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

Donohue, SarahMaria; Haine, James E.; Li, Zhanhai; Feldstein, David; Micek, Mark A.; Trowbridge, Elizabeth; Kamnetz, Sandra; Sosman, James M.; Wilke, Lee G.; Sesto, Mary E.; Tevaarwerk, Amye J.

doi:10.1007/s13187-017-1295-3

Cited by 12 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a study of childhood cancer survivorship care, only 51% of PCPs sent an SCP as part of the study recalled receiving it ( 61 ). PCPs in a survey regarding primary care for adult breast cancer survivors reported being unaware of the SCP (73%), difficulty locating it (30%), and finding needed information faster via another mechanism (15%) ( 62 ). These barriers were reported even though SCPs are standardly housed in the EHR problem list within their institution.…”

Section: Resultsmentioning

confidence: 99%

Realist Review of Care Models That Include Primary Care for Adult Childhood Cancer Survivors

Snyder

Choi

Smith

et al. 2022

JNCI Cancer Spectrum

View full text Add to dashboard Cite

Appropriate models of survivorship care for the growing number of adult survivors of childhood cancer are unclear. We conducted a realist review to describe how models of care that include primary care, and relevant resources (e.g., tools, training), could be effective for adult survivors of childhood cancer. We first developed an initial program theory based on qualitative literature (studies, commentaries, opinion pieces) and stakeholder consultations. We then reviewed quantitative evidence and consulted stakeholders to refine the program theory, and to develop and refine context-mechanism-outcome (CMO) hypotheses regarding how models of care that include primary care could be effective for adult survivors of childhood cancer. Effectiveness for both resources and models is defined by survivors living longer and feeling better through high-value care. Intermediate measures of effectiveness evaluate the extent to which survivors and providers understand the survivor’s history, risks, symptoms and problems, healthcare needs, and available resources. Thus, the models of care and resources are intended to provide information to survivors and/or primary care providers to enable them to obtain/deliver appropriate care. The variables from our program theory found most consistently in the literature include oncology versus primary care specialty, survivor and provider knowledge, provider comfort treating childhood cancer survivors, communication and coordination between and among providers and survivors, and delivery/receipt of prevention and surveillance of late effects. In turn, these variables were prominent in our CMO hypotheses. The findings from this realist review can inform future research to improve childhood cancer survivorship care and outcomes.

show abstract

Section: Resultsmentioning

confidence: 99%

Realist Review of Care Models That Include Primary Care for Adult Childhood Cancer Survivors

Snyder

Choi

Smith

et al. 2022

JNCI Cancer Spectrum

View full text Add to dashboard Cite

show abstract

“…Using the EMR to care for survivors in the primary care setting has been difficult for PCPs as it is difficult to find these relevant documents and EMRs are not designed for survivorship care [ 43 ]. Of 88 PCPs surveyed who had received SCPs on their patients, most were unaware of the SCP in general (73%) and had difficulty locating it (30%) [ 44 ]. The same meta-analysis showed that most PCPs wanted to receive SCPs and used these in conversation with their patient, but the few studies which tracked PCP receipt and integration of SCP showed only 13% consistently received SCPs.…”

Section: Discussionmentioning

confidence: 99%

Developing a survivorship care plan (SCP) delivery process for patients and primary care providers serving poor, rural, and minority patients with cancer

Tawfik

Jaffe²,

Mohler

et al. 2021

Support Care Cancer

View full text Add to dashboard Cite

Background Survivorship care plans (SCPs) summarize patients’ treatment and act as an education and communication tool between oncologists and primary care providers (PCPs). But creation and delivery of SCPs are challenging, labor intensive, and costly. The University of New Mexico Comprehensive Cancer Center (UNM CCC) treats a poor, rural, and minority patient population, and our purpose was to implement and evaluate a process to create and deliver SCPs to patients and PCPs. Methods Providers placed an electronic SCP order, basic information was imported, and staff compiled treatment details. Flagged SCPs were then ready for delivery, providers approved of and delivered the SCP at the next encounter, and the SCP was sent to the PCP. Results By April 2020, 283 SCPs were ordered, 241 (85.2%) were created by the designated staff, and 97 (34.2%) were given to patients after definitive therapy for breast cancer (59.1%), gynecological cancers (10.8%), prostate cancer (7.4%), colorectal cancer (5.1%), and lymphomas (4.8%). Of 97 SCPs eligible to be sent to PCPs, 75 (77.3%) were mailed or sent via EMR. Of the 41 (48.9%) SCPs sent via mail or fax, only 8 (8.3%) were received and 5 (5.2%) integrated. Conclusions This study shows that SCPs can be delivered to patients in a poor, rural, and minority patient population but that PCP receipt and integration of SCPs are poor. Future efforts need to ensure that an oncologist to PCP education and communication tool is able reach and be integrated by PCPs.

show abstract

“…An initial questionnaire was developed by the authors based on literature about the side and long-term effects of cancer and cancer therapies. 2,36,37 The draft Care of Cancer Survivors questionnaire was reviewed and revised at a weekly research faculty meeting. The resulting 59-item questionnaire included 2 questions regarding patient demographics, 3 questions on office electronic medical record (EMR) capabilities, 10 questions on office policies regarding care of cancer survivors, 2 questions regarding physicians' awareness of history of persons with cancer in the office and how they knew of cancer survivorship status, 15 Likert-style questions on the physician's confidence managing mental health and side effects of cancer therapies, 13 questions regarding the availability of resources for cancer survivors, 5 questions on survivorship care, 3 questions on changes in psychosocial and physical health of cancer survivors and time frame of effects of cancer treatment, 3 questions on the concerns and barriers for cancer survivor patients, and 3 questions on the quality of life of the cancer survivors.…”

Section: Instrumentmentioning

confidence: 99%

“…The resulting 59-item questionnaire included 2 questions regarding patient demographics, 3 questions on office electronic medical record (EMR) capabilities, 10 questions on office policies regarding care of cancer survivors, 2 questions regarding physicians' awareness of history of persons with cancer in the office and how they knew of cancer survivorship status, 15 Likert-style questions on the physician's confidence managing mental health and side effects of cancer therapies, 13 questions regarding the availability of resources for cancer survivors, 5 questions on survivorship care, 3 questions on changes in psychosocial and physical health of cancer survivors and time frame of effects of cancer treatment, 3 questions on the concerns and barriers for cancer survivor patients, and 3 questions on the quality of life of the cancer survivors. 2,36 Office policy and EMR questions were modeled off another questionnaire the researchers had previously used. 37 Mailing A second duplicate mailing was sent to the nonresponders within 3 weeks of the first mailing.…”

Section: Instrumentmentioning

confidence: 99%

Rural Primary Care Offices and Cancer Survivorship Care: Part of the Care Trajectory for Cancer Survivors

Berry-Stoelzle

Parang

Daly

2019

Health Services Research and Managerial Epidemiology

View full text Add to dashboard Cite

Background:A cancer diagnosis is a monumental event in a patient’s life and with the number of cancer survivors increasing; most of these patients will be taken care of by a primary care provider at some point after their cancer therapy. The purpose of this study is to identify primary care physician’s needs to care for a patient who has had cancer.Methods:A cross-sectional survey of the physician members of the Iowa Research Network was conducted. The survey was designed to measure physician confidence in cancer survivor’s care, office strategies regarding cancer survivorship care, and resources available for patients with cancer. Two hundred seventy-four Iowa Research Network members were invited to participate in this survey.Results:Eighty-two physicians (30%) completed the questionnaire with 96% reporting that they are aware of their patient’s cancer survivorship status. Seventy-one physicians reported they were aware of cancer survivorship status by an oncologist sending a note to the office, 68 being diagnosed in their office, 61 by the patient keeping the office apprised, and 15 receiving a survivorship care plan. Physicians reported the top changes in a cancer survivor’s physical health as fatigue (81%) and pain (59%). Sixty-two physicians reported not feeling confident for managing chemobrain, cardiotoxicity (71%), and skin changes (35%). Male physicians were significantly more confident managing patients’ skin changes (P = .049) and musculoskeletal disturbances than female physicians (P = .027), while female physicians were significantly more confident managing early-onset menopause than male physicians (P = .027).Conclusion:Most respondents are aware of their patients who are cancer survivors and are mostly confident in the care they provide for them related to long-term effects and side effects of cancer therapies with limited receipt of cancer survivorship care plans.

show abstract

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

Cited by 12 publications

References 18 publications

Realist Review of Care Models That Include Primary Care for Adult Childhood Cancer Survivors

Realist Review of Care Models That Include Primary Care for Adult Childhood Cancer Survivors

Developing a survivorship care plan (SCP) delivery process for patients and primary care providers serving poor, rural, and minority patients with cancer

Rural Primary Care Offices and Cancer Survivorship Care: Part of the Care Trajectory for Cancer Survivors

Contact Info

Product

Resources

About