title: Associations among survivorship care plans, experiences of survivorship care, and functioning in older breast cancer survivors: CALGB/Alliance 369901.
abstract: OBJECTIVE
  Survivorship care plans (SCP) are recommended for all cancer patients and could be especially useful to survivors 65 years and over ("older"). This study examined receipt of SCPs among older breast cancer survivors and whether SCPs were associated with improved patient-reported outcomes.
  
  
  METHODS
  Three hundred and twenty-eight older women diagnosed with invasive, nonmetastatic breast cancer between 2007-2011 were recruited from 78 cooperative-group sites. Participants completed telephone interviews at baseline and 1-year posttreatment. Regression analyses examined SCP receipt (yes/no) and functioning (EORTC-QLQ-C30), cancer worry, and experiences of survivorship care (care coordination, knowledge).
  
  
  RESULTS
  Only 35% of women received SCPs. For each 1-year increase in age, there was a 5% lower odds of receiving an SCP (odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.91-0.98, p = 0.007). Besides age, no other factor predicted SCPs. SCP receipt was associated with greater knowledge and understanding of requisite follow-up care (p < 0.05); however, functioning was not significantly different among those with vs. without SCPs.
  
  
  CONCLUSIONS
  Receipt of care plans was limited. SCPs improved understanding of breast cancer follow-up care among older survivors, but did not impact functioning one year post-treatment.
  
  
  CONCLUSIONS
  To impact functioning and salient needs of the growing cohort of older survivors, survivorship care plans likely should be tailored to geriatric-specific issues. To improve functioning, SCP content should expand to include exercise, nutrition, polypharmacy, social support and management of symptom burden from cancer, and other comorbid conditions. To improve follow-up care for cancer survivors, SCPs should delineate shared care roles between oncology and primary care in managing recurrence surveillance, screening, and cancer sequelae.
authors.affiliation: Department of Oncology, Georgetown University Medical Center and Cancer Prevention and Control Program, Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, USA, laf56@georgetown.edu.
authors.forename: Leigh Anne
authors.initials: LA
authors.lastname: Faul
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Luta
authors.forename: Vanessa
authors.initials: V
authors.lastname: Sheppard
authors.forename: Claudine
authors.initials: C
authors.lastname: Isaacs
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Cohen
authors.forename: Hyman B
authors.initials: HB
authors.lastname: Muss
authors.forename: Rachel
authors.initials: R
authors.lastname: Yung
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Clapp
authors.forename: Eric
authors.initials: E
authors.lastname: Winer
authors.forename: Clifford
authors.initials: C
authors.lastname: Hudis
authors.forename: Michelle
authors.initials: M
authors.lastname: Tallarico
authors.forename: Julhy
authors.initials: J
authors.lastname: Wang
authors.forename: William T
authors.initials: WT
authors.lastname: Barry
authors.forename: Jeanne S
authors.initials: JS
authors.lastname: Mandelblatt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors; D016896:Treatment Outcome