UPMC Pinnacle, Harrisburg, PA
Beth Rudge , Megan Lanigan , Theresa M. Lee , Lisa Torp , Kit Yu Lu
Background: Survivors of breast cancer can face a multitude of long term and late effects after completing active treatment. Recommendations for side effect management can vary widely based on professional society guidelines, a provider’s clinical experience, and patient preference. When providing survivorship care in a multidisciplinary institution, maintaining consistent recommendations between providers and disciplines can be a daunting challenge. A cohesive approach is extremely important for a satisfying patient-clinician relationship and for patient safety. Our objective is to create standardized management of breast cancer survivorship issues. Methods: A quarterly Survivorship Multidisciplinary Conference (SMC) was initiated for case review and education on side effect management. The multidisciplinary group included medical and radiation oncologists, surgeons, nurse practitioners, nurse navigators, dieticians, physical therapists, social workers, spiritual care, and a genetic counselor. We used an evidence-based approach, including ASCO and NCCN guidelines as well as published peer-reviewed recommendations to create a treatment consensus for side effect management. Clinicians attending SMC were surveyed regarding their approach to late and long term effects of breast cancer pre- and post-SMC and their overall satisfaction with the conference. Results: Prior to involvement in SMC, most providers based their treatment of side effects on their own professional society’s guidelines and their personal clinical experience. After implementing SMC, 60% of providers reported a change in their practice and there was a 37.5% reported increase in the use of ASCO and NCCN survivorship guidelines across disciplines. 94% of providers reported the SMC is effective in providing evidence based guidelines. Providers also reported a high level of satisfaction and that SMC provided opportunity for a more collaborative multidisciplinary approach. Conclusions: Survivorship Multidisciplinary Conference brings multiple specialties together for review of evidence-based approaches to survivorship care, increasing consistency in management of survivors' late and long term effects after completing breast cancer treatment.
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