Survivorship care planning after the Institute of Medicine recommendations: how are we faring?

Abstract

Introduction This study evaluates the concordance of treatment summaries (TSs) and survivorship care plans (SCPs) delivered to breast cancer survivors within the LIVESTRONG™ Network of Survivorship Centers of Excellence with Institute of Medicine (IOM) recommendations and describes additional structure/process variables. Method Seven NCI-designated comprehensive cancer centers and six community-based centers participated. TS/SCPs for 65 patients were rated against IOM recommendations using a study-derived checklist, and surveys were administered to better understand the structure and process of delivering TSs/SCPs. Results On average, fewer than half of IOM content recommendations were met for TSs (M=46%) and less than two thirds for SCPs (M=59%). No sites achieved ≥75% overall concordance with IOM recommendations for TSs and only two of 13 met this criterion for SCPs. Content domain scores across sites varied widely, as did the number of sites addressing domain content with ≥75% concordance. Nonetheless, resources required for document preparation and delivery were substantial. Discussion Gaps in concordance with IOM recommendations exist even in dedicated survivorship centers. A substantial time burden was also noted. Further research is needed to determine which informational elements are essential, to develop and test strategies for improving efficiency and reach, and to determine if outcomes of survivorship care planning warrant the resources required in their preparation and delivery. Implications for survivors TSs and SCPs have been recommended for all cancer survivors. Essential elements must be determined, approaches made more efficient, outcome improvements demonstrated, and cost-benefit analyses determined before survivors should expect widespread implementation of this recommendation for survivorship care.

Patient Satisfaction With Breast and Colorectal Cancer Survivorship Care Plans

“…Author Manuscript addition, the inclusion of contact information for care coordinators or navigators in survivorship care plans is rare (Strieker et al, 2011). The authors' results provide additional evidence that an urgent need exists for guidelines from professional societies and other organizations that can clarify the role of primary care providers and oncologists in survivorship care and reduce uncertainty for providers and patients.…”

Wellness beyond Cancer Program: Building an Effective Survivorship Program

“…Criticisms of scps include the substantial amount of time required for their preparation 17 and poor use or uptake by the pcps for whom the plans are intended [17][18][19][20] . Further no funding is specifically dedicated for the preparation of such a document.…”

Development and validation of an individualized survivorship care plan (ISCP) for women with endometrial cancer during the transition of the end of active treatment to the cancer survivorship

“…According to Stricker et al (2011), only 59% of existing IFCPs contain the IOM-proposed content (Hewitt et al, 2006). In addition to these recommendations, participants also suggest that simple, easy-to-understand (non-medical) language be used and that the information contained in the IFCP be relevant to the survivor (Burg et al, 2009).…”