Long term care planning for cancer survivors: a health services research agenda.
BACKGROUND
The recent Institute of Medicine report From Cancer Patient to Cancer Survivor: Lost in Transition recommended that 'survivorship care plans' be created for patients as they complete primary therapy for cancer in order to ensure clarity for all involved about patients' diagnoses, treatment received, and plan for surveillance. It should explicitly identify the providers responsible for each aspect of ongoing care, and provide information on resources available for psychosocial and other practical issues that may arise as a result of the prior cancer diagnosis. The IOM stated that survivorship care plans 'have strong face validity and can reasonably be assumed to improve care unless and until evidence accumulates to the contrary.'


METHODS
As an example of how to approach evaluation of a new health care delivery service, this article reviews the health services research agenda that will have to be carried out in order to refine and determine the clinical utility of survivorship care planning.


RESULTS
For any change in medical practice such as this to really occur, not only is advocacy needed from a number of different stakeholders, but there must also be convincing, scientifically sound evidence that the change is cost effective, improves outcomes of interest, and is feasible.


CONCLUSIONS
It is incumbent on the research community to rigorously evaluate each element of survivorship care plans in order to justify their widespread adoption. Similar approaches can be taken to evaluate other health care delivery questions.
Earle
Craig C
CC
Center for Outcomes and Policy Research, Dana-Farber Cancer Center, 44 Binney St., SM 271, Boston, MA 02115, USA. craig_earle@dfci.harvard.edu
D019317:Evidence-Based Medicine / Q000191:economics*; D006291:Health Policy; D006302:Health Services Research / Q000191:economics* / Q000379:methods; D006801:Humans; D008134:Long-Term Care; D009369:Neoplasms / Q000175:diagnosis / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010347:Patient Care Planning; D011787:Quality of Health Care / Q000191:economics / Q000592:standards*; D011788:Quality of Life; D012107:Research Design; D055502:Secondary Prevention; D017741:Survivors