A randomized trial of immediate versus delayed survivorship care plan receipt on patient satisfaction and knowledge of diagnosis and treatment

Abstract

BACKGROUND: Survivorship care plans (SCPs) and care-planning sessions have been recommended for over a decade, yet evidence for their benefit remains mixed. In a randomized trial, changes in survivor knowledge and satisfaction before and after the receipt of an SCP were assessed. METHODS: Patients with breast cancer who had completed curative-intent treatment were randomized to immediate versus delayed receipt of an individualized SCP. All participants completed the modified Wisconsin Survey of Cancer Diagnosis and Management in Breast Cancer and the Preparing for Life As a New Survivor survey to assess individual knowledge about cancer diagnosis, treatment, side effects, and follow-up as well as satisfaction with communication and care coordination. Surveys were completed at baseline, at 4 weeks (before delayed receipt), and again at 12 weeks (after all participants had received SCPs); the primary outcome was change in knowledge at 4 weeks. RESULTS: In total, 127 eligible women were randomized. An improvement in individual knowledge was observed between baseline and week 12 for both arms combined (+1.6; 95% confidence interval, 0.9-2.3; P < .001). There was no statistically significant difference in the change in knowledge from baseline through week 4 between the arms. No significant change occurred for satisfaction scores over time. CONCLUSIONS: This randomized trial of immediate versus delayed SCP receipt demonstrated a small improvement (4%) in survivor knowledge. However, this improvement did not appear to be related to SCP provision. The authors hypothesized that the improvement was because of repeated administration of the knowledge survey. If improved survivor knowledge is a goal, then strategies beyond the 1-time provision and review of an SCP should be explored.

Survivorship, Version 1.2021

“…36,37 Health insurance access may in fact be a main reason that survivors work even when they are not fully recovered. 38 The psychosocial advantages derived from work may include a sense of purpose, emotional well-being, a link to identity, improved health-related quality of life (HRQoL), connection with others, and distraction. When employment is disrupted, these advantages can be lost.…”

Has the Quality of Patient–Provider Communication About Survivorship Care Improved?

“…Crucial issues regarding the implementation of SCPs include a lack of standardized models of survivorship care, uncertainty about the timing and mode of plan delivery, and lack of clarity regarding how to integrate treatment plans and summaries into the care workflow and EHRs. 34,35 Other challenges include clinician time required to create SCPs, lack of reimbursement for this time, and the lack of evidence that SCPs improve outcomes. 19,34,36,37 Concerns also have been raised about an overemphasis on the meansthe documentation and distribution of SCPs-but an insufficient focus on the ends: streamlining care and improving communication about sequelae of cancer, its treatment, and other vital aspects of follow-up.…”

Impact of Survivorship Care Planning of Oncology Care at the End of Treatment for Breast Cancer: A Randomized Controlled Trial

“…13 Therefore, the present study utilizes Tucker and Kelley's (2000) patient satisfaction theory as its theoretical framework. 14 Developed from Linder-Peltz's expectancy-value theory, along with the work of several other studies, patient satisfaction theory posits that satisfaction is determined by the perception of access, communication, quality of care, and outcomes. Because the POST SCP is tailored to each patient, we expected that women who received this care plan would have a positive perception of communication and knowledge with their providers and would receive more information on survivorship topics.…”