Many cancer survivors do not receive adequate post-treatment care.1-8 To address deficiencies in post- treatment (survivorship) care, the Institute of Medicine (IOM) proposed the development of survivorship care plans, which will be called """"""""care plans"""""""" in this proposal.9 Each care plan contains personalized information about the survivor's diagnosis and treatment, recommended ongoing care, and a list of resources for cancer survivors. These written plans are provided by cancer specialists to each cancer survivor and are to be shared with their primary care physician. The two goals of using care plans are to 1) educate survivors about cancer survivorship issues and 2) help primary care physicians deliver high quality care for cancer survivors. Care plans have excellent face validity, but they have not been evaluated in terms of their ability to address the needs and preferences of those who create and disseminate care plans (cancer specialists) and those who receive care plans (cancer survivors and primary care physicians). In order to improve the quality of care that cancer survivors receive, care plans must contain the critical information that survivors need to seek out appropriate post-treatment care and that will help primary care physicians provide high quality care to cancer survivors. Further, care plans must be convenient to implement. To maximize the use and benefits of care plans, they need to be designed around the needs and preferences of survivors, cancer specialists, and primary care physicians. These needs and preferences have not yet been evaluated. The proposed study aims to step back from promoting care plans and answer these important questions by surveying cancer survivors, primary care physicians, and cancer specialists. We focus on the care of colorectal cancer (CRC) survivors, who number approximately 1 million in the U.S.9 and have well-documented deficiencies in post-cancer care, including low rates of testing for new CRCs, low rates of testing for other cancers, low rates of use of necessary medical care, and high rates of psychological distress.1-8, 10-12 We aim to develop, pilot-test, and administer surveys to survivors and physicians and report their needs and preferences in a descriptive study. Further, we aim to systematically review care plans for both CRC and breast cancer that are already in use at NCI-designated cancer centers, in order to describe the reach and content of existing care plans. We will use the IOM's proposal for care plans as criteria to evaluate care plans.9 In a future study, the findings from the surveys and the review of existing care plans will guide the development of a new care plan that responds to the needs of survivors and physicians. We will submit an NIH R01 grant proposal to test how effectively the new care plan improves the quality of care for CRC survivors.
Although survivorship care plans are increasingly being used and disseminated to cancer survivors, this study fills in an important gap in understanding the problems care plans need to address and how care plans can best be targeted to cancer survivors and the physicians who care for them. Findings from this study will contribute to the development of a care plan that responds to the needs and preferences of these individuals, and its effectiveness in promoting high quality survivorship care will be evaluated in a future randomized clinical trial.
| Atkinson, Thomas M; Salz, Talya; Touza, Kaitlin K et al. (2015) Does colorectal cancer risk perception predict screening behavior? A systematic review and meta-analysis. J Behav Med 38:837-50 |
| Salz, Talya; McCabe, Mary S; Onstad, Erin E et al. (2014) Survivorship care plans: is there buy-in from community oncology providers? Cancer 120:722-30 |
| Salz, Talya; Baxi, Shrujal S; Blinder, Victoria S et al. (2014) Colorectal cancer survivors' needs and preferences for survivorship information. J Oncol Pract 10:e277-82 |
| Salz, Talya; Oeffinger, Kevin C; McCabe, Mary S et al. (2012) Survivorship care plans in research and practice. CA Cancer J Clin 62:101-17 |
| Salz, Talya; Oeffinger, Kevin C; Lewis, Peter R et al. (2012) Primary care providers' needs and preferences for information about colorectal cancer survivorship care. J Am Board Fam Med 25:635-51 |
