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Effectiveness and implementation of models of cancer survivorship care: an overview of systematic reviews
Open accessAbstract
Purpose To critically assess the effectiveness and implementation of different models of post-treatment cancer survivorship care compared to specialist-led models of survivorship care assessed in published systematic reviews.Methods MEDLINE, CINAHL, Embase, and Cochrane CENTRAL databases were searched from January 2005 to May 2021. Systematic reviews that compared at least two models of cancer survivorship care were included. Article selection, data extraction, and critical appraisal were conducted independently by two authors. The models were evaluated according to cancer survivorship care domains, patient and caregiver experience, communication and decision-making, care coordination, quality of life, healthcare utilization, costs, and mortality. Barriers and facilitators to implementation were also synthesized.Results Twelve systematic reviews were included, capturing 53 primary studies. Effectiveness for managing survivors' physical and psychosocial outcomes was found to be no different across models. Nurse-led and primary care provider-led models may produce cost savings to cancer survivors and healthcare systems. Barriers to the implementation of different models of care included limited resources, communication, and care coordination, while facilitators included survivor engagement, planning, and flexible services.Conclusions Despite evidence regarding the equivalent effectiveness of nurse-led, primary care-led, or shared care models, these models are not widely adopted, and evidence-based recommendations to guide implementation are required. Further research is needed to address effectiveness in understudied domains of care and outcomes and across different population groups.Implications for cancer survivors Rather than aiming for an optimal "one-size fits all" model of survivorship care, applying the most appropriate model in distinct contexts can improve outcomes and healthcare efficiency.
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“Within the framework of the German guideline of diagnosis and care of breast cancer (“AWMF S3 Leitlinie”) and the development of Cancer Survivorship Programmes, a needs- and risk-adapted follow-up care is recommended after completion of primary treatment [15–17].”
From The BrEasT cancer afTER-CARE (BETTER-CARE) programme to improve breast cancer follow-up: design and feasibility study results of a cluster-randomised complex intervention trial (2024) · cites this paper as [17]
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“The feasibility of these concepts depends heavily on the local healthcare system, financial constraints, patient population, and practitioners [16, 17].”
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Metadata
- Authors
- Chan, R. J., Crawford-Williams, F., Crichton, M., Joseph, R., Hart, N. H., Milley, K., Druce, P., Zhang, J., Jefford, M., Lisy, K., Emery, J., & Nekhlyudov, L.
- Affiliations
- Queensland University of Technology (AU)
- Bond University (AU)
- Edith Cowan University (AU)
- The University of Melbourne (AU)
- Brigham and Women's Hospital (US)
- Corresponding author
- Chan, Raymond J.
- ORCID
- Venue
- Journal of Cancer Survivorship
- Published
- 2021-11-16
- Volume
- 17
- Issue
- 1
- Pages
- 197-221
- ISSN
- 1932-2259 (ISSN-L)
- 1932-2267
- PMC
- PMC8594645
- OpenAlex
- W3211795967
- Cited by
- 192
- References
- 58
- Citations by year
- 2026: 60 · 2025: 55 · 2024: 38 · 2023: 19 · 2022: 18 · 2021: 1
- FWCI
- 2.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Cancer Survivorship (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Australasian Journal of Paramedicine (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion)
- Griffith Research Online (submittedVersion, other-oa)
- Funders
- National Health and Medical Research Council (APP1194051, APP1195302)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- survivorship care, models of care, nurse-led care, shared care, implementation barriers and facilitators, care coordination, health care costs, quality of life, psychosocial outcomes, health care utilization
- MeSH terms
- Cancer Survivors, Survivorship, Systematic Reviews as Topic, Delivery of Health Care, Humans, Neoplasms, Quality of Life
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