Development of phase-specific breast cancer survivorship care plans (SCPs).

Authors

null

Susan K. Parsons

Tufts Medical Center, Boston, MA

Susan K. Parsons , Tracey Weisberg , Lauren Boehm , Arlene O'Rourke , Angie Mae Rodday , Nadine Linendoll , John Kalil Erban

Organizations

Tufts Medical Center, Boston, MA, New England Cancer Specialists, Scarborough, ME, Tufts University School of Medicine, Boston, MA

Research Funding

Other

Background: There are nearly 3 million breast cancer (BC) survivors in the US. Among the recently diagnosed, accrediting organizations (e.g., Commission on Cancer) now require SCPs at the completion of curative therapy. Within the Oncology Care Model, the preparation and delivery of SCPs is recognized as one of the 13 quality metrics. SCPs, combining treatment summaries (TS) and follow-up care plans (FUCPs), assist patients and providers in the delivery of high quality long-term care. BC presents a unique challenge, as the risk of recurrence extends decades past initial treatment; adjuvant risk reduction may extend up to 15 years. Periodic FUCPs provide a mechanism to review updated information and may allow providers to catch up with longer term BC survivors whose care was delivered prior to SCPs. We explored the role of phase-specific SCPs within the heterogeneous BC survivor population. Methods: Oncologists and nurse practitioners (NPs) from the Breast Health and Survivorship Programs at Tufts MC, an academic medical center in Boston, and New England Cancer Specialists, a community-based private oncology practice in Maine--together caring for more than 2,000 BC survivors--convened to develop and test phase-specific survivorship tools. Using an adapted ASCO template for BC, TS were completed at the end of initial therapy by trained NPs. FUCPs for initial, 5-year, and 10-year visits were designed with clinical input, literature reviews, and existing guidelines. Results: FUCPs were pilot tested and refined before incorporation into the electronic health record. Further testing is planned to identify barriers to effective survivorship care, particularly involving documentation of changes in recommendations and the transition from oncologist to primary care physician. Conclusions: SCPs are critical for providing quality health care to BC survivors, but a single SCP, written at the conclusion of curative treatment, might not be sufficient to address changing needs of individuals as they progress through survivorship. Thus, phase-specific SCPs enable providers to focus on salient aspects of care that may change over time. Despite growing recognition of the value of SCPs, implementation remains a challenge across cancer programs.

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Abstract Details

Meeting

2017 Cancer Survivorship Symposium

Session Type

Poster Session

Session Title

Poster Session A: Care Coordination and Financial Implications, Communication, and Health Promotion

Track

Care Coordination and Financial Implications,Communication,Health Promotion

Sub Track

Survivorship Care Plans

Citation

J Clin Oncol 35, 2017 (suppl 5S; abstr 61)

DOI

10.1200/JCO.2017.35.5_suppl.61

Abstract #

61

Poster Bd #

F6

Abstract Disclosures

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