Benefit of Survivorship Care Plans Among Low-Income, Predominantly Latina Breast Cancer Survivors
A randomized trial, reported by Maly et al in the Journal of Clinical Oncology, has shown that having an individualized survivorship care plan in place was associated with increased physician implementation of recommended breast cancer survivorship care among low-income, predominantly Latina breast cancer survivors.
Study Details
In the study, 212 women (73% Latina; average age = 53 years) with stage 0 to III disease from 2 Los Angeles County public hospitals were randomized between December 2012 and July 2014 to an intervention group (n = 107) or a usual-care group (n = 105). All patients identified survivorship care needs at a baseline interview.
Patients in the intervention group received a survivorship care nurse counseling session, and they and their health-care providers were given individualized treatment summaries and survivorship care plans. Physician implementation scores for survivorship needs and patient scores for adherence to recommended survivorship care were transformed to a 0 to 100 (highest implementation/adherence) score. The primary outcome was physician implementation of treatment summaries and survivorship care plans recommendations over 12 months, assessed by quarterly participant interviews, with patent adherence to recommended care as a secondary outcome measure. Knowledge of Survivorship Issues, Perceived Efficacy in Patient-Physician Interactions, and Satisfaction With Care and Information scales were used as covariables.
Improved Physician Implementation
The mean physician implementation score for treatment summaries and survivorship care plans recommendations was 60.8 (median = 66.7) in the intervention group vs 48.6 (median = 50) in the control group (unadjusted P = .005). The mean patient adherence score was 55.7 vs 48.7 (unadjusted P = .07).
On multivariate analysis, the effect of intervention remained significant for physician implementation (estimated difference = 16.0, P = .003) but was not significant for patient adherence. Physicians were more likely to implement recommended survivorship care for patients with higher baseline scores on the Satisfaction with Care and Information scale (P = .02). Having a spouse or partner (P = .004) and older age (P = .028) were significant negative predictors of patient adherence to recommended survivorship care.
The investigators concluded: “To our knowledge, this is the first [randomized controlled trial] 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.”
The study was supported by the National Cancer Institute.
Rose C. Maly, MD, MSPH, of the David Geffen School of Medicine at the University of California at Los Angeles, is the corresponding author of the Journal of Clinical Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
