title: Provision and discussion of survivorship care plans among cancer survivors: results of a nationally representative survey of oncologists and primary care physicians.
abstract: OBJECTIVE
  Survivorship care planning should involve discussions between providers and cancer survivors to address survivors' needs and optimize adherence. We examined the frequency and factors associated with oncologists' and primary care physicians' (PCPs) reports of provision of written survivorship care plans (SCPs) and discussion of survivorship care recommendations with survivors.
  
  
  METHODS
  A nationally representative sample of 1,130 oncologists and 1,020 PCPs was surveyed about survivorship care practices with survivors. Logistic regression models predicted multilevel factors associated with providing SCPs or discussing recommendations with survivors.
  
  
  RESULTS
  Although a majority of oncologists (64%) reported always/almost always discussing survivorship care recommendations with survivors, fewer also discussed who survivors should see for cancer-related and other follow-up care (32%); fewer still also provided a written SCP to the survivor (< 5%). Survivorship care recommendations and provider responsibility were not regularly discussed by PCPs and survivors (12%). Oncologists who reported detailed training about late and long-term effects of cancer were more likely to provide written SCPs (odds ratio [OR], 1.73; 95% CI, 1.22 to 2.44) and discuss survivorship care planning with survivors (OR, 2.02; 95% CI, 1.51 to 2.70). PCPs who received SCPs from oncologists were 9× more likely (95% CI, 5.74 to 14.82) to report survivorship discussions with survivors.
  
  
  CONCLUSIONS
  A minority of both PCPs and oncologists reported consistently discussing and providing SCPs to cancer survivors. Training and knowledge specific to survivorship care and coordinated care between PCPs and oncologists were associated with increased survivorship discussions with survivors. These nationally representative data provide a useful benchmark to assess implementation of new efforts to improve the follow-up care of survivors.
authors.affiliation: Danielle Blanch-Hartigan, Catherine M. Alfano, and Julia H. Rowland, National Cancer Institute, Bethesda, MD; Laura P. Forsythe, Patient-Centered Outcomes Research Institute, Washington, DC; Tenbroeck Smith, American Cancer Society, Atlanta, GA; Larissa Nekhlyudov, Harvard Medical School and Harvard Vanguard Medical Associates, Boston, MA; and Patricia A. Ganz, University of California Los Angeles Schools of Medicine and Public Health, Los Angeles, CA. danielle.hartigan@nih.gov.
authors.forename: Danielle
authors.initials: D
authors.lastname: Blanch-Hartigan
authors.affiliation: Danielle Blanch-Hartigan, Catherine M. Alfano, and Julia H. Rowland, National Cancer Institute, Bethesda, MD; Laura P. Forsythe, Patient-Centered Outcomes Research Institute, Washington, DC; Tenbroeck Smith, American Cancer Society, Atlanta, GA; Larissa Nekhlyudov, Harvard Medical School and Harvard Vanguard Medical Associates, Boston, MA; and Patricia A. Ganz, University of California Los Angeles Schools of Medicine and Public Health, Los Angeles, CA.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Forsythe
authors.affiliation: Danielle Blanch-Hartigan, Catherine M. Alfano, and Julia H. Rowland, National Cancer Institute, Bethesda, MD; Laura P. Forsythe, Patient-Centered Outcomes Research Institute, Washington, DC; Tenbroeck Smith, American Cancer Society, Atlanta, GA; Larissa Nekhlyudov, Harvard Medical School and Harvard Vanguard Medical Associates, Boston, MA; and Patricia A. Ganz, University of California Los Angeles Schools of Medicine and Public Health, Los Angeles, CA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.affiliation: Danielle Blanch-Hartigan, Catherine M. Alfano, and Julia H. Rowland, National Cancer Institute, Bethesda, MD; Laura P. Forsythe, Patient-Centered Outcomes Research Institute, Washington, DC; Tenbroeck Smith, American Cancer Society, Atlanta, GA; Larissa Nekhlyudov, Harvard Medical School and Harvard Vanguard Medical Associates, Boston, MA; and Patricia A. Ganz, University of California Los Angeles Schools of Medicine and Public Health, Los Angeles, CA.
authors.forename: Tenbroeck
authors.initials: T
authors.lastname: Smith
authors.affiliation: Danielle Blanch-Hartigan, Catherine M. Alfano, and Julia H. Rowland, National Cancer Institute, Bethesda, MD; Laura P. Forsythe, Patient-Centered Outcomes Research Institute, Washington, DC; Tenbroeck Smith, American Cancer Society, Atlanta, GA; Larissa Nekhlyudov, Harvard Medical School and Harvard Vanguard Medical Associates, Boston, MA; and Patricia A. Ganz, University of California Los Angeles Schools of Medicine and Public Health, Los Angeles, CA.
authors.forename: Larissa
authors.initials: L
authors.lastname: Nekhlyudov
authors.affiliation: Danielle Blanch-Hartigan, Catherine M. Alfano, and Julia H. Rowland, National Cancer Institute, Bethesda, MD; Laura P. Forsythe, Patient-Centered Outcomes Research Institute, Washington, DC; Tenbroeck Smith, American Cancer Society, Atlanta, GA; Larissa Nekhlyudov, Harvard Medical School and Harvard Vanguard Medical Associates, Boston, MA; and Patricia A. Ganz, University of California Los Angeles Schools of Medicine and Public Health, Los Angeles, CA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.affiliation: Danielle Blanch-Hartigan, Catherine M. Alfano, and Julia H. Rowland, National Cancer Institute, Bethesda, MD; Laura P. Forsythe, Patient-Centered Outcomes Research Institute, Washington, DC; Tenbroeck Smith, American Cancer Society, Atlanta, GA; Larissa Nekhlyudov, Harvard Medical School and Harvard Vanguard Medical Associates, Boston, MA; and Patricia A. Ganz, University of California Los Angeles Schools of Medicine and Public Health, Los Angeles, CA.
authors.forename: Julia H
authors.initials: JH
authors.lastname: Rowland
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033183:Interdisciplinary Communication; D016015:Logistic Models; D008134:Long-Term Care; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D016017:Odds Ratio; D010347:Patient Care Planning; D010348:Patient Care Team; D010349:Patient Compliance; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D014481:United States
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