Systematic Approach to Providing Breast Cancer Survivors With Survivorship Care Plans: A Feasibility Study

Bulloch, Kaleigh; Irwin, Melinda L.; Chagpar, Anees B.; Pusztai, Lajos; Killelea, Brigid K.; Horowitz, Nina; Hofstatter, Erin; Abu-Khalaf, Maysa; DiGiovanna, Michael P.; Chung, Gina G.; Sanft, Tara

doi:10.1200/jop.2015.005173

Cited by 13 publications

(10 citation statements)

References 20 publications

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“…Caregiver experience was often examined as an outcome indicator for integrated care plans focused on the palliative stage of care [ 87 92 ]. Provider-level outcomes included provider satisfaction with the use of integrated care plans, i.e., workflow interruptions, ease of use, time associated with generating or discussing the integrated care plan with patients [ 74 83 ], and provider’s perceptions of benefits (i.e., improvements in information sharing between providers) [ 71 74 79 80 83 98 ]. System-level indicators included common healthcare utilization measures such as length of stay, complication rates (post-operative), hospital readmissions, and cost (hospital-related costs and the cost of delivering the integrated care plan) [ 36 39 40 41 43 46 47 48 49 51 54 55 56 57 58 60 61 67 85 95 ].…”

Section: Resultsmentioning

confidence: 99%

Integrated Care Planning for Cancer Patients: A Scoping Review

Khan¹,

Arthurs²,

Gradin³

et al. 2017

International Journal of Integrated Care

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Introduction:There has been a growing emphasis on the use of integrated care plans to deliver cancer care. However little is known about how integrated care plans for cancer patients are developed including featured core activities, facilitators for uptake and indicators for assessing impact.Methods:Given limited consensus around what constitutes an integrated care plan for cancer patients, a scoping review was conducted to explore the components of integrated care plans and contextual factors that influence design and uptake.Results:Five types of integrated care plans based on the stage of cancer care: surgical, systemic, survivorship, palliative and comprehensive (involving a transition between stages) are described in current literature. Breast, esophageal and colorectal cancers were common disease sites. Multi-disciplinary teams, patient needs assessment and transitional planning emerged as key features. Provider buy-in and training alongside informational technology support served as important facilitators for plan uptake. Provider-level measurement was considerably less robust compared to patient and system-level indicators.Conclusions:Similarities in design features, components and facilitators across the various types of integrated care plans indicates opportunities to leverage shared features and enable a management lens that spans the trajectory of a patient’s journey rather than a phase-specific silo approach to care.

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Section: Resultsmentioning

confidence: 99%

Integrated Care Planning for Cancer Patients: A Scoping Review

Khan¹,

Arthurs²,

Gradin³

et al. 2017

International Journal of Integrated Care

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“…Although improving knowledge alone is not sufficient to improve care coordination, it is a necessary component. To date, no randomized controlled study has examined whether SCPs have an impact on survivor knowledge, although 2 studies 15,19 have demonstrated improvements in assessed Cancer March 15, 2019 knowledge using surveys before and after SCP receipt. Although we also demonstrated an improvement in survivor knowledge, this change was likely unrelated to SCP provision.…”

Section: Discussionmentioning

confidence: 99%

“…15,18,19 Without a control group, it is difficult to separate change driven by increasing familiarity, because surveys are repeated or participants seek out knowledge in response to a survey question rather than learning from the SCP or care-planning visit. 15,18,19 Without a control group, it is difficult to separate change driven by increasing familiarity, because surveys are repeated or participants seek out knowledge in response to a survey question rather than learning from the SCP or care-planning visit.…”

Section: Introductionmentioning

confidence: 99%

“…The literature suggests improvements in survivor knowledge after receipt of a treatment summary, SCP, or care-planning visit, but these studies have been limited by small size 14 or lack of a control group. 15,18,19 Without a control group, it is difficult to separate change driven by increasing familiarity, because surveys are repeated or participants seek out knowledge in response to a survey question rather than learning from the SCP or care-planning visit. To test our hypothesis that SCPs improve survivor knowledge regarding the details of cancer diagnosis, treatment, side effects, and follow-up, we conducted a randomized clinical trial to determine the impact of SCP documents.…”

Section: Introductionmentioning

confidence: 99%

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A randomized trial of immediate versus delayed survivorship care plan receipt on patient satisfaction and knowledge of diagnosis and treatment

Tevaarwerk

Hocking

Buhr

et al. 2019

Cancer

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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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“…Reflecting this, centres in North America have the most experience with survivorship care planning though they are now in use in many countries [8]. SCPs improve engagement with patients' general practitioners [9,10], facilitate discussion between patients and their families [10,11] and are associated with higher levels of satisfaction [12], knowledge [13] and self-reported understanding by survivors [11,12].…”

Section: Livestrong Tm Scp Developed In 2007) Function As a Communicmentioning

confidence: 99%

Advance care planning within survivorship care plans for older cancer survivors: A systematic review

et al. 2017

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Advances in the medical treatment of cancer have increased the number of survivors, particularly among older adults, who now represent the majority of these. Survivorship care plans (SCPs) are documents that cancer patients receive summarising their care, usually at the end of treatment but preferably from initial diagnosis. These may increase patient satisfaction and represent an opportunity to initiate preventative strategies and address future care needs. Advance care planning (ACP), incorporating advance healthcare decision-making, including formal written directives, increases satisfaction and end-of-life care. This paper systematically reviews evaluations of ACP within SCPs among older (≥65 years) cancer survivors. No studies meeting the inclusion criteria were identified by search strategies conducted in PubMed/MEDLINE and the Cochrane databases. One paper examined cancer survivors' mainly positive views of ACP. Another discussed the use of a SCP supported by a 'distress inventory' that included an advance care directive (living will) as an issue, though no formal evaluation was reported. Although ACP is important for older adults, no study was found that evaluated its role within survivorship care planning. Despite the risk of recurrence and the potential for morbidity and mortality, especially among older cancer survivors, ACP is not yet a feature of SCPs.

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Systematic Approach to Providing Breast Cancer Survivors With Survivorship Care Plans: A Feasibility Study

Abstract: It is feasible to identify and deliver SCPs to women with breast cancer who are approached during the postoperative visit in a surgical clinic. Additionally, SCPs seem to improve patient knowledge in several areas.

Cited by 13 publications

References 20 publications

Integrated Care Planning for Cancer Patients: A Scoping Review

Integrated Care Planning for Cancer Patients: A Scoping Review

A randomized trial of immediate versus delayed survivorship care plan receipt on patient satisfaction and knowledge of diagnosis and treatment

Advance care planning within survivorship care plans for older cancer survivors: A systematic review

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