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J Cancer Surviv. 2015 Dec;9(4):683-91. doi: 10.1007/s11764-015-0443-1. Epub 2015 Apr 21.

A survivorship care plan for breast cancer survivors: extended results of a randomized clinical trial.

Author information

1
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. a.boekhout@nki.nl.
2
Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. a.boekhout@nki.nl.
3
Center de Recherché du CHU de Québec, Québec, Québec, Canada.
4
Département de Médecine Sociale et Préventive, Université Laval, Québec, Québec, Canada.
5
Ontario Clinical Oncology Group, Hamilton, Ontario, Canada.
6
Department of Oncology, McMaster University, Hamilton, Ontario, Canada.
7
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.
8
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
9
Ontario Institute for Cancer Research, Toronto, Ontario, Canada.

Abstract

PURPOSE:

Prevailing wisdom suggests that implementation of a survivorship care plan (SCP) will address deficits in survivorship care planning and delivery for cancer patients. Here, we present 24-month results of a randomized clinical trial on health service and patient-reported outcomes among breast cancer patients transferred to their primary care physician for follow-up care. The 24-month assessments represent the long-term benefit and sustainability of the implantation of a SCP.

METHODS:

In all, 408 patients with early-stage breast cancer were randomized to the SCP or control group. Patient self-completed questionnaires, supplemented with telephone interviews, during the 24-month study period assessed health service and patient-reported outcomes. The primary outcome was cancer-specific distress. Secondary outcomes included health-related quality of life, patient satisfaction, continuity and coordination of care, and health service outcomes such as adherence to guidelines.

RESULTS:

Over the course of 24 months, there were no differences between both groups in health service and patient-reported outcomes. Women from Quebec compared to those from Western Canada (p < 0.001), women within 2 years of completion of primary treatment compared to a longer period (p = 0.013), and those with a higher SF-36 mental component score compared to a lower score (p = 0.044) were positively associated with adherence to guidelines.

CONCLUSION:

The implementation of a SCP in the transition of survivorship care from cancer center to primary care did not contribute to improved health service or patient-reported outcomes in this study population. Therefore, additional research is needed before widespread implementation of a SCP in clinical practice.

IMPLICATIONS OF CANCER SURVIVORS:

The transition of survivorship care from cancer center to the primary care setting showed no negative effect on health service and patient-reported outcomes.

KEYWORDS:

Breast cancer; Randomized clinical trial; Survivorship care plan

PMID:
25896265
DOI:
10.1007/s11764-015-0443-1
[Indexed for MEDLINE]

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