title: Evaluating survivorship care plans: results of a randomized, clinical trial of patients with breast cancer.
abstract: OBJECTIVE
  An Institute of Medicine report recommends that patients with cancer receive a survivorship care plan (SCP). The trial objective was to determine if an SCP for breast cancer survivors improves patient-reported outcomes.
  
  
  METHODS
  Women with early-stage breast cancer who completed primary treatment at least 3 months previously were eligible. Consenting patients were allocated within two strata: less than 24 months and ≥ 24 months since diagnosis. All patients were transferred to their own primary care physician (PCP) for follow-up. In addition to a discharge visit, the intervention group received an SCP, which was reviewed during a 30-minute educational session with a nurse, and their PCP received the SCP and guideline on follow-up. The primary outcome was cancer-related distress at 12 months, assessed by the Impact of Event Scale (IES). Secondary outcomes included quality of life, patient satisfaction, continuity/coordination of care, and health service measures.
  
  
  RESULTS
  Overall, 408 survivors were enrolled through nine tertiary cancer centers. There were no differences between groups on cancer-related distress or on any of the patient-reported secondary outcomes, and there were no differences when the two strata were analyzed separately. More patients in the intervention than control group correctly identify their PCP as primarily responsible for follow-up (98.7% v 89.1%; difference, 9.6%; 95% CI, 3.9 to 15.9; P = .005).
  
  
  CONCLUSIONS
  The results do not support the hypothesis that SCPs are beneficial for improving patient-reported outcomes. Transferring follow-up to PCPs is considered an important strategy to meet the demand for scarce oncology resources. SCPs were no better than a standard discharge visit with the oncologist to facilitate transfer.
authors: Ontario Institute for Cancer Research, Ontario, Canada. eva.grunfeld@utoronto.ca
authors: Eva
authors: E
authors: Grunfeld
authors: Jim A
authors: JA
authors: Julian
authors: Gregory
authors: G
authors: Pond
authors: Elizabeth
authors: E
authors: Maunsell
authors: Douglas
authors: D
authors: Coyle
authors: Amy
authors: A
authors: Folkes
authors: Anil A
authors: AA
authors: Joy
authors: Louise
authors: L
authors: Provencher
authors: Daniel
authors: D
authors: Rayson
authors: Dorianne E
authors: DE
authors: Rheaume
authors: Geoffrey A
authors: GA
authors: Porter
authors: Lawrence F
authors: LF
authors: Paszat
authors: Kathleen I
authors: KI
authors: Pritchard
authors: André
authors: A
authors: Robidoux
authors: Sally
authors: S
authors: Smith
authors: Jonathan
authors: J
authors: Sussman
authors: Susan
authors: S
authors: Dent
authors: Jeffrey
authors: J
authors: Sisler
authors: Jennifer
authors: J
authors: Wiernikowski
authors: Mark N
authors: MN
authors: Levine
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality*; D005260:Female; D006801:Humans; D008875:Middle Aged; D058007:Physicians, Primary Care; D015996:Survival Rate