Using Survivorship Care Plans to Enhance Communication and Cancer Care Coordination: Results of a Pilot Study

Deborah K. Mayer

Allison M. Deal

Jeffrey M. Crane

Ronald C. Chen

Gary N. Asher

Laura C. Hanson

Stephanie B. Wheeler

Adrian Gerstel

Melissa Green

Sarah Birken

Donald L. Rosenstein

survivorship care plan, cancer surveillance, cancer care coordination, patient activation, cancer worries
ONF 2016, 43(5), 636-645. DOI: 10.1188/16.ONF.636-645

Purpose/Objectives: To compare a structured cancer survivorship care plan (SCP) transition visit versus an SCP transition visit coupled with a coordinated follow-up visit from the primary care provider (PCP).

Design: Pilot randomized, controlled study.

Setting: REX Cancer Hospital, a community cancer center in Raleigh, North Carolina.

Sample: 34 adults completing treatment with curative intent.

Methods: Patients and PCPs completed measures at baseline and at six weeks. Wilcoxon signed rank and rank sum tests were used for comparisons of SCP only versus SCP with PCP follow-up visit, as well as between high- and low-activated patients.

Main Research Variables: Confidence in survivorship information and survivor concerns.

Findings: The intervention was feasible and acceptable to patients and their PCPs. All patients (N = 34) had less contradictory information about care after SCP receipt. PCPs reported improved confidence in patients, regardless of intervention arm. Highly activated or empowered patients benefited more and had increased confidence and fewer concerns about cancer care.

Conclusions: The SCP interventions led to increased confidence in survivorship information, but some benefits were greater for highly activated patients. PCPs also had improved confidence in survivorship care after SCP receipt, whether or not they saw the patient in follow-up. A larger study is needed to further explore these findings and the changes over time.

Implications for Nursing: Nurses can be instrumental in facilitating the development and delivery of SCP to survivors and PCPs.

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