian, 463000 China
| | - Guanghua Yang
- The First Department of Oncology, Zhumadian Central Hospital, 747 Zhumadian Zhonghua Road, Zhumadian, 463000 China
| | - Dongdong Gao
- The First Department of Oncology, Zhumadian Central Hospital, 747 Zhumadian Zhonghua Road, Zhumadian, 463000 China
| | - Chen Zeng
- The First Department of Oncology, Zhumadian Central Hospital, 747 Zhumadian Zhonghua Road, Zhumadian, 463000 China
| | - Miao He
- The First Department of Oncology, Zhumadian Central Hospital, 747 Zhumadian Zhonghua Road, Zhumadian, 463000 China
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Ivanics T, Proctor E, Chen Y, Ali H, Severson D, Nasser H, Colbert S, Susick L, Walker E, Petersen L, Bensenhaver J, Loutfi R, Nathanson SD, Newman LA. Evaluation of a Multidisciplinary Team Approach for Generating Survivorship Care Plan Treatment Summaries in Patients With Breast Cancer. J Oncol Pract 2019; 15:e467-e474. [DOI: 10.1200/jop.18.00509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION: The optimal structure for survivorship care plan (SCP) programs and methodology for generating treatment summaries (TSs) has not yet been defined, but the Commission on Cancer and the National Accreditation Program for Breast Centers both mandate that participating oncology programs implement SCP-TS processes for patients that have completed treatment. METHODS: We used the Institute for Healthcare Improvement’s Plan-Do-Study-Act model for conducting a quality improvement project evaluating two different SCP-TS programs implemented at the Henry Ford Health System/Henry Ford Cancer Institute’s Breast Oncology Program in Detroit, Michigan. System I involved TSs drafted by nonspecialist breast clinic staff; System II involved TSs vetted through a multidisciplinary breast specialist conference approach. Accuracy of basic documentation entries related to dates and components of treatment were compared for the two approaches. RESULTS: Seventy-one System I and 93 System II documents were reviewed. Documentation was accurate in at least 90% of documents for both systems regarding delivery of chemotherapy and/or endocrine therapy and for documenting the identity of the various members of the cancer treatment team. Both systems had notable inaccuracies in documenting type of surgery performed, but System II had fewer inaccuracies than System I (33.78% v 51.67%, respectively; P = .05). System II, compared with System I, had fewer inaccuracies in documenting date of diagnosis (9.68% v 25.35%, respectively; P = .01) and had less missing information for dose of radiation delivered (9.33% v 33.9%, respectively; P < .01). CONCLUSION: A multidisciplinary team approach to drafting and reviewing SCP-TS documents improved content accuracy for our program, but ongoing education regarding documentation of various surgical procedures is warranted.
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Affiliation(s)
- Tommy Ivanics
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Erica Proctor
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Yalei Chen
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Haythem Ali
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Dawn Severson
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Hassan Nasser
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Sonja Colbert
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Laura Susick
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Eleanor Walker
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | - Lindsay Petersen
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | | | - Randa Loutfi
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
| | | | - Lisa A. Newman
- Henry Ford Health System/Henry Ford Cancer Institute, Detroit, MI
- Weill Cornell Medicine, New York NY
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7
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Donohue S, Haine JE, Li Z, Feldstein DA, Micek M, Trowbridge ER, Kamnetz SA, Sosman JM, Wilke LG, Sesto ME, Tevaarwerk AJ. Cancer Survivorship Care Plan Utilization and Impact on Clinical Decision-Making at Point-of-Care Visits with Primary Care: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:252-258. [PMID: 29098650 PMCID: PMC5932279 DOI: 10.1007/s13187-017-1295-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Every cancer survivor and his/her primary care provider should receive an individualized survivorship care plan (SCP) following curative treatment. Little is known regarding point-of-care utilization at primary care visits. We assessed SCP utilization in the clinical context of primary care visits. Primary care physicians and advanced practice providers (APPs) who had seen survivors following provision of an SCP were identified. Eligible primary care physicians and APPs were sent an online survey, evaluating SCP utilization and influence on decision-making at the point-of-care, accompanied by copies of the survivor's SCP and the clinic note. Eighty-eight primary care physicians and APPs were surveyed November 2016, with 40 (45%) responding. Most respondents (60%) reported discussing cancer or related issues during the visit. Information needed included treatment (66%) and follow-up visits, and the cancer team was responsible for (58%) vs primary care (58%). Respondents acquired this information by asking the patient (79%), checking oncology notes (75%), the SCP (17%), or online resources (8%). Barriers to SCP use included being unaware of the SCP (73%), difficulty locating it (30%), and finding needed information faster via another mechanism (15%). Despite largely not using the SCP for the visit (90%), most respondents (61%) believed one would be quite or very helpful for future visits. Most primary care visits included discussion of cancer or cancer-related issues. SCPs may provide the information necessary to deliver optimal survivor care but efforts are needed to reduce barriers and design SCPs for primary care use.
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Affiliation(s)
| | - James E Haine
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - Zhanhai Li
- Biostatistics, University of Wisconsin, Madison, WI, USA
| | - David A Feldstein
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - Mark Micek
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - Elizabeth R Trowbridge
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - Sandra A Kamnetz
- Department of Family and Community Health, University of Wisconsin, Madison, WI, USA
| | - James M Sosman
- Department of Medicine, Division of Internal Medicine, University of Wisconsin, Madison, WI, USA
| | - Lee G Wilke
- Department of Surgery, University of Wisconsin, Madison, WI, USA
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
| | - Mary E Sesto
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin, 1111 Highland Ave, WIMR 6037, Madison, WI, 53705, USA
- Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI, USA
| | - Amye J Tevaarwerk
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA.
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin, 1111 Highland Ave, WIMR 6037, Madison, WI, 53705, USA.
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8
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Tevaarwerk AJ, Hocking WG, Buhr KA, Gribble M, Seaborne LA, Wisinski KB, Burkard ME, Yen T, Wiegmann DA, Sesto ME. A randomized trial of immediate versus delayed survivorship care plan receipt on patient satisfaction and knowledge of diagnosis and treatment. Cancer 2019; 125:1000-1007. [PMID: 30690714 DOI: 10.1002/cncr.31875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/07/2018] [Accepted: 10/08/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND Survivorship care plans (SCPs) and care-planning sessions have been recommended for over a decade, yet evidence for their benefit remains mixed. In a randomized trial, changes in survivor knowledge and satisfaction before and after the receipt of an SCP were assessed. METHODS Patients with breast cancer who had completed curative-intent treatment were randomized to immediate versus delayed receipt of an individualized SCP. All participants completed the modified Wisconsin Survey of Cancer Diagnosis and Management in Breast Cancer and the Preparing for Life As a New Survivor survey to assess individual knowledge about cancer diagnosis, treatment, side effects, and follow-up as well as satisfaction with communication and care coordination. Surveys were completed at baseline, at 4 weeks (before delayed receipt), and again at 12 weeks (after all participants had received SCPs); the primary outcome was change in knowledge at 4 weeks. RESULTS In total, 127 eligible women were randomized. An improvement in individual knowledge was observed between baseline and week 12 for both arms combined (+1.6; 95% confidence interval, 0.9-2.3; P < .001). There was no statistically significant difference in the change in knowledge from baseline through week 4 between the arms. No significant change occurred for satisfaction scores over time. CONCLUSIONS This randomized trial of immediate versus delayed SCP receipt demonstrated a small improvement (4%) in survivor knowledge. However, this improvement did not appear to be related to SCP provision. The authors hypothesized that the improvement was because of repeated administration of the knowledge survey. If improved survivor knowledge is a goal, then strategies beyond the 1-time provision and review of an SCP should be explored.
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Affiliation(s)
- Amye J Tevaarwerk
- Division of Hematology/Oncology, Department of Medicine, The University of Wisconsin-Madison, Madison, Wisconsin.,The University of Wisconsin-Madison Carbone Cancer Center, Madison, Wisconsin
| | | | - Kevin A Buhr
- Department of Biostatistics and Medical Informatics, The University of Wisconsin-Madison, Madison, Wisconsin
| | - Mindy Gribble
- Marshfield Clinic Health System, Marshfield, Wisconsin
| | - Lori A Seaborne
- Department of Surgery, The University of Wisconsin-Madison, Madison, Wisconsin
| | - Kari B Wisinski
- The University of Wisconsin-Madison Carbone Cancer Center, Madison, Wisconsin.,The University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin
| | - Mark E Burkard
- Division of Hematology/Oncology, Department of Medicine, The University of Wisconsin-Madison, Madison, Wisconsin.,The University of Wisconsin-Madison Carbone Cancer Center, Madison, Wisconsin
| | - Thomas Yen
- The University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin
| | - Douglas A Wiegmann
- The University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin
| | - Mary E Sesto
- The University of Wisconsin-Madison Carbone Cancer Center, Madison, Wisconsin.,Department of Medicine, The University of Wisconsin-Madison, Madison, Wisconsin
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9
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Tevaarwerk AJ, Sesto ME. Continued Challenges to the Adoption and Implementation of Survivorship Care Plans. J Oncol Pract 2018; 14:573-576. [PMID: 30192692 PMCID: PMC6184078 DOI: 10.1200/jop.18.00378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Amye J. Tevaarwerk
- University of Wisconsin; and University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Mary E. Sesto
- University of Wisconsin; and University of Wisconsin Carbone Cancer Center, Madison, WI
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10
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Tevaarwerk AJ, Klemp JR, van Londen GJ, Hesse BW, Sesto ME. Moving beyond static survivorship care plans: A systems engineering approach to population health management for cancer survivors. Cancer 2018; 124:4292-4300. [PMID: 30277575 DOI: 10.1002/cncr.31546] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/13/2018] [Accepted: 03/19/2018] [Indexed: 01/22/2023]
Abstract
The American cancer survivor population is ever-growing, with necessary follow-up primarily accomplished in a high-touch fashion-adding to unsustainability and fragmentation of care. Given the complexities of the health care system processes needed to support survivorship, engineering approaches may best address performance deficits and facilitate the provision of patient-centered care. Such collaboration between health care and engineering is recommended for redesigning health care delivery systems. By using Systems Engineering Initiative for Patient Safety (SEIPS), a systems engineering model widely used to improve health care quality and delivery, the authors examine the work system to identify the barriers and facilitators to necessary care in the presence of a survivorship care plan and visit. Recommendations for future improvement include ensuring that care-planning processes are dynamic, clearly assigned, resilient, and integrated with electronic health record systems.
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Affiliation(s)
- Amye J Tevaarwerk
- Department of Medicine, University of Wisconsin, Madison and Carbone Cancer Center, Madison, Wisconsin
| | - Jennifer R Klemp
- Department of Medicine, University of Kansas Medical Center and University of Kansas Cancer Center, Kansas City, Kansas
| | - Gijsberta J van Londen
- University of Pittsburgh Cancer Institute and School/Department of Medicine, Pittsburgh, Pennsylvania
| | - Bradford W Hesse
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Mary E Sesto
- Department of Medicine, University of Wisconsin, Madison and Carbone Cancer Center, Madison, Wisconsin
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11
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Birken SA, Clary AS, Bernstein S, Bolton J, Tardif-Douglin M, Mayer DK, Deal AM, Jacobs SR. Strategies for Successful Survivorship Care Plan Implementation: Results From a Qualitative Study. J Oncol Pract 2018; 14:e462-e483. [PMID: 30004824 PMCID: PMC6804914 DOI: 10.1200/jop.17.00054] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Care for US cancer survivors is often fragmented, contributing to poor health outcomes. Care and outcomes may improve when survivors and follow-up care providers receive survivorship care plans (SCPs), written documents containing information regarding cancer diagnosis, treatment, surveillance plans, and health promotion. However, implementing SCPs is challenging. As such, we sought to identify strategies for successfully implementing SCPs. METHODS We measured SCP implementation using performance data from cancer programs participating in the American Society of Clinical Oncology Quality Oncology Practice Initiative, an oncologist-led quality assessment and improvement program. We used semistructured interviews with cancer program employees (eg, physicians) to identify strategies for successfully implementing SCPs by comparing approaches in cancer programs that, according to Quality Oncology Practice Initiative performance indicators, developed and delivered SCPs to a relatively small proportion of eligible survivors and their follow-up care providers (ie, low performers; n = 6 participants in five programs) with approaches among programs with better performance (ie, moderate performers; n = 15 participants in nine programs). RESULTS Ten of 14 cancer programs developed SCPs for ≥ 50% of eligible survivors; two of 14 delivered SCPs to any survivors; and eight of 14 delivered SCPs to ≥ 25% of follow-up care providers. We found that moderate performers proactively addressed SCP requirements, leveraged requirements to improve survivorship care, set internal targets, automated implementation, had active leaders and champions, and tasked appropriate employees with SCP implementation. CONCLUSION SCP implementation remains challenging. We identified strategies for successfully implementing SCPs. Future research should examine how cancer programs have achieved these strategies; findings could contribute to an understanding of the changes needed to implement comprehensive survivorship care.
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Affiliation(s)
- Sarah A. Birken
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill; and RTI International, Research Triangle Park, NC
| | - Alecia S. Clary
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill; and RTI International, Research Triangle Park, NC
| | - Shampa Bernstein
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill; and RTI International, Research Triangle Park, NC
| | - Jamiyla Bolton
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill; and RTI International, Research Triangle Park, NC
| | - Miriam Tardif-Douglin
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill; and RTI International, Research Triangle Park, NC
| | - Deborah K. Mayer
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill; and RTI International, Research Triangle Park, NC
| | - Allison M. Deal
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill; and RTI International, Research Triangle Park, NC
| | - Sara R. Jacobs
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill; and RTI International, Research Triangle Park, NC
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12
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Giese-Davis J, Sisler J, Zhong L, Brandelli Y, McCormick JL, Railton C, Shirt L, Lau H, Hao D, Chobanuk J, Walley B, Joy AA, Taylor A, Carlson L. Alberta CancerBridges development of a care plan evaluation measure. ACTA ACUST UNITED AC 2018; 25:e59-e72. [PMID: 29507497 DOI: 10.3747/co.25.3766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background No standardized measures specifically assess cancer survivors' and healthcare providers' experience of Survivor Care Plans (scps). We sought to develop two care plan evaluation (cpe) measures, one for survivors (cpe-s) and one for healthcare providers (cpe-p), examine initial psychometric qualities in Alberta, and assess generalizability in Manitoba, Canada. Methods We developed the initial measures using convenience samples of breast (n = 35) and head and neck (n = 18) survivors who received scps at the end of active cancer-centre treatment. After assessing Alberta's scp concordance with Institute of Medicine (iom) recommendations using a published coding scheme, we examined psychometric qualities for the cpe-s and cpe-p. We examined generalizability in Manitoba, Canada, with colorectal survivors discharged to primary care providers for follow-up (n = 75). Results We demonstrated acceptable internal consistency for the cpe-s and cpe-p subscales and total score after eliminating one item per subscale for cpe-s, two for cpe-p, resulting in revised scales with four 7-item and 6-item subscales, respectively. Subscale scores correlated highly indicating that for each measure the total score may be the most reliable and valid. We provide initial cpe-s discriminant, convergent, and predictive validity using the total score. Using the Manitoba sample, initial psychometrics similarly indicated good generalizability across differences in tumour groups, scp, and location. Conclusions We recommend the revised cpe-s and cpe-p for further use and development. Studies documenting the creation and standardization of scp evaluations are few, and we recommend further development of patient experience measures to improve both clinical practice and the specificity of research questions.
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Affiliation(s)
- J Giese-Davis
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - J Sisler
- Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba
| | - L Zhong
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - Y Brandelli
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - J L McCormick
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - C Railton
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta
| | - L Shirt
- Palliative Consult Service-Calgary Zone Urban, Alberta Health Services, Calgary, Alberta
| | - H Lau
- Department of Radiation Oncology, Head and Neck Tumour Group, Tom Baker Cancer Center, Calgary
| | - D Hao
- Department of Radiation Oncology, Head and Neck Tumour Group, Tom Baker Cancer Center, Calgary
| | - J Chobanuk
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta
| | - B Walley
- Comprehensive Breast Care Program (cbcp), Community Oncology, Alberta Health Services-Cancer Care, Edmonton, Alberta
| | - A A Joy
- Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta; and
| | - A Taylor
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta.,Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta; and
| | - L Carlson
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
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