A new study found that low-income breast cancer survivors who receive tailored survivorship care plans and counselling have 8% higher adherence to recommended survivorship care.
The researchers identified three factors that affect survivor health outcomes: survivors’ breast cancer knowledge, confidence in interacting with physicians, and having a usual source of health care (e.g., primary care provider).
According to the authors, this is the first randomised clinical trial to show survivorship care plans can significantly improve patient outcomes.
The study was presented at the upcoming 2016 Cancer Survivorship Symposium in San Francisco.
“Low-income women tend to have less access to high-quality health care, along with unique needs and concerns,” said Rose C. Maly, MD, MSPH, an associate professor of family medicine at the University of California in Los Angeles, California.
“This personalised intervention would be of greatest benefit to this vulnerable group, and it could be adapted for use with other types of cancer.”
After treatment for breast cancer, follow-up (survivorship) care is important in helping maintain good health.
Survivorship care may include managing short- and long-term side effects from treatment and watching for signs of a cancer recurrence.
The researchers randomly assigned 212 low-income women with stage 0-III breast cancer to a survivorship care intervention or usual care.
The women in the intervention group completed a questionnaire assessing their needs and concerns, such as hot flashes, memory problems, weight gain, and sexual dysfunction.
Based on their responses, the researchers provided recommendations for further care.
A survivorship care nurse drafted personalised survivorship care plans, which were provided to the patient and their physicians of record (oncologist, surgeon, primary care physician).
Besides recommendations for further care, the plans included personalised breast cancer treatment summaries and a list of resources, such as patient support groups.
All survivors in the intervention group also received an hour long counselling session with the survivorship care nurse.
Through role-play, the women were coached how to ask their physicians to implement the survivorship care recommendations.
At 12 months, patients in the intervention group reported approximately 9.5% greater adherence to survivorship care recommendations than those in the usual care group.
Patient adherence rates were 51.1 % and 60.6% in the control and intervention groups, respectively.
Breast cancer knowledge about survivorship issues, as measured by the Preparing for Life as a New Survivor Scale (PLANS Scale), and confidence in the ability to interact with the physician, as measured by the Perceived Efficacy in Patient-Physician Interactions Scale (PEPPI), were associated with greater adherence to recommended care.
On the other hand, women who had no usual source of health care (e.g., primary care provider) were less likely to receive the recommended care.
The Institute of Medicine recommends that each patient with cancer receive an individualised treatment summary and survivorship care plan.
Nonetheless, such plans are underutilised in routine practice.
(24 Jan 2017)