title: Following through: the consistency of survivorship care plan use in United States cancer programs.
abstract: The Institute of Medicine suggests that consistent survivorship care plan (SCP) use involves developing and delivering SCPs to all cancer survivors and their primary care providers (PCPs). We describe the consistency of SCP use in US cancer programs and assess its relationship with cancer-program-level determinants. We surveyed employees knowledgeable about survivorship practices in cancer programs reporting current SCP use (n = 36, 81 % response rate). We operationalized consistent SCP use as whether SCPs were (1) developed for ≥75 % survivors, (2) delivered to ≥75 % survivors, (3) delivered to ≥75 % PCPs, and (4) all of the above. We use descriptive statistics to report SCP use consistency and evaluate associations using Fisher's exact and Wilcoxon rank sum tests. SCPs were developed for ≥75 % survivors in five programs (15 %), eight (25 %) delivered ≥75 % SCPs to survivors, seven (23 %) delivered ≥75 % SCPs to PCPs, and only one program (4 %) met all three criteria. We found relationships between SCP use consistency and geographic region (p = .05), initiating SCP use in response to survivors' requests (p = .03), and membership in the National Cancer Institute's National Community Cancer Centers Program (p = .01). SCP use is highly inconsistent. Survivors and cancer care quality improvement organizations may play a key role in improving the consistency of SCP use in US cancer programs. Survivors can initiate SCP use. Cancer care quality improvement organizations can specify how cancer programs' compliance with SCP guidelines will be assessed. Future research should identify mechanisms underlying the relationships that we found.
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 1107A McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA, sarah1@email.unc.edu.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Birken
authors.forename: Allison M
authors.initials: AM
authors.lastname: Deal
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Mayer
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Weiner
mesh_terms: D000359:Aftercare / Q000706:statistics & numerical data*; D003266:Continuity of Patient Care / Q000592:standards / Q000639:trends*; D003430:Cross-Sectional Studies; D006301:Health Services Needs and Demand; D006801:Humans; D054547:National Cancer Institute (U.S.); D009369:Neoplasms / Q000517:prevention & control*; D010347:Patient Care Planning / Q000592:standards / Q000639:trends*; D010818:Practice Patterns, Physicians'; D017741:Survivors / Q000706:statistics & numerical data*; D014481:United States