care plan created by a specialized nurse practitioner during a consultation in a survivorship clinic or during a routine visit with their medical oncologist near the end of primary therapy, comparing measures of satisfaction between the two groups.

  • Question: Can specific interventions targeted to lifestyle changes to decrease risk behaviors be more successful in the context of survivorship care planning.

    • Study design: Randomized controlled trial in which breast cancer patients completing adjuvant chemotherapy all receive a transition consultation and survivorship care plan, but half are invited to take part in an intensive diet and exercise intervention immediately, while the other half receive the same intervention 6 months later. Acceptance, compliance, and measures of dietary and exercise improvement would be the outcomes.

  • Question: Does survivorship care planning decrease unnecessary health care resource utilization?

    • Study Design: Practices are randomized between usual care: giving patients individually-tailored treatment summaries, informal discussion of surveillance plans, and standard information about available resources; and an intervention group in which the survivorship care plan explicitly lays out the plan for surveillance and which symptoms should prompt medical evaluation. Data collected will include the costs associated with creating the care plan, and enumeration of physician visits and investigations received. This study could also inform cost-effectiveness analyses should improvement in survival and/or quality of life be found to be attributable to institution of such plans.

  • Question: Which format of survivorship care plan is most effective at increasing communication among providers?

    • Study Design: Practices are randomized between web-based and paper versions of the survivorship care plan (with copies sent to all involved physicians). Survivors’ PCPs are later asked to answer basic questions about the survivor’s cancer and its care, using records available in their office.

Conclusion

Over time, as studies evaluating the effects of survivorship care planning on relevant outcomes are carried out, they would serve as the basis for secondary data analyses such as systematic overviews and technology assessments. Surveillance practices have already been the subject of several meta-analyses and decision analyses but this is only one component of care



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