title: Survivorship care plans in cancer: a systematic review of care plan outcomes.
abstract: BACKGROUND
  Eight years after the Institute of Medicine recommended survivorship care plans (SCPs) for all cancer survivors, this study systematically reviewed the evidence for their use.
  
  
  METHODS
  Studies evaluating outcomes after implementation of SCPs for cancer survivors were identified by searching databases (MEDLINE, EMBASE and Cochrane). Data were extracted and summarised.
  
  
  RESULTS
  Ten prospective studies (2286 survivors) met inclusion criteria (5 randomised controlled trials (RCTs)). Study populations included survivors of breast, gynaecological, colorectal and childhood cancer. Several models of SCP were evaluated (paper based/on-line, oncologist/nurse/primary-care physician-delivered and different templates). No significant effect of SCPs was found on survivor distress, satisfaction with care, cancer-care coordination or oncological outcomes in RCTs. Breast cancer survivors with SCPs were better able to correctly identify the clinician responsible for their follow-up care. One study suggested a positive impact on reducing unmet needs. Levels of survivor satisfaction with, and self-reported understanding of, their SCP were very high. Feasibility was raised by health professionals as a significant barrier, as SCPs took 1-4 h of their time to develop.
  
  
  CONCLUSIONS
  Emerging evidence shows very few measurable benefits of SCPs. Survivors reported high levels of satisfaction with SCPs. Resource issues were identified as a significant barrier to implementation.
authors.affiliation: 1] Breast and Surgical Oncology at The Poche Centre, North Sydney, NSW, Australia [2] Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia [3] The Mater Hospital, North Sydney, NSW, Australia.
authors.forename: M E
authors.initials: ME
authors.lastname: Brennan
authors.affiliation: The Mater Hospital, North Sydney, NSW, Australia.
authors.forename: J F
authors.initials: JF
authors.lastname: Gormally
authors.affiliation: Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Butow
authors.affiliation: 1] Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia [2] The Mater Hospital, North Sydney, NSW, Australia.
authors.forename: F M
authors.initials: FM
authors.lastname: Boyle
authors.affiliation: 1] Breast and Surgical Oncology at The Poche Centre, North Sydney, NSW, Australia [2] Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia [3] The Mater Hospital, North Sydney, NSW, Australia [4] Royal North Shore Hospital, St Leonards, NSW, Australia.
authors.forename: A J
authors.initials: AJ
authors.lastname: Spillane
mesh_terms: D002986:Clinical Trials as Topic; D003266:Continuity of Patient Care; D006301:Health Services Needs and Demand; D006801:Humans; D015201:Meta-Analysis as Topic; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010347:Patient Care Planning; D017741:Survivors