Avoiding Implementation Errors in Cancer Survivorship Care Plan Effectiveness Studies
Open accessAbstract
Although survivorship care plans (SCPs) have been recommended for the last decade, implementation and dissemination has been slow, low, and sporadic. In the accompanying article, Nicolaije et al report on the longitudinal effectiveness of SCPs. This is the fourth publication from the Registrationsystem Oncological Gynecology (ROGY) program, which electronically generates an SCP for women with gynecologic malignancies in the Netherlands. Previously, Nicolaije et al documented the degree of dissatisfaction of information provided for women with endometrial cancer, concluding that SCPs could address many of these unmet needs. They conducted a pragmatic cluster randomized controlled trial in 12 institutions in which half used the ROGY system to create and deliver an individualized SCP and half received usual care for patients ending treatment between 2011 and 2012. This study contributes to a growing number of randomized controlled trials of SCP effectiveness. These and other studies have primarily assessed the effects of SCPs on distal outcomes, such as patient satisfaction with care. They tend not to address the more proximal, process-related outcomes that we might expect SCPs to influence (eg, knowledge, communication, and care coordination) or how SCPs are implemented. In this sense, the standards to which we hold studies of SCP effectiveness diverge from standards for other innovations in cancer care. For example, studies of the effectiveness of a cancer drug report on its indications, mode of administration, dose, frequency, adverse effects, and response rates; we take these into account when evaluating their results. In contrast, SCP effectiveness studies rarely define the information that SCPs contain, how they are developed and delivered, whether survivors or primary care providers (PCPs) receive and use them, whether and how frequently they are updated, and whether SCPs have any negative effects. Without this information, SCP effectiveness studies cannot be compared or contrasted, and they cannot inform future implementation and dissemination efforts. Moreover, omitting this information exposes SCP effectiveness studies to the possibility that outcomes are the result not of the inherent (in)effectiveness of SCPs but rather of poor or inconsistent SCP implementation (type III error).
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An SCP is unlikely to be effective if there are no mechanisms in place to implement the plan's recommendations.
“An SCP is unlikely to be effective if there are no mechanisms in place to implement the plan’s recommendations.41”
From Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery (2018) · cites this paper as [41]
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Self-citation
- Authors
- Mayer, D. K., Birken, S. A., & Chen, R. C.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Journal of Clinical Oncology
- Published
- 2015-11-01
- Volume
- 33
- Issue
- 31
- Pages
- 3528-3530
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W1915955486
- Cited by
- 31
- References
- 23
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 8 · 2020: 1 · 2019: 3 · 2018: 4 · 2017: 4 · 2016: 6
- FWCI
- 8.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- cancer survivorship care plans, Type III error, implementation errors, effectiveness research, gynecologic cancer, endometrial cancer, primary care providers, process outcomes, patient satisfaction, care coordination
- MeSH terms
- Female, Humans, Physician-Patient Relations, Endometrial Neoplasms, Patient Outcome Assessment
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