Evidence-based care for breast cancer survivors: communicating the Institute of Medicine Guidelines in medical practice.
OBJECTIVE
To investigate patient reports of physician communication about the 2006 Institute of Medicine (IOM) Guidelines for Survivorship Care, and patient follow-up care behaviors in a sample of African American and Caucasian breast cancer survivors.


METHODS
Fifteen-minute telephone interviews were conducted in a cross-sectional study with a sample of African American (n=30) and Caucasian (n=69) breast cancer patients, who were within 5 years of their diagnosis and primary treatment for breast cancer at two Baltimore, Maryland medical centers, during the summer of 2006. Multiple items assessed patient reports of physician discussions about IOM Guidelines, their recurrence concerns, and their follow-up treatment, screening, diet and exercise practices.


RESULTS
Patients with higher incomes, more education, female physicians, and of younger ages reported more complete physician discussions of the IOM Guidelines. No significant differences were noted between African American and Caucasian patients.


CONCLUSIONS
Patients at greatest risk for breast cancer recurrence - those with less education, income, and resources - report limited guidance from their physicians about evidence-based, follow-up care guidelines, designed to minimize their risk.


CONCLUSIONS
Physicians need strategies for effectively delivering the IOM Guidelines for Survivorship Care to disadvantaged breast cancer patients, to promote enhanced quality of life and reduced risk of recurrence.
Royak-Schaler
Renee
R
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 660 W. Redwood St., HH 102E, Baltimore, MD 21201, USA. rroyak@som.umaryland.edu
Gardner
Lisa D
LD
Shardell
Michelle
M
Zhan
Min
M
Passmore
Susan Racine
SR
Gadalla
Shahinaz M
SM
Hoy
M Katherine
MK
Tkaczuk
Katherine H Rak
KH
Nesbitt
Kim
K
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms; D003142:Communication; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic