title: Effectiveness of a Survivorship Program: An Assessment of Patients With Breast Cancer in a Community Setting.
abstract: This study assesses the effectiveness of a single institution's breast cancer survivorship program on patient perceptions, quality of life (QOL), and compliance with National Comprehensive Cancer Network (NCCN) guidelines for follow-up.
  
  
  
  Sampled patients completed all their breast cancer treatment at a single tertiary center. Surveys designed to evaluate QOL were obtained, and retrospective medical record review was conducted to assess NCCN compliance. Survivorship clinic (SC) attendees and nonattendees were matched for age and disease stage for comparison of the outcomes (QOL, NCCN compliance, and overall effectiveness).
  
  
  
  SC patients (n = 63) tended to perceive their concerns in various categories to be addressed more adequately than did nonattendees (n = 54), with significant differences in the areas of practical concerns (P = .03) and late-term adverse effects (P = .03). There was a significant difference in compliance with three NCCN guidelines (history and physical every 3 to 6 months, annual mammography, and a pelvic examination if on tamoxifen) between survivorship attendees and nonattendees (P < .001, P = .02, and P < .001, respectively). Women who attended an SC used other survivorship support resources more often.
  
  
  
  Survivorship programs can be time and resource consuming, but our study is one of the first to show that a survivorship program effectively changes patient behavior in important ways. Patients who attended an SC were more likely to be compliant with NCCN-recommended follow-up and to use other survivorship resources and felt their concerns were better addressed. These measures can be used to help us improve our survivorship services and by other institutions to measure the quality and effectiveness of their programs.
authors.affiliation: Gundersen Health System and Gundersen Lutheran Medical Foundation, La Crosse, WI.
authors.forename: Leah
authors.initials: L
authors.lastname: Dietrich
authors.affiliation: Gundersen Health System and Gundersen Lutheran Medical Foundation, La Crosse, WI alsmith@gundersenhealth.org.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Smith
authors.affiliation: Gundersen Health System and Gundersen Lutheran Medical Foundation, La Crosse, WI.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Watral
authors.affiliation: Gundersen Health System and Gundersen Lutheran Medical Foundation, La Crosse, WI.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Borgert
authors.affiliation: Gundersen Health System and Gundersen Lutheran Medical Foundation, La Crosse, WI.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al-Hamadani
authors.affiliation: Gundersen Health System and Gundersen Lutheran Medical Foundation, La Crosse, WI.
authors.forename: Marie
authors.initials: M
authors.lastname: Van Oosbree
authors.affiliation: Gundersen Health System and Gundersen Lutheran Medical Foundation, La Crosse, WI.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Meyer
mesh_terms: D000368:Aged; D001943:Breast Neoplasms; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D010465:Perception; D011788:Quality of Life; D017741:Survivors