Implementation of treatment summaries and survivorship care plans (TSSPs) improved physician adherence to survivorship care recommendations for low-income patients with breast cancer, according to a study published in the Journal of Clinical Oncology.1
TSSPs are recommended by the Institute of Medicine to improve coordination of post–cancer treatment care for cancer survivors. The purpose of this trial was to evaluate the effect of TSSPs on physician implementation of the recommended survivorship care.
The multicenter study randomly assigned 212 low-income patients with stage 0 to III breast cancer and their health care providers to TSSPs or usual care. The intervention included a survivorship care nurse counseling session, individualized treatment summaries, and survivorship care plans.
Survivorship care included evaluation and treatment when appropriate for bone health, depression, weight gain, decreased range of motion, fatigue, fertility, insomnia, and lymphedema, among other issues. Treatment summaries included providing information of genetic testing and characteristics of the patient’s disease and treatment.
The mean age was 53, 72.6% of patients were Latina, 42% had a high school or higher education level, and 91% had an annual income < $30,000. At baseline, the general health status was poor or fair for 75%, 3.4% were knowledgeable of survivorship issues, and 11.5% were satisfied with care and information received.
The intervention significantly improved overall physician implementation of recommended survivorship care with a rate of 60.8 (± 32.6) compared with 48.6 (± 29.1; P = .005) in the control group. There was no significant difference in overall patient adherence to survivorship care between arms.
Physician implementation was positively associated with patient baseline satisfaction with care and information. Patient adherence was negatively associated with being married/partnered and age.
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The results of this study suggest that treatment summaries and survivorship care plans may improve physician implementation of recommended survivorship care.
The authors wrote that future studies should “examine whether greater benefits would accrue if the interventions were delivered at the point of transitioning off active treatment.”
- Maly RC, Liang LJ, Liu Y, Griggs JJ, Ganz PA. Randomized controlled trial of survivorship care plans among low-income, predominantly Latina breast cancer survivors. J Clin Oncol. 2017 Apr 18. doi: 10.1200/JCO.2016.68.9497 [Epub ahead of print]