title: Evidence-based care for breast cancer survivors: communicating the Institute of Medicine Guidelines in medical practice.
abstract: 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.
authors.affiliation: 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
authors.forename: Renee
authors.initials: R
authors.lastname: Royak-Schaler
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Gardner
authors.forename: Michelle
authors.initials: M
authors.lastname: Shardell
authors.forename: Min
authors.initials: M
authors.lastname: Zhan
authors.forename: Susan Racine
authors.initials: SR
authors.lastname: Passmore
authors.forename: Shahinaz M
authors.initials: SM
authors.lastname: Gadalla
authors.forename: M Katherine
authors.initials: MK
authors.lastname: Hoy
authors.forename: Katherine H Rak
authors.initials: KH
authors.lastname: Tkaczuk
authors.forename: Kim
authors.initials: K
authors.lastname: Nesbitt
mesh_terms: 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