Abstract PS9-04: The optimal living and survivorship program: Piloting a novel cancer survivorship care model
Authors: Corcoran Stacie , Russell John , Clayton Jill , Smith Andrea , Keenan Kate , Robson Mark , Iyengar Neil 
Published: February 2021

Background: Multiple national agencies define cancer survivorship as beginning at the time of cancer diagnosis. However, traditional care models typically deliver “survivorship care” months or years after diagnosis, which can lead to disruption in care and “transition anxiety”. We hypothesized that an approach centered around wellbeing could be applied across the cancer continuum (starting at diagnosis) and serve as a novel survivorship care model.

Methods: We developed the Optimal Living and Survivorship Program, a novel telehealth platform that is designed to better engage cancer survivors by providing multidisciplinary and individualized lifestyle management during and after cancer therapy. Our multilevel approach relies on three key components: 1) a digitized centralized model that provides automated and coordinated multidisciplinary care; 2) an individualized Wellness Plan (WP); and 3) enrollment at the time of cancer diagnosis in order to mitigate the experience of post-treatment transition. Participants complete a digital wellness questionnaire (WQ) consisting of validated instruments that provide risk assessment for a broad range of lifestyle and psychosocial factors prior to the first medical oncology consult, receive a validated algorithm-based WP reviewed by a Wellness Coordinator, and meet with a specially trained Wellness Advanced Practice Provider (WAPP) via tele-medicine. The WP consists of individualized topic-specific educational materials (e.g., webinars, videos) and referrals to indicated supportive services (e.g., nutrition, exercise physiology, financial counseling, integrative medicine). The WAPP will ultimately assume care of the patient in the post-treatment (“survivorship”) phase. We piloted this approach in patients diagnosed with breast cancer beginning in November 2019. The primary outcome is feasibility defined by completion of the WQ. Secondary outcomes include participation in the WAPP visits, attendance at referral appointments, and quality of life (QOL).

Results: As a result of COVID-19, the pilot was paused in February 2020. Data collected from November 2019 through February 2020 reveal a total of 67 eligible patients with newly diagnosed breast cancer were approached, with 65 (97%) enrolled in the program. All participants completed the WQ and all received a WP with indicated supportive referrals and educational resources. All participants engaged partially or fully with WP recommendations. Participants were screened at high risk for an average of 3.8 unmet needs, and 98% were at high risk for 2 or more needs at the time of diagnosis. Exercise was identified as the highest unmet need (83%). There was 76% adherence with referral to the program’s Exercise Physiologist. Other commonly identified areas of needs were nutrition (59%) and sleep quality (51%). WAPP tele-medicine visits began in June 2020 and are ongoing; visit completion rates and interventions will be presented. Qualitative data regarding patient experience and QOL will be obtained via focused interviews and feedback will be categorized in thematic domains.

Conclusions: In this pilot, the majority of patients with newly diagnosed breast cancer enrolled in the program, completed a WQ in advance of their initial medical oncology visit, and engaged with the WP. Our findings suggest that this early introduction to survivorship care is feasible. Earlier patient engagement and incorporation of wellness and supportive services from time of diagnosis may significantly improve our ability to address multifactorial needs during and after cancer therapy.

Citation Format: Stacie Corcoran, John Russell, Jill Clayton, Andrea Smith, Kate Keenan, Mark Robson, Neil Iyengar. The optimal living and survivorship program: Piloting a novel cancer survivorship care model [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-04.