Abstract
Introduction: A decade ago the Institute of Medicine recommended that every survivor receive a survivor care plan (SCP) yet despite endorsements of clinical merit, evidence is still evolving regarding SCP utility and value to patients. Method: This pilot enrolled 65 women (Mean (M) age 60 years, range 43-82) who recently completed active treatment for breast cancer (stage 0-III, M=5 months since diagnosis). Patients completed an electronic patient reported outcomes (ePRO) survey via the Carevive Care Planning System (CPS) which is combined with clinical data to electronically generate tailored care plans with survivorship and symptom specific recommendations (i.e. follow-up care, self-management, supportive care referrals). Nurse practitioners conducted a consultative survivorship visit during which patients received their care plan. Patients completed follow-up assessments approximately 6 weeks later. Data Analysis/Results: Study outcomes include patient-reported use and helpfulness of, and satisfaction (1-5 Likert scale) with, their SCP. N=41 follow-up surveys (63%) were completed to date. Patients reported high overall satisfaction (M=4.19) and 95% (n=37) would, “recommend other women receive a similar care plan after cancer treatment.” Patients also reported using the care plans M=6 ways, the most prominent being; 1) reading/planning to read carefully (100%), 2) using/planning to use to help inform about symptoms (89%), 3) using/planning to use to find information online and to help in talking to health care professionals about concerns (84% each). There was a trend toward patients with a higher number of symptom recommendations (recommendations linked to ePRO) reporting higher usefulness of the SCP (number of ways used; p = .055; t = -.379). No correlation was found between usefulness and number of surveillance/risk recommendations (recommendations not directly linked to ePRO). SCPs were most helpful to patients by, 1) helping to make decisions about what tests to receive and when (76% of patients), 2) helping them talk to family about their cancer experience (74% of patients), and 3) helping them to make changes in diet and exercise (73% and 70%, respectively). Conclusions: Satisfaction with the SCP was high and patients reported a variety of ways in which their SCP was used and was helpful. By linking point of care symptom screening with survivorship care planning, there is potential to provide patients the most valuable SCP possible by combining broader survivorship concerns with active symptom needs. Further studies are needed to determine whether these tailored SCP actually improve patient outcomes. l
