Piloting breast cancer survivorship care planning in a safety net hospital.

Authors

null

Sofia F. Garcia

Northwestern University Feinberg School of Medicine, Chicago, IL

Sofia F. Garcia , Katy Wortman , Yanina Guevara , Elizabeth A. Hahn , Maria E. Corona , Shakuntala Shrestha , Paramjeet Khosla , Pam Khosla

Organizations

Northwestern University Feinberg School of Medicine, Chicago, IL, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, Mount Sinai Hospital, Chicago, IL, The Mount Sinai Comprehensive Cancer Center

Research Funding

Other Foundation

Background: Survivorship care plans (SCPs) include treatment summaries and follow-up care recommendations intended to improve patient care and well-being after cancer treatment. Limited research has yielded mixed results regarding SCPs' impact on patient and system outcomes, but emphasized provider burden as an implementation barrier. We created a patient-centered SCP template and implemented its delivery at a safety net hospital that serves primarily racial/ethnic minority patients. Methods: In a single-arm feasibility study, oncologists and advanced practice nurses used the template to deliver SCPs to post-treatment breast cancer survivors (BCS) in consultation visits. We assessed changes in patient-reported outcomes from baseline (pre-SCP) to a 3-month follow-up, as well as provider time burden. Results: Female BCS participants (n = 75; mean age = 58.5 years) were primarily African-American (73%) and had high school/GED education or less (61%). Average time since diagnosis was 3.7 years (SD = 3.8); all received surgery; most received radiation (84%), hormone (77%), and/or chemotherapy treatment (73%). At follow-up, a majority rated their SCPs as good to excellent (92%), easy or very easy to understand (84%), a good to excellent summary of their treatment (92%) and as motivation for healthy lifestyles (88%). BCS follow-up scores improved significantly from baseline on breast cancer knowledge (p = .02), self-efficacy (p = .03), the QLQ-INFO25 (p < .01), and the FACIT TS-PS satisfaction with health care staff communication subscale (p < .01). No significant differences between baseline and follow-up scores (p < .05) were found for overall treatment satisfaction, health behaviors, and health-related quality of life. Preparing and delivering SCPs took providers considerable time (M = 54 & 22 minutes, respectively). Conclusions: This pilot study is limited by a single-arm design, but results suggest that SCPs may be related to improved survivor knowledge, information, self-efficacy and communication with health care staff. The individualized, comprehensive SCPs were well received by BCS in a safety net hospital but delivery was time-intensive. These findings will inform future research trials and clinical care initiatives.

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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 65)

DOI

10.1200/JCO.2017.35.5_suppl.65

Abstract #

65

Poster Bd #

F10

Abstract Disclosures

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