Impact of Cancer Survivorship Care Plans on Health Care Delivery, QoL
A systematic review presented at the 2018 ASCO Cancer Survivorship Symposium (February 16-17, 2018; Orlando, FL) determined whether survivorship care plans have a positive impact on health outcomes and health care delivery.
The Institute of Medicine (IOM) recommended in 2006 that patients with cancer nearing the end of treatment should be provided with survivorship care plans to improve care delivery and outcomes in the post-treatment period. Included in the recommended care plans were treatment summaries, relevant health information, and follow-up care plans.
Paul B Jacobsen, PhD, associate director, Division of Cancer Control and Population Science Healthcare Delivery Research Program, National Cancer Institute (NCI), and colleagues conducted a systematic review of published literature to determine if survivorship care plans have a positive impact on health outcomes and health care delivery. Thirteen randomized and 11 non-randomized studies were identified through MEDLINE, Embase, PsycINFO, and Cochrane Library that evaluated patient-reported outcomes, health care utilization, and disease outcomes after delivery of survivorship care plans. Data were extracted by independent raters and summarized based on qualitative synthesis.
Researchers noted that variability was observed across studies in cancer diagnoses, timing if survivorship care plan delivery in relation to treatment completion, survivorship care plan delivery method and recipients, survivorship care plan content, survivorship care plan-related counseling, and outcomes assessed.
Non-randomized studies yielded data only on outcomes such as satisfaction with care and reactions to survivorship care plans.
Among the randomized studies, findings were mostly negative for the impact of survivorship care plans on the commonly assessed outcomes (eg, physical, functional, and psychological well-being). However, findings were positive in single studies for other outcomes including amount of information received, satisfaction with care, and physician implementation of recommended survivorship care.
Dr Jacobsen and colleagues concluded that the existing research provides minimal evidence that survivorship care plans improve quality of life in cancer survivors, most likely due to heterogeneity in study designs as well as the low likelihood that survivorship care plan alone influences distal health outcomes. “In light of current findings, future research should focus to a greater extent on evaluating ways to ensure survivorship care plan recommendations are subsequently implemented as part of ongoing care,” they wrote.—Zachary Bessette