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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    • "All studies evaluated SCPs that consisted of at least two components: a treatment summary and a plan for long-term follow-up care. Nine of the 10 SCPs were accompanied by other survivorship resources such as booklets, DVDs or websites that contained information about late effects of treatment, supportive care, lifestyle/general health information or copies of follow-up care guidelines (Grunfeld et al, 1996, 2006, 2011; Oeffinger et al, 2010; Jefford et al, 2011; Blaauwbroek et al, 2012; Blinder et al, 2013; Brothers et al, 2013; Hershman et al, 2013). Most of the SCPs were developed primarily as a resource for cancer survivors (Oeffinger et al, 2010; Grunfeld et al, 2011; Jefford et al, 2011; Blaauwbroek et al, 2012; Spain et al, 2012; Blinder et al, 2013; Brothers et al, 2013; Hershman et al, 2013). "
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    ABSTRACT: Background: Eight years after the Institute of Medicine recommended survivorship care plans (SCPs) for all cancer survivors, this study systematically reviewed the evidence for their use. Methods: Studies evaluating outcomes after implementation of SCPs for cancer survivors were identified by searching databases (MEDLINE, EMBASE and Cochrane). Data were extracted and summarised. Results: Ten prospective studies (2286 survivors) met inclusion criteria (5 randomised controlled trials (RCTs)). Study populations included survivors of breast, gynaecological, colorectal and childhood cancer. Several models of SCP were evaluated (paper based/on-line, oncologist/nurse/primary-care physician-delivered and different templates). No significant effect of SCPs was found on survivor distress, satisfaction with care, cancer-care coordination or oncological outcomes in RCTs. Breast cancer survivors with SCPs were better able to correctly identify the clinician responsible for their follow-up care. One study suggested a positive impact on reducing unmet needs. Levels of survivor satisfaction with, and self-reported understanding of, their SCP were very high. Feasibility was raised by health professionals as a significant barrier, as SCPs took 1-4 h of their time to develop. Conclusions: Emerging evidence shows very few measurable benefits of SCPs. Survivors reported high levels of satisfaction with SCPs. Resource issues were identified as a significant barrier to implementation.
    Full-text · Article · Oct 2014 · British Journal of Cancer
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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.
    Preview · Article · Jan 2013 · Cancer
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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.
    No preview · Article · Dec 2013 · Seminars in Oncology
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