title: Randomized controlled trial of a clinic-based survivorship intervention following adjuvant therapy in breast cancer survivors.
abstract: In 2006, the IOM released a report citing the importance of "survivorship plans" to improve quality of life and care coordination for cancer survivors, but little has been done to evaluate their efficacy. Women with early-stage breast cancer were randomized within 6 weeks of completing adjuvant therapy to a survivorship intervention group (SI) or control group (CG). All subjects were given the NCI publication, "Facing Forward: Life after Cancer Treatment." The SI also met with a nurse/nutritionist to receive a treatment summary, surveillance, and lifestyle recommendations. Both groups completed questionnaires on the impact of cancer (IOC), patient satisfaction (FACIT-TS-PS), and assessment of survivor concerns (ASC) at baseline, 3 and 6 months. Within and between group t tests and linear regression analyses were performed. Among 126 women (60 CG, 66 SI), mean age was 54 years, 48 % were Hispanic, and the groups were well-balanced by baseline characteristics. No significant differences between the CG and SI on the FACIT-TS-PS or IOC at 3 and 6 months were seen. The ASC health worry subscale was lower (less worry) in the SI compared to CG (p = 0.02). At all time-points, Hispanic women had higher (worse) health worry (p = 0.0008), social-life interference (p = 0.009), and meaning of cancer scales (p = 0.0004), and more trust in medical professionals (p = 0.03) compared to non-Hispanic women. While the SI did not lead to significant improvements in most patient-reported outcomes, it was associated with decreased health worry. Future interventions should determine the most efficient and effective method for delivering survivorship care plans.
authors.affiliation: Department of Medicine, The Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University, 161 Fort Washington Avenue, 10-1068, New York, NY 10032, USA. dlh23@columbia.edu
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.forename: Heather
authors.initials: H
authors.lastname: Greenlee
authors.forename: Danielle
authors.initials: D
authors.lastname: Awad
authors.forename: Kevin
authors.initials: K
authors.lastname: Kalinsky
authors.forename: Matthew
authors.initials: M
authors.lastname: Maurer
authors.forename: Grace
authors.initials: G
authors.lastname: Kranwinkel
authors.forename: Lois
authors.initials: L
authors.lastname: Brafman
authors.forename: Ramona
authors.initials: R
authors.lastname: Jayasena
authors.forename: Wei-Yann
authors.initials: WY
authors.lastname: Tsai
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Crew
mesh_terms: D001943:Breast Neoplasms / Q000208:ethnology / Q000523:psychology* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology