Recall and Uptake of Survivorship Care Plan Recommendations
Andrew Salner, MD1; Ellen Dornelas, PhD1; Deb Walker APRN1; Amanda Katzman, LMSW1; SarahLena Panzer BS2, Carrie Stricker, PhD, RN2
1Hartford Healthcare Cancer Institute (Hartford,CT); 2Carevive Systems,Inc.(Miami,FL
Despite the growing delivery of survivorship care plans (SCPs), little research has examined survivors’ recall and adoption of SCP recommendations, including those based on patient-reported symptoms and concerns.
This pilot project enrolled breast cancer (BC) patients who had recently completed active treatment. Patients completed an electronic patient-reported outcomes (ePRO) survey prior to a visit with a nurse practitioner, who delivered a tailored SCP generated by the Carevive Care Planning System (CPS). The Carevive CPS uses evidence-based algorithms driven by both ePRO and diagnosis/treatment data.
Approximately 6-weeks following SCP receipt, patients completed a survey to evaluate their recall of recommendations and any corresponding action taken (scheduled or completed the activity). Actual SCP recommendations were extracted from the Carevive CPS database and matched to follow-up surveys to determine recall accuracy. Analysis was organized by IOM categories of SCP content:
- cancer surveillance,
- health promotion, and
- intervention for cancer/treatment consequences.
- Care coordination with PCP is reported elsewhere.
Incorporating an ePRO survey into SCP delivery enables tailoring to patient needs and concerns, which may in turn enhance recall and follow through given saliency. Patients tended to recall more accurately SCP recommendations for active or more severe symptoms of a condition (e.g., lymphedema, anxiety/depression) than for prevention or mild symptoms. Additional research is needed to maximize retention and follow through on SCP recommendations including psychosocial and genetics referrals.