With the growing cohort of cancer survivors now numbering 11 million Americans, appropriate follow-up care is pivotal to their ongoing long-term health. Despite guidelines regarding surveillance for recurrence and monitoring of toxicities and late effects, cancer survivors are often lost to follow-up, resulting in fragmented, inadequate care. Recently there has been increased emphasis on the gap between the needs of cancer survivors and current practice. Survivorship care planning, specifically provision of a treatment summary and survivorship care plan (TS/SCP) to patients completing active treatment, has been proffered by the Institute of Medicine as one solution to this growing public health issue. The goals of TS/SCPs are: 1) enhance patient knowledge of their cancer care, and extant health risks;2) increase patient awareness of and confidence in obtaining requisite follow-up care;3) communication and coordination of care between patients and providers and 4) impact patients'length and quality of survival via a focus on health promotion and prevention. Treatment summaries and survivorship care plans have yet to be widely adopted or empirically investigated despite their foreseeable advantages, due in part to a lack of methodology and outcome measures to assess their potential benefits. Thus, development and pilot of methodology targeting detection of the benefits of implementation of treatment summary and survivorship care plans is a crucial first step, one that may have implications for understanding longer-term outcomes. The proposed project will;1) develop methodology to assess potential benefits of treatment summaries and survivorship care plans;and 2) pilot the developed outcome measures with cancer patients transitioning to off-treatment. In Study 1, qualitative research will be conducted to formulate and refine outcome measures via interviews with diverse stakeholders (health care providers and colorectal cancer survivors). The outcome measures identified and refined in Study 1 will then be used in Study 2 to evaluate the benefits of providing TS/SCPs to colorectal cancer patients finishing active treatment and transitioning to off-treatment status. Study 2 will assess the ability of the outcome measures to detect the anticipated benefits of treatment summaries and survivorship care plans. In a randomized wait-list control design, patients who receive written treatment summaries and survivorship care plans will be compared to patients who did not receive written treatment summaries and survivorship care plans on outcome measures. Thus, this study is expected to yield measures and methodology to empirically assess the potential benefits of treatment summaries and survivorship care plans. Findings from this study will be used together in a future randomized longitudinal study to more definitively evaluate the impact of treatment summaries and survivorship care plans for patients with colorectal cancer and other common types of cancer.
Ongoing follow-up care is pivotal to the long-term health of the rapidly growing group of cancer survivors, now numbering 11 million Americans. The transition from active treatment to off-treatment status is characterized as a vulnerable period, when quality of care often breaks down. A better understanding of this issue is critical to provide higher quality care to cancer survivors, thereby improving public health. Provision of a detailed cancer care record and surveillance plan, called a cancer treatment summary and survivorship care plan, is one potential solution, though untried and untested. Adequate methodology to conduct an assessment of the potential benefits of implementing a treatment summary and survivorship care plan is essential to ensure that cancer patients receive ongoing high-quality follow-up care as survivors. The proposed study will 1) develop outcome measures to assess potential benefits of treatment summaries and survivorship care plans, and 2) pilot the newly developed outcome measures with colorectal cancer patients completing active treatment and transitioning to survivorship.
| Faul, Leigh Anne; Rivers, Brian; Shibata, David et al. (2012) Survivorship care planning in colorectal cancer: feedback from survivors & providers. J Psychosoc Oncol 30:198-216 |
| Mandelblatt, Jeanne S; Faul, Leigh Anne; Luta, George et al. (2012) Patient and physician decision styles and breast cancer chemotherapy use in older women: Cancer and Leukemia Group B protocol 369901. J Clin Oncol 30:2609-14 |
