Do Cancer Survivorship Care Plans Improve Health Outcomes, Care Delivery?

05/23/18

A recent systematic review evaluated whether survivorship care plan delivery has a positive impact on health outcomes and health care delivery for patients with cancer.

The review was presented in part at the 2018 ASCO Cancer Survivorship Symposium (February 16-17, 2018; Orlando, FL) and is published in full in the Journal of Clinical Oncology (online May 18, 2018; doi:10.1200/JCO.2018.77.7482).

Many health systems recommend that patients with cancer receive a survivorship care plan, comprised of a treatment summary and follow-up care plans. However, there are multiple barriers to implementation of survivorship care plans, including provider concerns about the strength of evidence demonstrating improved outcomes.

Paul B Jacobsen, PhD, National Cancer Institute (Bethesda, MD), and colleagues designed a review to determine whether survivorship care plans have a measurable impact on health outcomes and health care delivery for survivors of cancer. A total of 13 randomized and 11 non-randomized studies evaluating patient-reported outcomes, health care use, and disease outcomes after survivorship care plan delivery were identified through MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library.

Results of the review showed that variability existed across studies in cancer types, survivorship care plan delivery timing and methodology, recipients and content, counseling, and outcomes assessed. While non-randomized study findings yielded descriptive information on satisfaction with care and reactions to survivorship care plans, randomized study findings were mostly negative for the commonly assessed outcomes (ie, physical, functional, and psychological well-being).

Dr Jacobsen and colleagues acknowledged that findings were positive in single randomized studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care.

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“Existing research provides little evidence that survivorship care plans improve health outcomes and health care delivery,” Dr Jacobsen and colleagues concluded. “Possible explanations include heterogeneity in study designs and the low likelihood that survivorship care plan delivery alone would influence distal outcomes.”

Additionally, authors of the study noted that findings were limited but more positive for proximal outcomes and for care delivery, especially when survivorship care plans were accompanied by counseling to prepare survivors for future clinical events.—Zachary Bessette