title: Survivorship care planning after the institute of medicine recommendations: how are we faring?
abstract: BACKGROUND
  This study evaluates the concordance of treatment summaries (TSs) and survivorship care plans (SCPs) delivered to breast cancer survivors within the LIVESTRONG™ Network of Survivorship Centers of Excellence with Institute of Medicine (IOM) recommendations and describes additional structure/process variables.
  
  
  METHODS
  Seven NCI-designated comprehensive cancer centers and six community-based centers participated. TS/SCPs for 65 patients were rated against IOM recommendations using a study-derived checklist, and surveys were administered to better understand the structure and process of delivering TSs/SCPs.
  
  
  RESULTS
  On average, fewer than half of IOM content recommendations were met for TSs (M = 46%) and less than two thirds for SCPs (M = 59%). No sites achieved ≥75% overall concordance with IOM recommendations for TSs and only two of 13 met this criterion for SCPs. Content domain scores across sites varied widely, as did the number of sites addressing domain content with ≥75% concordance. Nonetheless, resources required for document preparation and delivery were substantial.
  
  
  CONCLUSIONS
  Gaps in concordance with IOM recommendations exist even in dedicated survivorship centers. A substantial time burden was also noted. Further research is needed to determine which informational elements are essential, to develop and test strategies for improving efficiency and reach, and to determine if outcomes of survivorship care planning warrant the resources required in their preparation and delivery.                                               IMPLICATIONS FOR SURVIVORS:                          TSs and SCPs have been recommended for all cancer survivors. Essential elements must be determined, approaches made more efficient, outcome improvements demonstrated, and cost-benefit analyses determined before survivors should expect widespread implementation of this recommendation for survivorship care.
authors.affiliation: Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA 19104, USA. carrie.stricker@uphs.upenn.edu
authors.forename: Carrie Tompkins
authors.initials: CT
authors.lastname: Stricker
authors.forename: Linda A
authors.initials: LA
authors.lastname: Jacobs
authors.forename: Betsy
authors.initials: B
authors.lastname: Risendal
authors.forename: Alison
authors.initials: A
authors.lastname: Jones
authors.forename: Sarahlena
authors.initials: S
authors.lastname: Panzer
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.forename: Karen L
authors.initials: KL
authors.lastname: Syrjala
authors.forename: Mary S
authors.initials: MS
authors.lastname: McCabe
authors.forename: K Scott
authors.initials: KS
authors.lastname: Baker
authors.forename: Kenneth
authors.initials: K
authors.lastname: Miller
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Casillas
authors.forename: Donald L
authors.initials: DL
authors.lastname: Rosenstein
authors.forename: Marci
authors.initials: M
authors.lastname: Campbell
authors.forename: Steven C
authors.initials: SC
authors.lastname: Palmer
mesh_terms: D001943:Breast Neoplasms / Q000401:mortality* / Q000628:therapy*; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D054547:National Cancer Institute (U.S.); D010347:Patient Care Planning; D015996:Survival Rate; D017741:Survivors; D014481:United States