Remote Electronic Assessment of Survivors With Feedback Communication and Directed Referrals
Condition: Breast Cancer
MeSH terms: Breast Neoplasms
Study type: Interventional

Summary: 
      This study tests a novel, risk-stratified approach for low risk breast cancer survivor
      follow-up care that reduces burden for survivors and their oncologists while simultaneously
      delivering more comprehensive care. The intervention is called Remote Electronic Assessment
      of Survivors with Feedback Communication and Directed Referrals (REASSURE). 50 participants
      will be enrolled into 2 cohorts, 25 into cohort 1 who will experience the REASSURE
      intervention 6 months from enrollment and 25 into cohort 2 who will experience components of
      the REASSURE intervention at their next follow-up visit. Participants can expect to be on
      study for up to 9 months.
    

Detailed description: 
      Current follow-up care for 3 million+ breast cancer survivors is both burdensome and fails to
      comprehensively address survivors' needs. Survivors and oncologists value these visits
      because visits reassure survivors about recurrence, and support oncologists' views about
      their responsibilities for managing ongoing therapy. However, early-stage survivors derive
      less benefit from follow-up, while incurring substantial financial burdens. Further,
      follow-up visit time restraints prevent addressing all topics prioritized by survivors or
      recommended as comprehensive survivorship care. Because most low-risk breast cancer survivors
      will never experience a recurrence, there is a critical need to develop a novel,
      risk-stratified approach to follow-up that reduces burden for survivors and their oncologists
      while simultaneously delivering more comprehensive care.

      To address this gap, the team engaged stakeholders to develop an intervention for low-risk
      breast cancer survivors, called Remote Electronic Assessment of Survivors with Feedback
      Communication and Directed Referrals (REASSURE). REASSURE maintains one annual in-person
      oncology visit, consistent with stakeholder preferences for oncology-based follow-up.
      REASSURE utilizes remote patient-reported outcomes assessments to comprehensively assess
      symptoms, promotes practice change by providing feedback reports to oncologists and engaging
      primary care providers (PCPs) in survivorship care, and reduces the burden of follow-up by
      substituting an oncology visit for thriving survivors with reassurance messaging and
      encouragement to pursue preventive care. The investigators have successfully pilot tested the
      PRO assessment and estimate that 25% of low-risk breast cancer survivors will have symptoms
      requiring a follow-up visit with medical oncology.

      In this pilot feasibility study, the REASSURE intervention will be implemented into clinical
      care for the first time. Eligible survivors will be recruited and use mixed methods to
      accomplish four study objectives:

        -  Objective 1. Assess the feasibility of implementing REASSURE into clinical practice.

        -  Objective 2. Determine the number of survivorship symptoms/concerns that were addressed
           during the follow-up visit following clinician review of the REASSURE PRO assessment.

        -  Objective 3. Characterize the impact of REASSURE on healthcare utilization.

        -  Objective 4. Assess concordance between the referral recommendation generated from the
           PRO assessment and medical oncologist opinion.
    

Intervention name(s): REASSURE
Intervention type(s): Other
Intervention description(s): REASSURE utilizes remote patient-reported outcomes assessments to comprehensively assess symptoms, promotes practice change by providing feedback reports to oncologists and engaging primary care providers (PCPs) in survivorship care, and reduces the burden of follow-up by substituting an oncology visit for thriving survivors with reassurance messaging and encouragement to pursue preventive care.
Other intervention name(s): Remote Electronic Assessment of Survivors with Feedback Communication and Directed Referrals
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: low risk breast cancer; survivor; follow up care