Do survivorship care plans impact patients' evaluations of care? A randomized evaluation with gynecologic oncology patients

Abstract

OBJECTIVE Despite recommendations from the Institute of Medicine regarding survivorship care plan (SCP) delivery to cancer patients, there have been few health service outcome evaluations thus far. METHODS Gynecologic cancer survivors who were up to one-year post-treatment could participate in an evaluation assessing the health services provided and their perceptions of quality of care. A randomized, nested, cross-sectional design was used in a large group gynecologic oncology practice. Half (n=3) of physicians were randomized to provide and discuss a SCP to patients during a follow-up visit, and the other half did not. Following their visits, all patients were informed that a health services evaluation of the practice was being conducted. Interested patients completed an anonymous 26-item survey assessing administrative, clinical, and educational health services, helpfulness of written materials, and perceptions of quality of care. RESULTS Of the 121 survivors surveyed, 64 received SCPs and 57 were in the no-SCP condition. As a validity check, one question asked about educational materials received during the visit with an expected significant difference noted between conditions (X2=5.513, p=.019; more SCP patients reported receiving materials). However, there were no differences between conditions when patients rated health services (Fs>.37) or helpfulness of materials and perceptions of care (Fs>.19). CONCLUSIONS Gynecologic oncology patients providing ratings of health services and satisfaction with care provided equivalent evaluations, regardless if they had/had not received a SCP from the physician. Thus, the need remains for further evaluations of SCPs if they are to be vehicles for improving health service outcomes.

The impact of cancer survivorship care plans on patient and health care provider outcomes: a current perspective

“…Three early randomized studies [10][11][12] did not find any differences in satisfaction with care [10][11][12], distress [12] and quality of life [12] between patients who did or did not receive an SCP. Although these studies provided important first insights into the impact of SCPs, there were limitations in the study designs, including the timing of the intervention and outcomes assessment [13].…”

“…First of all, there is no substantial evidence of a benefit of SCPs. Except for the first positive impact on patient outcomes in the recently published small POSTCARE trial [9], no differences in satisfaction with information provision [8], satisfaction with care [10][11][12], distress [12], and quality of life [12] have been found between patients who did or did not receive an SCP. Second, at this point, no definitive statements can be made about the potential negative consequences of SCPs.…”

Alberta CancerBridges Development of a Care Plan Evaluation Measure

“…While scp research has grown, best practices for patient and provider assessment and scp delivery post-treatment remain unclear or not broadly instituted 2,7,8 . A developing literature supports the use of scps [9][10][11][12][13][14] , and describes optimal content, formats 4,[15][16][17][18][19][20][21][22] , and key-stakeholders' views 1,23,24 , but methods of evaluating scps and their impact on stakeholders are just emerging 4,[25][26][27][28][29][30] .…”

“…Due to the absence of a common validated measure 4,[31][32][33][34][35] , researchers often generate study-specific measures of patients' and providers' scp experiences, including satisfaction, usefulness, emotional reaction, or communication value 4,[25][26][27][28][29][30] . Some studies measure how closely scps adhere to recommended iom standards 4,36 so that the thoroughness of scp format can be linked with outcomes.…”

Development and validation of an individualized survivorship care plan (ISCP) for women with endometrial cancer during the transition of the end of active treatment to the cancer survivorship

“…It is a partnership between the survivor and the caregiving team (McCorkle et al, 2011). Few gynecological cancer survivors currently have an IFCP (Brothers, Easley, Salani, & Andersen, 2013;Grover et al, 2012;Sabatino et al, 2013;Salani, 2013).…”