Abstract OT3-03-02:

A

ssessment of cancer

C

oncerns at the

E

nd of treatment (ACE): What do survivors need and want?
Authors: Jacobs LA , DeMichele A , Glanz K , Schapira M , Pucci DA , Blauch AN , Palmer SC 
Published: May 2016

Discussion:

There are over 14 million cancer survivors in the United States today and this population will continue to grow. Not only are survivors at risk for recurrence, but increasingly complex treatments place them at risk for a range of long-term and late effects. Provision of survivorship care plans (SCPs) at an end of treatment (EOT) visit that includes referrals to appropriate resources may be assumed to improve the care provided to survivors. There are, however, few relevant studies examining the outcomes of providing patients with referrals to resources identified through the completion of patient reported outcomes (PROs) reported in the literature. Current research has focused on documenting the frequency with which SCPs are provided and the perceived usefulness of these documents. Such data are a necessary but an insufficient step in the creation of practice guidelines in part guided by PROs, or standards of care that support the provision of SCPs. This study will provide a comprehensive description of breast cancer (BC) survivors' symptom burden and other concerns, as well as health behaviors as they enter the survivorship phase of care. These items will be evaluated by data generated by a pre visit PROs questionnaire completed through the patient portal. Significant symptoms and concerns will be addressed during a clinical encounter at the EOT visit. It will also describe referrals triggered by these data.

Trial Design:

Quasi-experimental single-group design with historical controls. Our study describes patient-reported symptom burden, desire for assistance, quality of life (QoL) and health behaviors of BC survivors who have completed initial treatment using a web-based platform to collect PRO data. As well, it estimates differences in referral and uptake between participants and historical controls.

Eligibility Criteria:

Survivors must understand English, have internet access and a working email address, and be age 18 years or older within 1 year of completing initial treatment (chemotherapy, radiotherapy, and/or surgery). Participants may still be receiving hormonal or targeted therapy.

Specific Aims:

1) Describe physical and psychosocial PROs of BC survivors after completion of treatment so as to define targets and develop metrics for future intervention; 1A) examine diagnosis and treatment variables that moderate PROs; 2) determine provider satisfaction with a web based patient questionnaire that includes a summary of significant patient concerns; 3) estimate the impact of providing the summary of patient concerns on utilization of/referral to available services relative to historic controls.

Statistical Methods:

Parameter estimates with confidence intervals for concerns and desire for help. Bivariate associations between unmet needs and quality of life. Non-parametric comparison of referral patterns between ACE participants and historical controls.

Present Accrual and Target:

To date 107 BC survivors have consented to complete a self-report survey questionnaire prior to their scheduled EOT visit, 61 completed the survey, 28 pending a visit. Target 250.

Citation Format: Jacobs LA, DeMichele A, Glanz K, Schapira M, Pucci DA, Blauch AN, Palmer SC. Assessment of cancer Concerns at the End of treatment (ACE): What do survivors need and want?. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT3-03-02.