Improving quality of cancer survivorship care: From framework to action.

Authors

Larissa Nekhlyudov

Larissa Nekhlyudov

Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA

Larissa Nekhlyudov, Michelle Mollica, Paul B. Jacobsen, Ann M. Geiger

Organizations

Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, National Cancer Institute, Bethesda, MD, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, Natl Cancer Inst, Rockville, MD

Research Funding

NIH

Background: One decade after the Institute of Medicine report recommended the development of quality of cancer survivorship care measures, there remains little progress in achieving that goal. Our goal was to develop a framework for quality measurement and outline the next steps needed to drive research, policy and clinical care. Methods: We conducted a scoping review to identify quality domains and indicators for cancer survivorship care that included: (1) published cancer/cancer survivorship guidelines; (2) National Cancer Institute and Patient-Centered Outcomes Research Institute-funded cancer survivorship studies; (3) U.S. state Comprehensive Cancer Control Plans; (4) indicators developed by national quality organizations. We also reviewed published literature, specifically focusing on narrative and systematic reviews, commentaries/editorials and position papers addressing cancer survivorship care quality. We then conducted interviews with key experts in cancer survivorship and quality. Once the framework was developed, we convened a stakeholder meeting to outline actionable next steps. Results: Key domains focused on (1) cancer and its treatment, specifically prevention and surveillance of recurrences and second cancers as well as surveillance and management of physical and psychosocial effects and (2) primary health care needs such as management of multiple medical conditions and health promotion. Patient experience, communication, care coordination and health care delivery structure are critical domains in cancer survivorship care that must be measured. Lastly, domains included health care outcomes, such as utilization, costs, mortality and quality of life. Respective indicators and findings from stakeholder meeting will be presented at the Symposium. Conclusions: We developed a framework that will promote a systematic approach to (1) designing effective, evidence-based clinical care for cancer survivors in oncology and primary care settings, (2) expanding research initiatives to address identified gaps in quality measurement and (3) developing policy recommendations to encourage the implementation of standardized measures for quality improvement.

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Abstract Details

Meeting

2018 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Big Data Studies; Projects Relating to Equity, Value, and Policy

Track

Projects Relating to Equity, Value and Policy,Big Data Studies

Sub Track

Guideline Concordant Care Initiatives

Citation

J Clin Oncol 36, 2018 (suppl 30; abstr 49)

DOI

10.1200/JCO.2018.36.30_suppl.49

Abstract #

49

Poster Bd #

F2

Abstract Disclosures

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