Study: Damage plans for cancer survivors more than they use?

reference

de rooij BH, Ezendam N., Nicalaije K., et al. Effects of survival plans on the results in ovarian cancer reported by patients during the 2-year aftercare-the Rogy care study. gynecological oncology . 2017; S0090-8258 (17): 30162-2.

objective

Assessment of the long-term effects of automatically generated survival plans (SCPS) on the registered results of patients with ovarian and endometrium carcinoma

draft

pragmatic cluster-randomized study with 12 hospitals in the southern Netherlands. The patients received SCP care or the usual care.

participant

A total of 395 patients (221 endometrium and 174 ovarian patients) took part in this study with an average age of 63.3 years and different stages of the disease. All patients filled the questionnaires immediately after the first treatment and then after 6, 12 and 24 months.

All patients in the SCP group received an automatically generated SCP during their treatment plan advice. The SCP consisted of a detailed treatment summary, which included diagnostic tests, type of cancer, stage, degrees and treatments preserved. It also contained photos of the organs concerned as well as a detailed list of possible treatment effects, social and sexual side effects, possible signs of recurrence or secondary tumors and resources for psychosocial support.

result measurements

This study assessed 3 primary endpoints: patient satisfaction with regard to the information provided, disease perception and use of health care.

important knowledge

The most important result of this study was that in patients with ovarian cancer who received a SCP, compared to patients who had no SCP, there was less trust that their treatment would help or heal their illness. It was also significant that in the endometrium group those who received the SCPs unnecessarily had more concerns about symptoms and experienced negative emotional effects than patients who did not receive the SCPs.

practice implications

In the United States, Survivorship Care Plans are an answer to the unique health needs of the 15.5 million US cancer survivors. ^{1 The Commission on Cancer (COC) of the American College of Surgeon has ordered that cancer centers have received treatment with curative intentions by 2019 have to. 2 According to the KHK mandate, a SCP must give a treatment overview, describe a recommended aftercare and inform about a lifestyle-based risk reduction. The SCP is intended to facilitate efficient continuity of the supply and provide survivors to use a resource to tackle treatment -related symptoms and risk reduction.}

Despite the intention of the SCP mandate, the results of this study agree with earlier examinations that show that SCPs can strengthen the concern of patients and have negative emotional effects. ³ is a reason that the SCPs mainly focus on information on treatment and follow-up examinations, but rarely only offer superficial information on self-controlled lifestyle-based strategies Reduce and optimize health. ^{4 In our experience, reports that a sole concentration on a treatment summary and aftercare screening only serves to remind you of the challenges that you are exposed to due to your diagnosis and treatment, and fear of the possibility of another occurrence.}

The majority of the SCPs that are currently being given to patients do not offer strategies for risk reduction and cannot include the survivors in a change in lifestyle. Despite the fact that the SCP mandate comes from survivors, research has shown that it does not do justice to its needs for continuity of care and proactive risk reduction. Instead, the fulfillment of this mandate contributes to its need.

In fact, previous studies have shown that patients who have SCPS have more symptoms, seek more medical help and have an increased degree of emotional stress. ^5.6 These results agree with other reviews in which SCPs alone were not significant that SCPs have no significant positive effect on the stress or satisfaction of the survivors with the care have. 7.8

Since the provision of SCPs has become part of the supply standard, it is important to change their content in such a way that tertiary prevention is included in order to involve patients in their ongoing health care. Coping with the suffering of cancer survivors with meaningful, proactive and lifestyle -based strategies for risk reduction and health optimization remains a critical need.

disclosure of conflicts of interest

The authors of this study have a management and financial interest in the Ithrive plan, an online wellness program for cancer survivors.