J Natl Cancer Inst. 2021 Jul 24:djab148. doi: 10.1093/jnci/djab148. Online ahead of print.
ABSTRACT
BACKGROUND: Survivorship care plans seek to improve the transition to survivorship, but the required resources present implementation barriers. This randomized controlled trial aimed to identify the simplest, most effective approach for survivorship care planning.
METHODS: Stage 1-3 breast, colorectal, and prostate cancer patients aged 21+ completing treatment were recruited from an urban-academic and rural-community cancer center. Participants were randomized, stratified by recruitment site and cancer type, 1:1:1 to (a)mailed plan, (b)plan delivered during one-time transition visit, or (c)plan delivered during transition visit plus 6-month follow-up visit. Health service use data were collected from participants and medical records for 18 months. The primary outcome, receipt of all plan-recommended care, was compared across intervention arms using logistic regression adjusting for cancer type and recruitment site with p < 0.05 considered statistically significant.
RESULTS: Of 378 participants randomized, 159 (42.1%) were breast, 142 (37.6%) prostate, 77 (20.4%) colorectal cancer survivors; 207 (54.8%) from the academic site, 171 (45.2%) from the community site; 316 analyzable for the primary outcome. There was no difference across arms in the proportion of participants receiving all plan-recommended care: 45.2% mail, 50.5% one-visit, 42.7% two-visit (2-sided P = 0.60). Adherence by cancer type for mail, one-visit, and two-visit, respectively, was 52.2%, 53.3%, 40.0% for breast cancer; 48.6%, 64.1%, 57.1% for prostate cancer; and 23.8%, 19.0%, 26.1% for colorectal cancer. There were no statistically significant interactions by recruitment site or cancer type.
CONCLUSIONS: This study did not find differences in receipt of recommended follow-up care by plan delivery approach. Feasibility and other factors may determine the best approach for survivorship care planning.
PMID:34302474 | DOI:10.1093/jnci/djab148
