Cited by 274Cancer survivorship and careChildhood Cancer Survivors' Quality of LifePatient-Provider Communication in Healthcare

The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index; none of the 14 sources its claims cite is checked for support yet.

Systematic Review of the Impact of Cancer Survivorship Care Plans on Health Outcomes and Health Care Delivery

Open access

Abstract

Purpose: Numerous organizations recommend that patients with cancer receive a survivorship care plan (SCP) comprising a treatment summary and follow-up care plans. Among current barriers to implementation are providers’ concerns about the strength of evidence that SCPs improve outcomes. This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors. Methods: Randomized and nonrandomized studies evaluating patient-reported outcomes, health care use, and disease outcomes after delivery of SCPs were identified by searching MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library. Data extracted by independent raters were summarized on the basis of qualitative synthesis. Results: Eleven nonrandomized and 13 randomized studies met inclusion criteria. Variability was evident across studies in cancer types, SCP delivery timing and method, SCP recipients and content, SCP-related counseling, and outcomes assessed. Nonrandomized study findings yielded descriptive information on satisfaction with care and reactions to SCPs. Randomized study findings were generally negative for the most commonly assessed outcomes (ie, physical, functional, and psychological well-being); findings were positive in single studies for other outcomes, including amount of information received, satisfaction with care, and physician implementation of recommended care. Conclusion: Existing research provides little evidence that SCPs improve health outcomes and health care delivery. Possible explanations include heterogeneity in study designs and the low likelihood that SCP delivery alone would influence distal outcomes. Findings are limited but more positive for proximal outcomes (eg, information received) and for care delivery, particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters. Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review of 24 studies found limited evidence that survivorship care plans (SCPs) improve health outcomes or health care delivery for cancer survivors. Findings were generally null for commonly assessed patient-reported outcomes, with isolated positive findings for proximal outcomes and care delivery, especially when SCPs were accompanied by counseling.

Key findings

  • The review included 24 articles: 11 nonrandomized studies and 13 randomized studies. Nonrandomized studies were mostly descriptive and focused on feasibility, acceptability, and satisfaction; one analysis of changes in psychological distress found no statistically significant differences.
  • Among randomized studies, findings were generally negative for the most commonly assessed outcomes (physical, functional, and psychological well-being). Seven studies reported no statistically significant differences across intervention conditions; four reported beneficial effects limited to single studies (fewer depressive symptoms, less health worry and less negative outlook, greater satisfaction with care, greater amount of information received), and one reported adverse effects (more symptoms, illness concerns, and emotional impact of illness).
  • Six randomized studies assessed health care delivery and use; five reported beneficial effects (greater preference for shared care, greater likelihood of correctly identifying the PCP as responsible for follow-up, greater adherence to cardiomyopathy screening, better physician implementation of survivorship care recommendations, and more cancer-related contact with the PCP), while one reported no statistically significant differences.
  • Two studies assessed disease-related end points and found no statistically significant differences in time to diagnosis of recurrence or recurrence-related serious clinical events. Economic findings were mixed: one study reported lower health care costs in the SCP condition, while another reported higher societal and health care costs but negligible differences in quality-adjusted life years.

Methods

  • Systematic literature searches were conducted in PubMed/MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and Cochrane Library, with coverage ending July 16, 2017. Studies were eligible if published in English, involved delivery of an SCP to survivors and/or their health care providers, and evaluated patient-reported outcomes, health care use, or disease outcomes.
  • A total of 1,399 studies were identified through database searches and 54 additional articles from reference lists and previous reviews; after duplicates were removed, 1,091 articles were screened, 41 full texts were assessed, and 24 articles met inclusion criteria.
  • Two paired reviewers independently screened, extracted data, and rated quality using the Quality Assessment Tool for Quantitative Studies for nonrandomized studies and items adapted from the Cochrane Risk of Bias Tool for randomized studies. Because of limited size and marked heterogeneity, analysis focused on qualitative synthesis rather than meta-analysis.

Limitations

  • The paper states that the limited number of studies and heterogeneous methodology precluded quantitative synthesis, so the review examined whether randomized study findings reached statistical significance rather than aggregating effect sizes. It was also limited to published studies in English, excluding relevant unpublished studies and research in other languages, and examined only health outcomes and health care delivery, not other aspects such as survivor and provider preferences for SCP content and delivery methods.
  • Evident from the text: the nonrandomized studies were uncontrolled and focused mostly on feasibility and acceptability, limiting conclusions about impact. Many randomized studies had unclear risk-of-bias ratings because of insufficient information, and significant findings for any specific outcome were often limited to single studies, which the authors note seriously limits definitive conclusions.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1200/jco.2018.77.7482

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 14 cited sources checked · 0 supported · 0 flagged

Show all 40 claims

  • It may state two separate claims as one. 19
  • Probably not a substantial claim. 13
24 of 24
  • The paper relies on this without support.

    The outcomes assessed in the included studies adequately capture the benefits SCPs are intended to produce, so that null findings reflect a true absence of effect rather than unmeasured or unassessed benefits.

    “Existing research provides little evidence that SCPs improve health outcomes and health care delivery.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting study citation for identifying the PCP responsible for follow-up

    Minor

    The results attribute improved identification of the PCP responsible for follow-up to study 27, but the discussion attributes the same finding to study 23.

1 of 1

Citations

Cites

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Show all 44 references

Research works printed but not linked: 2

  1. American College of Surgeons Commision on Cancer, 2012, Cancer Program Standards 2012: Ensuring Patient-Centered Care
  2. Martin TA, 2013, JBI Database of Systematic Reviews and Implementation Reports, 11, 258

Cited by

Sorted by citations

Items 201–272 of 272

Metadata

Authors
Jacobsen, P. B., DeRosa, A. P., Henderson, T. O., Mayer, D. K., Moskowitz, C. S., Paskett, E. D., & Rowland, J. H.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
Jacobsen, Paul B.
Venue
Journal of Clinical Oncology
Published
2018-07-10
Volume
36
Issue
20
Pages
2088-2100
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
OpenAlex
W2803946275
Cited by
274
References
44
Citations by year
2026: 16 · 2025: 19 · 2024: 25 · 2023: 25 · 2022: 27 · 2021: 30 · 2020: 87 · 2019: 40 · 2018: 5
FWCI
4.23
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Oncology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Pfizer
  • National Cancer Institute (P30CA008748, P30CA016058)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
cancer survivorship care plans, cancer survivors, follow-up care, patient-reported outcomes, health care utilization, satisfaction with care, psychophysical well-being, functional well-being
MeSH terms
Cancer Survivors, Delivery of Health Care, Humans, Neoplasms, Patient Care Planning, Randomized Controlled Trials as Topic, Treatment Outcome

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