Use and impact of breast cancer survivorship care plans: a systematic review

Joshi, Abhishek, Larkins, Sarah, Evans, Rebecca, Moodley, Nishila, Brown, Amy, and Sabesan, Sabe (2021) Use and impact of breast cancer survivorship care plans: a systematic review. Breast Cancer, 28. pp. 1293-1317.

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Background: Survivorship care plan (SCP) comprising a treatment summary and plan for follow-up care is recommended by various organizations to address long-term needs of an increasing number of breast cancer survivors. Although there have been previous systematic reviews of SCPs in cancer, none has focused on breast cancer exclusively. This systematic review evaluates the use and impact of SCP in breast cancer survivors.

Methods: Randomized (RCTs) and non-randomized (non-RCT) studies evaluating health care and patient-related outcomes after implementation of SCPs for survivors were identified by searching databases (MEDLINE, EMBASE, CINHAL, and Scopus). Data were extracted, quality assessed, and summarized on the basis of qualitative synthesis.

Results: Ten non-RCTs and 14 RCTs met the inclusion criteria. Although the overall quality of RCTs was superior to non-RCTs with mean quality score of 81.5% vs 64.3%, two mixed-methods non-RCTs which were individualized and included both provider and patient perspectives had comparable scores like RCTs. Several models of SCP were evaluated (paper based/online, oncologist/nurse/primary-care physician-delivered, and different templates). Descriptive information from non-RCTs suggests improvement in survivorship knowledge, satisfaction with care, and improved communication with providers. Findings from RCTs were variable. Potential gaps existed in content of SCP including unclear recommendation on frequency and ownership of follow-up. Levels of survivor satisfaction with, and self-reported understanding of, their SCP were high. Distal outcomes like health care delivery measures including costs and efficiency were mostly mixed, but heterogeneous study designs make interpretation difficult.

Conclusions: Existing research provides positive impact of SCPs on more proximal outcomes of patient experience and care delivery but mixed results for health outcomes in breast cancer survivors. Future research should focus on better defining SCP content and ensuring follow-up recommendations are acted upon, and provider feedback is included and use of novel tools to empower stakeholders.

Item ID: 70890
Item Type: Article (Research - C1)
ISSN: 1880-4233
Keywords: Survivorship; care plan; Breast cancer; Care pathway
Copyright Information: © The Japanese Breast Cancer Society 2021
Date Deposited: 19 Nov 2021 01:11
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420319 Primary health care @ 100%
SEO Codes: 20 HEALTH > 2002 Evaluation of health and support services > 200206 Health system performance (incl. effectiveness of programs) @ 100%
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