Randomized Controlled Trial of Survivorship Care Plans Among Low-Income, Predominantly Latina Breast Cancer Survivors
Open accessAbstract
Purpose: The purpose of this study was to examine the effects of a randomized controlled trial (RCT) of treatment summaries and survivorship care plans coupled with a nurse counseling session, primarily on physician implementation of and secondarily on patient adherence to recommended survivorship care, among a low-income population of breast cancer survivors (survivors). Methods: We recruited 212 low-income, predominantly Latina (72.6%) survivors with stage 0 to III breast cancer, with an average age of 53 years, from two Los Angeles County public hospitals into an RCT of a survivorship care nurse counseling session coupled with the provision of individualized treatment summaries and survivorship care plans to patients and their health care providers from December 2012 to July 2014. One hundred seven survivors received the experimental intervention, and 105 survivors received usual care. Multiple linear regression analyses were performed to assess intervention effects on physician implementation of and patient adherence to recommended survivorship care. Scales that served as covariables were Knowledge of Survivorship Issues, Perceived Efficacy in Patient-Physician Interactions, and Satisfaction With Care and Information. Results: Survivors in the intervention group reported greater physician implementation of recommended breast cancer survivorship care, for example, treatment of depression or hot flashes, than did those in the control group (adjusted difference, 16 ± 5.3; P = .003). Baseline Satisfaction With Care and Information was positively associated with physician implementation (coefficient, 5.2 ± 2.2; P = .02). Being married/partnered (−11.8 ± 4.0; P = .004) and age (−0.5 ± 0.2; P = .028) were negatively associated with patient adherence. Conclusion: To our knowledge, this is the first RCT of survivorship care plans to show benefits in clinical outcomes, in this case, showing increased physician implementation of recommended breast cancer survivorship care in the intervention group, compared with the control group.
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In one reviewed study, using the delivery of an SCP as an opportunity to coach survivors in how to raise concerns about survivorship issues at subsequent visits with providers resulted in greater physician implementation of SCP recommendations.
“This strategy was used in one of the studies reviewed and resulted in greater physician implementation of SCP recommendations.33”
From Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery (2018) · cites this paper as [33]
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Jacobsen, P. B., DeRosa, A. P., Henderson, T. O., Mayer, D. K., Moskowitz, C. S., Paskett, E. D., & Rowland, J. H. (2018) · Journal of Clinical Oncology · doi:10.1200/jco.2018.77.7482 · Cited by 274 · see citing works
- Authors
- Maly, R. C., Liang, L.-J., Liu, Y., Griggs, J. J., & Ganz, P. A.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- Journal of Clinical Oncology
- Published
- 2017-06-01
- Volume
- 35
- Issue
- 16
- Pages
- 1814-1821
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC5455593
- OpenAlex
- W2606443724
- Cited by
- 69
- References
- 23
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 14 · 2020: 8 · 2019: 12 · 2018: 16 · 2017: 2
- FWCI
- 4.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Oncology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Society of Clinical Oncology
- National Cancer Institute (R01CA140481)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- breast cancer survivorship care, survivorship care plans, treatment summaries, nursing counseling, Latina breast cancer survivors, low-income patients, depression treatment, hot flashes, patient satisfaction, patient-physician interaction
- MeSH terms
- Adult, Aged, Aged, 80 and over, Breast Neoplasms, Female, Hispanic or Latino, Humans, Middle Aged, Neoplasm Staging, Patient Care Planning, Poverty, Social Class
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