Patient perspectives on breast cancer treatment plan and summary documents in community oncology care A pilot program

Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York. .
Cancer (Impact Factor: 4.89). 01/2013; 119(1). DOI: 10.1002/cncr.27856
Source: PubMed


Although the routine use of treatment plans and summaries (TPSs) has been recommended to improve the quality of cancer care, limited data exist about their impact on quality, including patient satisfaction and coordination of care.

Patients received TPSs as part of the American Society of Clinical Oncology Breast Cancer Registry (BCR) pilot program of 20 community oncology practices. Participants were surveyed 2 to 4 weeks after receiving a TPS to evaluate their perceptions of the document. Patients who were receiving chemotherapy received the TPS as separate plan and summary documents (at the start and the end of treatment) and could complete 2 surveys. Others received a single integrated TPS. Eligible survey participants had stage 0 through III breast cancer and were enrolled in the BCR.

Of 292 consented patients, 174 (60%) completed at least 1 survey. Of 157 patients who recalled receiving a TPS, 148 (94%) believed that the documents improved patient-physician communication, and 128 (82%) believed that they improved communication between physicians; 113 (72%) said the documents increased their peace of mind, whereas 2 (1%) had less peace of mind. Of 152 patients (97%) who still had their documents, 147 (97%) said they were useful, and 94 (62%) had given or planned to give the documents to another physician. All 63 patients who were surveyed after receiving a summary recommended that practices continue to provide TPSs to patients.

Participants in this study expressed high satisfaction with TPSs. Additional research is needed to study the broad-scale implementation of the BCR and to evaluate the impact of routine use of TPSs on the quality of care delivered.

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    ABSTRACT: This editorial comments on 2 companion articles that present the preliminary results of the American Society of Clinical Oncology (ASCO) breast cancer registry (BCR) pilot program. The ASCO BCR demonstrates how registry data can be collected prospectively for quality assessment purposes as well as the creation of treatment and survivorship care plans in a way that is acceptable to oncology clinicians and patients.
    Cancer 01/2013; 119(1). DOI:10.1002/cncr.27861 · 4.89 Impact Factor
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    ABSTRACT: Cancer survivors face substantial risks for morbidity, reduced quality of life, and premature mortality related to the cancer itself and/or the interventions undertaken to control cancer. Risk-based care that involves a personalized systematic plan of periodic screening, surveillance, and prevention relevant to the cancer experience is recommended to address the comprehensive health needs of the growing population of cancer survivors. Risk-based care and coordination between oncology and primary care providers have been identified as important metrics of quality cancer survivorship care. Various models of survivorship care, treatment summaries, and survivorship care plans have been promoted as methods to facilitate communication among providers across care transitions and improve survivor access to quality survivorship care. However, research supporting the feasibility of implementing these practices and their effectiveness in enhancing health outcomes is limited. This article reviews key concepts underpinning clinical and research initiatives endeavoring to improve access to quality care among long-term survivors and summarizes results of intervention studies implementing these elements in transitioning survivors from oncology to primary care providers for long-term follow-up care.
    Seminars in Oncology 12/2013; 40(6):804-812. DOI:10.1053/j.seminoncol.2013.09.004 · 3.90 Impact Factor
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    ABSTRACT: Objective As healthcare systems and providers move toward meaningful use of electronic health records, longitudinal care plans (LCPs) may provide a means to improve communication and coordination as patients transition across settings. The objective of this study was to determine the current state of communication of LCPs across settings and levels of care. Materials and methods We conducted surveys and interviews with professionals from emergency departments, acute care hospitals, skilled nursing facilities, and home health agency settings in six regions in the USA. We coded the transcripts according to the Agency for Healthcare Research and Quality (AHRQ) ‘Broad Approaches’ to care coordination to understand the degree to which current practice meets the definition of an LCP. Results Participants (n=22) from all settings reported that LCPs do not exist in their current state. We found LCPs in practice, and none of these were shared or reconciled across settings. Moreover, we found wide variation in the types and formats of care plan information that was communicated as patients transitioned. The most common formats, even when care plan information was communicated within the same healthcare system, were paper and fax. Discussion These findings have implications for data reuse, interoperability, and achieving widespread adoption of LCPs. Conclusions The use of LCPs to support care transitions is suboptimal. Strategies are needed to transform the LCP from vision to reality.
    Journal of the American Medical Informatics Association 07/2014; 21(6). DOI:10.1136/amiajnl-2013-002454 · 3.50 Impact Factor
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