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A survivorship care plan for breast cancer survivors: extended results of a randomized clinical trial

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Abstract

Purpose

Prevailing wisdom suggests that implementation of a survivorship care plan (SCP) will address deficits in survivorship care planning and delivery for cancer patients. Here, we present 24-month results of a randomized clinical trial on health service and patient-reported outcomes among breast cancer patients transferred to their primary care physician for follow-up care. The 24-month assessments represent the long-term benefit and sustainability of the implantation of a SCP.

Methods

In all, 408 patients with early-stage breast cancer were randomized to the SCP or control group. Patient self-completed questionnaires, supplemented with telephone interviews, during the 24-month study period assessed health service and patient-reported outcomes. The primary outcome was cancer-specific distress. Secondary outcomes included health-related quality of life, patient satisfaction, continuity and coordination of care, and health service outcomes such as adherence to guidelines.

Results

Over the course of 24 months, there were no differences between both groups in health service and patient-reported outcomes. Women from Quebec compared to those from Western Canada (p < 0.001), women within 2 years of completion of primary treatment compared to a longer period (p = 0.013), and those with a higher SF-36 mental component score compared to a lower score (p = 0.044) were positively associated with adherence to guidelines.

Conclusion

The implementation of a SCP in the transition of survivorship care from cancer center to primary care did not contribute to improved health service or patient-reported outcomes in this study population. Therefore, additional research is needed before widespread implementation of a SCP in clinical practice.

Implications of Cancer Survivors

The transition of survivorship care from cancer center to the primary care setting showed no negative effect on health service and patient-reported outcomes.

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Acknowledgments

The opinions, results, and conclusions are those of the authors and no endorsement by OICR, or the Government of Ontario is intended or should be inferred. Dr. Boekhout is supported by the Dutch Cancer Society.

Funding source

The study was funded by grant 17423 from the Canadian Breast Cancer Research Alliance. Dr. Grunfeld is supported by a clinician scientist award from the Ontario Institute of Cancer Research (OICR) through funding provided by the Ontario Ministry of Research and Innovation.

Conflict of interest

Author Boekhout, Maunsell, Pond, Julian, Coyle, Levine, and Grunfeld declare that they have no conflicts of interest to disclose.

All procedures followed were in accordance with the ethical standards of the responsible committee of human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada

    Annelies H. Boekhout & Eva Grunfeld

  2. Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Annelies H. Boekhout

  3. Center de Recherché du CHU de Québec, Québec, Québec, Canada

    Elizabeth Maunsell

  4. Département de Médecine Sociale et Préventive, Université Laval, Québec, Québec, Canada

    Elizabeth Maunsell

  5. Ontario Clinical Oncology Group, Hamilton, Ontario, Canada

    Gregory R. Pond, Jim A. Julian & Mark N. Levine

  6. Department of Oncology, McMaster University, Hamilton, Ontario, Canada

    Gregory R. Pond, Jim A. Julian & Mark N. Levine

  7. Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada

    Doug Coyle

  8. Ontario Institute for Cancer Research, Toronto, Ontario, Canada

    Eva Grunfeld

Authors
  1. Annelies H. Boekhout
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  2. Elizabeth Maunsell
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  3. Gregory R. Pond
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  4. Jim A. Julian
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  5. Doug Coyle
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  6. Mark N. Levine
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  7. Eva Grunfeld
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Consortia

for the FUPII Trial Investigators

Corresponding author

Correspondence to Annelies H. Boekhout.

Additional information

The FUPII Trial Investigators

J. Wiernikowski, S. Dent, D. Rayson, D. Rheaume, G. Porter, A. Joy, S. Smith, L. Provencher, J. Sussman, S. Lupichuk, L. Paszat, K. Pritchard, A. Robidoux, J. J. Sisler

Clinical Trials Registration Number

ISRCTN 86567908

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Boekhout, A.H., Maunsell, E., Pond, G.R. et al. A survivorship care plan for breast cancer survivors: extended results of a randomized clinical trial. J Cancer Surviv 9, 683–691 (2015). https://doi.org/10.1007/s11764-015-0443-1

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  • DOI: https://doi.org/10.1007/s11764-015-0443-1

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