Randomized Controlled Trial of Survivorship Care Plans Among Low-Income, Predominantly Latina Breast Cancer Survivors. Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery. Effects of Survivorship Care Plans on patient reported outcomes in ovarian cancer during 2-year follow-up - The ROGY care trial. Randomized controlled trial of a clinic-based survivorship intervention following adjuvant therapy in breast cancer survivors Telephone follow-up after treatment for endometrial cancer: A qualitative study of patients' and clinical nurse specialists' experiences in the ENDCAT trial. Randomized controlled trial of individualized treatment summary and survivorship care plans for hematopoietic cell transplantation survivors A randomized trial of immediate versus delayed survivorship care plan receipt on patient satisfaction and knowledge of diagnosis and treatment Care After Lymphoma (CALy) trial: A phase II pilot pragmatic randomised controlled trial of a nurse-led model of survivorship care.
Purpose The purpose of this study was to examine the effects of a r and omized controlled trial ( RCT ) of treatment summaries and survivorship care plans coupled with a nurse counseling session , primarily on physician implementation of and secondarily on patient adherence to recommended survivorship care , among a low-income population of breast cancer survivors ( survivors ) . Methods We recruited 212 low-income , predominantly Latina ( 72.6 % ) survivors with stage 0 to III breast cancer , with an average age of 53 years , from two Los Angeles County public hospitals into an RCT of a survivorship care nurse counseling session coupled with the provision of individualized treatment summaries and survivorship care plans to patients and their health care providers from December 2012 to July 2014 . One hundred seven survivors received the experimental intervention  , and 105 survivors received usual care . Multiple linear regression analyses were performed to assess intervention effects on physician implementation of and patient adherence to recommended survivorship care . Scales that served as covariables were Knowledge of Survivorship Issues , Perceived Efficacy in Patient-Physician Interactions , and Satisfaction With Care and Information . Results Survivors in the intervention group reported greater physician implementation of recommended breast cancer survivorship care , for example , treatment of depression or hot flashes , than did those in the control group ( adjusted difference , 16 ± 5.3 ; P = .003 ) . Baseline Satisfaction With Care and Information was positively associated with physician implementation ( coefficient , 5.2 ± 2.2 ; P = .02 ) . Being married/partnered ( -11.8 ± 4.0 ; P = .004 ) and age ( -0.5 ± 0.2 ; P = .028 ) were negatively associated with patient adherence . Conclusion To our knowledge , this is the first RCT of survivorship care plans to show benefits in clinical outcomes , in this case , showing increased physician implementation of recommended breast cancer survivorship care in the intervention group , compared with the control group Purpose Numerous organizations recommend that patients with cancer receive a survivorship care plan ( SCP ) comprising a treatment summary and follow-up care plans . Among current barriers to implementation are providers ' concerns about the strength of evidence that SCPs improve outcomes . This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors . Methods R and omized and nonr and omized studies evaluating  patient-reported outcomes , health care use , and disease outcomes after delivery of  SCPs were identified by search ing MEDLINE , Embase , PsycINFO , Cumulative Index to Nursing and Allied Health Literature , and Cochrane Library . Data extracted by independent raters were summarized on the basis of qualitative synthesis . Results Eleven nonr and omized and 13 r and omized studies met inclusion criteria . Variability was evident across studies in cancer types , SCP delivery timing and method , SCP recipients and content , SCP-related counseling , and outcomes assessed . Nonr and omized study findings yielded descriptive information on satisfaction with care and reactions to SCPs . R and omized study findings were generally negative for the most commonly assessed outcomes ( ie , physical , functional , and psychological well-being ) ; findings were positive in single studies for other outcomes , including amount of information received , satisfaction with care , and physician implementation of recommended care . Conclusion Existing research provides little evidence that SCPs improve health outcomes and health care delivery . Possible explanations include heterogeneity in study design s and the low likelihood that SCP delivery alone would influence distal outcomes . Findings are limited but more positive for proximal outcomes ( eg , information received ) and for care delivery , particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters . Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care OBJECTIVE The aim of this study was to assess the long-term impact of an automatically generated Survivorship Care Plan ( SCP ) on patient reported outcomes in ovarian cancer in routine clinical practice . Outcome measures included satisfaction with information provision and care , illness perceptions and health care utilization . METHODS In this pragmatic cluster r and omized trial , twelve hospitals in the South of the Netherl and s were r and omized to ' SCP care ' or ' usual care ' . All newly diagnosed ovarian cancer patients in the ' SCP care ' arm received an SCP that was automatically generated by the oncology provider , by clicking a button in the web-based Registration system Oncological GYnecology ( ROGY ) .  Ovarian cancer patients ( N=174 , mean age 63.3 , SD=11.4 ; all stages ) completed question naires directly after initial treatment and after 6 , 12 and 24months . RESULTS First question naires were returned from 61 ( 67 % ) ovarian cancer patients in the ' SCP care ' arm and 113 ( 72 % ) patients in the ' usual care ' arm . In the ' SCP care ' arm , 66 % ( N=41 ) of the patients reported receipt of an SCP . No overall differences were observed between the trial arms on satisfaction with information provision , satisfaction with care or health care utilization . Regarding illness perceptions , patients in the ' SCP care ' arm had lower beliefs that the treatment would help to cure their disease ( overall , 6.7 vs. 7.5 , P<0.01 ) . CONCLUSIONS SCPs did not increase satisfaction with information provision or care in ovarian cancer patients . Our trial results suggest that ovarian cancer patients may not benefit from an SCP . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01185626 In 2006 , the IOM released a report citing the importance of “ survivorship plans ” to improve quality of life and care coordination for cancer survivors , but little has been done to evaluate their efficacy . Women with early-stage breast cancer were r and omized within 6 weeks of completing adjuvant therapy to a survivorship intervention group ( SI ) or control group ( CG ) . All subjects were given the NCI publication , “ Facing Forward : Life after Cancer Treatment . ” The SI also met with a nurse/nutritionist to receive a treatment summary , surveillance , and lifestyle recommendations . Both groups completed question naires on the impact of cancer ( IOC ) , patient satisfaction ( FACIT-TS-PS ) , and assessment of survivor concerns ( ASC ) at baseline , 3 and 6 months . Within and between group t tests and linear regression analyses were performed . Among 126 women ( 60 CG , 66 SI ) , mean age was 54 years , 48 % were Hispanic , and the groups were well-balanced by baseline characteristics . No significant differences between the CG and SI on the FACIT-TS-PS or IOC at 3 and 6 months were seen . The ASC health worry subscale was lower ( less worry ) in the SI compared to CG ( p = 0.02 ) . At all time-points , Hispanic women had higher ( worse ) health worry ( p = 0.0008 ) , social-life interference ( p = 0.009 ) , and meaning of cancer scales ( p = 0.0004 ) , and more trust in medical professionals ( p = 0.03 ) compared to non-Hispanic women . While the SI did not lead to significant improvements in most patient-reported outcomes , it was associated with decreased health worry . Future interventions should determine the most efficient and effective method for delivering survivorship care plans PURPOSE Endometrial cancer is the sixth most common female cancer worldwide . There is little evidence that routine hospital surveillance increases survival or decreases morbidity following treatment . Gynaecology Oncology clinical nurse specialists ( CNSs ) are ideally placed to provide the care , information and support to enable women with a gynaecological cancer to self-manage and live well . A multi-centre r and omised controlled trial ( RCT ) compared hospital follow-up ( HFU ) with telephone follow-up ( TFU ) by CNSs . The structured telephone intervention focused on information provision to meet patients psychosocial and information needs . This study aim ed to explore the views of women who had received TFU and the CNS 's who had delivered the service . METHOD A qualitative study to complement the RCT using semi-structured interviews was conducted . Twenty-five patients were r and omly selected from participants in the TFU arm stratified by study site . Seven CNSs were interviewed . RESULTS Patient and CNS regarded TFU positively ; Three themes emerged from the patient interviews ; Convenient Care , Discrete Personalised Care , Confidence and Reassurance . Themes arising from the CNS interviews were Patient Centred Care , Holistic Care and , Confidence and Skills . Patients found that TFU with CNS 's was convenient and enabled discussion of issues and information provision at time-points relevant to them . The CNS 's found the structured format of TFU enabled them to utilise their skills and knowledge to identify and meet patients holistic needs . CONCLUSIONS Alternative models of care such as TFU provided by CNSs provides the care , information and support to enable women treated for endometrial cancer to self-manage and live well Survivorship Care Plans ( SCPs ) may facilitate long-term care for cancer survivors , but their effectiveness has not been established in hematopoietic cell transplantation recipients . We evaluated the impact of individualized SCPs on patient-reported outcomes among transplant survivors . Adult ( ≥18 years at transplant ) survivors who were 1 - 5 years post transplantation , proficient in English , and without relapse or secondary cancers were eligible for this multicenter r and omized trial . SCPs were developed based on risk-factors and treatment exposures using patient data routinely su bmi tted by transplant centers to the Center for International Blood and Marrow Transplant Research and published guidelines for long-term follow up of transplant survivors . Phone surveys assessing patient-reported outcomes were conducted at baseline and at 6 months . The primary end point was confidence in survivorship information , and secondary end points included cancer and treatment distress , knowledge of transplant exposures , health care utilization , and health-related quality of life . Of 495 patients enrolled , 458 completed a baseline survey and were r and omized ( care plan=231 , st and ard care=227 ) ; 200 ( 87 % ) and 199 ( 88 % ) completed the 6-month assessment s , respectively . Patients ’ characteristics were similar in the two arms . Participants on the care plan arm reported significantly lower distress scores at 6 months and an increase in the Mental Component Summary quality of life score assessed by the Short Form 12 ( SF-12 ) instrument . No effect was observed on the end point of confidence in survivorship information or other secondary outcomes . Provision of individualized SCPs generated using registry data was associated with reduced distress and improved mental domain of quality of life among 1 - 5 year hematopoietic cell transplantation survivors . Trial registered at clinical trials.gov 02200133 Survivorship care plans ( SCPs ) and care‐planning sessions have been recommended for over a decade , yet evidence for their benefit remains mixed . In a r and omized trial , changes in survivor knowledge and satisfaction before and after the receipt of an SCP were assessed PURPOSE Post-treatment follow-up for lymphoma potentially fails to address the supportive care needs of survivors . A nurse-led lymphoma survivorship model of care was developed and tested in a phase II pilot pragmatic r and omised controlled trial ( RCT ) . The intervention comprised three face-to-face appointments , delivery of tailored re sources and an individualised survivorship care plan and treatment summary ( SCPTS ) , shared with the general practitioner ( GP ) . METHOD Three months ' post-treatment completion , eligible lymphoma patients were r and omised 1:1 to usual care ( control ) or usual care plus intervention .  Survivorship unmet needs ( Short-Form Survivor Unmet Needs Survey ) , distress ( Depression Anxiety Stress Scale 21 ) , adjustment to cancer ( Mini-Mental Adjustment to Cancer scale ) and self-empowerment ( Patient Empowerment Scale ) were assessed at baseline , three and six months . Univariate and multivariate analyses examined changes within and between groups at the three time points . A GP evaluation survey sought information on the perceived utility of the SCPTS . RESULTS Statistical significance was set at 0.05 ( 2-tailed ) . Although not statistically significant , by study completion , intervention participants ( n = 30 ) , reported less unmet needs ( M = 21.41 vs M = 25.72 , p = .506 ) , less distress ( ( M = 13.03 vs M = 15.14 , p = .558 ) and an increase in empowerment ( M = 50.21 vs M = 47.21 , p = .056 ) compared with control participants ( n = 30 ) . The SCPTS was rated good to very good by a majority of GPs ( n = 13 , 81 % ) . CONCLUSIONS The nurse-led lymphoma survivorship model of care may be a helpful intervention for lymphoma patients who had completed treatment . Survivors require individualised and tailored support and re sources . A tailored SCPTS may promote survivor self-management and increase GP engagement
As a treatment summary ( TS ) documents information for follow-up care , it is believed to be an important communication tool for the patient , their GP , and other health professionals .
The aim of this systematic review ( SR ) was to evaluate the impact of receiving a TS for cancer survivors when compared to receiving st and ard care and to identify knowledge gaps to inform future research .