Evaluation of a Technology-Based Survivor Care Plan for Breast Cancer Survivors: Pre-Post Pilot Study.

cancer survivor care plan patient activation technology

Journal

JMIR cancer
ISSN: 2369-1999
Titre abrégé: JMIR Cancer
Pays: Canada
ID NLM: 101666844

Informations de publication

Date de publication:
20 Dec 2019
Historique:
received: 06 09 2018
accepted: 03 09 2019
revised: 21 05 2019
entrez: 21 12 2019
pubmed: 21 12 2019
medline: 21 12 2019
Statut: epublish

Résumé

As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors. This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan. A single group pretest-posttest design was used to study breast cancer survivors in an academic cancer center and a community cancer center during their medical visit after they completed chemotherapy. The intervention was a technology-based survivor care plan. Measures were taken before, immediately after, and 1 month after receipt of the survivor care plan. A total of 38 breast cancer survivors agreed to participate in the study. Compared to baseline levels before receipt of the survivor care plan, participants reported increased knowledge both immediately after its receipt at the academic center (P<.001) and the community center (P<.001) as well as one month later at the academic center (P=.002) and the community center (P<.001). Participants also reported increased confidence immediately following receipt of the survivor care plan at the academic center (P=.63) and the community center (P=.003) and one month later at both the academic center (P=.63) and the community center (P<.001). Activation was increased from baseline to post-survivor care plan at both the academic center (P=.05) and community center (P<.001) as well as from baseline to 1-month follow-up at the academic center (P=.56) and the community center (P<.001). Overall, community center participants had lower knowledge, confidence, and activation at baseline compared with academic center participants. Overall, 22/38 (58%) participants chose the fully functional electronic survivor care plan. However, 12/23 (52%) in the community center group chose the paper version compared to 4/15 (27%) in the academic center group. Satisfaction with the format (38/38 participants) and the content (37/38 participants) of the survivor care plan was high for both groups. This study provides evidence that knowledge, confidence, and activation of survivors were associated with implementation of the survivor care plan. This research agrees with previous research showing that cancer survivors found the technology-based survivor care plan to be acceptable. More research is needed to determine the optimal approach to survivor care planning to ensure that all cancer survivors can benefit from it.

Sections du résumé

BACKGROUND BACKGROUND
As of 2016, almost 16 million individuals were cancer survivors, including over 3.5 million survivors of breast cancer. Because cancer survivors are living longer and have unique health care needs, the Institute of Medicine proposed a survivor care plan as a way to alleviate the many medical, emotional, and care coordination problems of survivors.
OBJECTIVE OBJECTIVE
This pilot study for breast cancer survivors was undertaken to: (1) examine self-reported changes in knowledge, confidence, and activation from before receipt to after receipt of a survivor care plan; and (2) describe survivor preferences for, and satisfaction with, a technology-based survivor care plan.
METHODS METHODS
A single group pretest-posttest design was used to study breast cancer survivors in an academic cancer center and a community cancer center during their medical visit after they completed chemotherapy. The intervention was a technology-based survivor care plan. Measures were taken before, immediately after, and 1 month after receipt of the survivor care plan.
RESULTS RESULTS
A total of 38 breast cancer survivors agreed to participate in the study. Compared to baseline levels before receipt of the survivor care plan, participants reported increased knowledge both immediately after its receipt at the academic center (P<.001) and the community center (P<.001) as well as one month later at the academic center (P=.002) and the community center (P<.001). Participants also reported increased confidence immediately following receipt of the survivor care plan at the academic center (P=.63) and the community center (P=.003) and one month later at both the academic center (P=.63) and the community center (P<.001). Activation was increased from baseline to post-survivor care plan at both the academic center (P=.05) and community center (P<.001) as well as from baseline to 1-month follow-up at the academic center (P=.56) and the community center (P<.001). Overall, community center participants had lower knowledge, confidence, and activation at baseline compared with academic center participants. Overall, 22/38 (58%) participants chose the fully functional electronic survivor care plan. However, 12/23 (52%) in the community center group chose the paper version compared to 4/15 (27%) in the academic center group. Satisfaction with the format (38/38 participants) and the content (37/38 participants) of the survivor care plan was high for both groups.
CONCLUSIONS CONCLUSIONS
This study provides evidence that knowledge, confidence, and activation of survivors were associated with implementation of the survivor care plan. This research agrees with previous research showing that cancer survivors found the technology-based survivor care plan to be acceptable. More research is needed to determine the optimal approach to survivor care planning to ensure that all cancer survivors can benefit from it.

Identifiants

pubmed: 31859683
pii: v5i2e12090
doi: 10.2196/12090
pmc: PMC6942181
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e12090

Informations de copyright

©Talya Laufer, Bryan Lerner, Anett Petrich, Anna M Quinn, Leah Ernst, Alicin Roop, Janet Knoblauch, Nick C Leasure, Rebecca J Jaslow, Sarah Hegarty, Amy Leader, Andrea Barsevick. Originally published in JMIR Cancer (http://cancer.jmir.org), 20.12.2019.

Références

Breast Cancer Res Treat. 2013 Apr;138(3):795-806
pubmed: 23542954
Health Aff (Millwood). 2013 Feb;32(2):207-14
pubmed: 23381511
Gynecol Oncol. 2013 Jun;129(3):554-8
pubmed: 23474344
J Cancer Surviv. 2013 Jun;7(2):211-8
pubmed: 23417167
JMIR Cancer. 2016 Sep 14;2(2):e13
pubmed: 28410189
J Oncol Pract. 2015 Mar;11(2):e222-9
pubmed: 25784579
J Clin Oncol. 2015 Nov 1;33(31):3550-9
pubmed: 26304900
Clin J Oncol Nurs. 2014;18 Suppl:15-22
pubmed: 24480658
J Oncol Navig Surviv. 2016 Nov;7(10):11-24
pubmed: 28845364
J Med Internet Res. 2018 Mar 20;20(3):e95
pubmed: 29559424
Cancer. 2015 Apr 1;121(7):978-96
pubmed: 25252164
Comput Inform Nurs. 2017 Apr;35(4):201-211
pubmed: 28002115
J Ambul Care Manage. 2007 Jan-Mar;30(1):21-9
pubmed: 17170635
JMIR Cancer. 2016 May 10;2(1):e3
pubmed: 28410178
Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26
pubmed: 15230939
J Gen Intern Med. 2012 May;27(5):520-6
pubmed: 22127797
J Clin Oncol. 2011 Dec 20;29(36):4755-62
pubmed: 22042959
Cancer. 2016 Oct 15;122(20):3232-3242
pubmed: 27387096
Health Serv Res. 2007 Aug;42(4):1443-63
pubmed: 17610432
JMIR Cancer. 2016 Aug 30;2(2):e12
pubmed: 28410187
Cancer Control. 2010 Jan;17(1):35-43
pubmed: 20010517
Health Serv Res. 2005 Dec;40(6 Pt 1):1918-30
pubmed: 16336556
JMIR Cancer. 2017 Sep 26;3(2):e14
pubmed: 28951383
Health Aff (Millwood). 2004;Suppl Variation:VAR133-5
pubmed: 15471780
Support Care Cancer. 2015 Aug;23(8):2225-30
pubmed: 25559037
J Cancer Surviv. 2012 Mar;6(1):20-32
pubmed: 21735277
J Gen Intern Med. 2013 May;28(5):668-74
pubmed: 23288378
Br J Cancer. 2014 Nov 11;111(10):1899-908
pubmed: 25314068
J Cancer Educ. 2018 Oct;33(5):1027-1035
pubmed: 28265863

Auteurs

Talya Laufer (T)

Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States.

Bryan Lerner (B)

Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States.

Anett Petrich (A)

Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States.

Anna M Quinn (AM)

Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States.

Leah Ernst (L)

McGlinn Cancer Institute, Reading Health System, West Reading, PA, United States.

Alicin Roop (A)

McGlinn Cancer Institute, Reading Health System, West Reading, PA, United States.

Janet Knoblauch (J)

McGlinn Cancer Institute, Reading Health System, West Reading, PA, United States.

Nick C Leasure (NC)

McGlinn Cancer Institute, Reading Health System, West Reading, PA, United States.

Rebecca J Jaslow (RJ)

Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.

Sarah Hegarty (S)

Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, United States.

Amy Leader (A)

Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States.

Andrea Barsevick (A)

Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States.

Classifications MeSH