title: Doctor, what are my options? A prospective cohort study of an individualized care plan for patients with gastrointestinal cancer.
abstract: BACKGROUND
  For cancer patients, information about their disease and its treatment is often delivered within a short time period, potentially leading to patient misunderstanding, which can impede optimal patient care. In this 3-part clinical study, we investigated the utility of an individualized care plan for patients with gastrointestinal (gi) cancer starting a new treatment.
  
  
  METHODS
  In part 1, a comprehensive literature search identified items for potential inclusion in the care plan. Those items were formatted into a questionnaire. The questionnaire was then administered to patients as a structured interview. In part 2, health care professionals involved in the care of patients with gi cancer evaluated the resulting care plan for content and relevancy. In part 3, a 20-week prospective cohort study (10 weeks using standard of care, 10 weeks using individualized care plans) was conducted. Outcomes were assessed at baseline and at 2-4 weeks after administration of the care plan.
  
  
  RESULTS
  In part 1, a 73-item questionnaire was developed and completed by 20 patients in semi-structured interviews. In part 2, long and short versions of the care plan were created. Most health care professionals preferred the long version. Based on their comments, a final version of the care plan was created. The part 3 study enrolled 104 patients. Overall satisfaction scores were significantly higher in the intervention group at baseline (p = 0.010) and follow-up (p = 0.005). Compared with control patients, the intervention cohort also reported significantly higher overall quality of life (p = 0.044) and fewer symptoms of anxiety (p = 0.048) at follow-up.
  
  
  CONCLUSIONS
  Provision of an individualized care plan resulted in improvements in outcome measures at both baseline and follow-up. Future studies are needed to confirm these findings.
authors.affiliation: Division of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, ON;
authors.forename: A E
authors.initials: AE
authors.lastname: Hird
authors.affiliation: Division of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, ON;
authors.forename: M
authors.initials: M
authors.lastname: Lemke
authors.affiliation: Division of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, ON;
authors.forename: M
authors.initials: M
authors.lastname: Turovsky
authors.affiliation: Division of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, ON;
authors.forename: V
authors.initials: V
authors.lastname: Malecki
authors.affiliation: Division of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, ON;
authors.forename: K
authors.initials: K
authors.lastname: Kumar
authors.affiliation: Department of Pharmacy, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, ON;
authors.forename: C
authors.initials: C
authors.lastname: DeAngelis
authors.affiliation: Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, ON.
authors.forename: E
authors.initials: E
authors.lastname: Chow
authors.affiliation: Division of Medical Oncology and Hematology, Sunnybrook Health Sciences Centre, Odette Cancer Centre, Toronto, ON;
authors.forename: Y J
authors.initials: YJ
authors.lastname: Ko
keywords: Gastrointestinal cancer; care plans; communication; patient satisfaction; quality of life