TY - JOUR
T1 - What are survivorship care plans failing to tell men after prostate cancer treatment?
AU - Choi, Youngjee
AU - Smith, Katherine C.
AU - Shukla, Aishwarya
AU - Blackford, Amanda L.
AU - Tran, Phuoc T.
AU - Peairs, Kimberly S.
AU - DeMarco, Thomas M.
AU - Choflet, Amanda
AU - Farling, Kristen
AU - Kelso, Madeline
AU - Carducci, Michael A.
AU - Mayonado, Nancy
AU - Snyder, Claire F.
N1 - Funding Information:
This study was funded through a Patient‐Centered Outcomes Research Institute (PCORI) Award (IHS‐1409‐22534). The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins receives funding from the National Cancer Institute (P30CA006973). The statements in this publication are solely the responsibility of the authors and do not necessarily represent the views of PCORI, its Board of Governors or Methodology Committee.
Funding Information:
Drs. Youngjee Choi and Kimberly S. Peairs received research grant support from the Merck Foundation. Dr. Phuoc T. Tran reports grants from Astellas Pharm, Bayer Healthcare, and RefleXion Medical; and advisory board/consulting for Noxopharm, Janssen‐Taris Biomedical, AstraZeneca, and Myovant outside the submitted work. In addition, Dr. Tran has a patent 9114158—Compounds and Methods of Use in Ablative Radiotherapy licensed to Natsar Pharm. Dr. Claire Snyder currently receives research support from Pfizer and Genentech and previously received royalties from UptoDate for section authorship related to survivorship. The remaining authors declare that they have no conflict of interests.
Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2021/5/15
Y1 - 2021/5/15
N2 - Background: Survivorship care plans contain important information for patients and primary care physicians regarding appropriate care for cancer survivors after treatment. We describe the completeness of prostate cancer survivorship care plans and evaluate the concordance of follow-up recommendations with guidelines. Methods: We analyzed 119 prostate cancer survivorship care plans from one academic and one community cancer center, abstracting demographics, cancer/treatment details, and follow-up recommendations. Follow-up recommendations were compared with the American Cancer Society (ACS), American Society of Clinical Oncology (ASCO), and National Comprehensive Cancer Network (NCCN) guidelines. Results: Content in >90% of plans included cancer TNM stage; prostate-specific antigen (PSA) at diagnosis; radiation treatment details (98% of men received radiation); and PSA monitoring recommendations. Potential treatment-specific side effects were listed for 82% of men who had surgery, 86% who received androgen deprivation therapy (ADT), and 97% who underwent radiation. The presence of posttreatment symptoms was noted in 71% of plans. Regarding surveillance follow-up, all guidelines recommend an annual digital rectal exam (DRE). No plans specified DRE. However, all 71 plans at the community site recommended at least annual follow-up visits with urology, radiation oncology, and primary care. Only 2/48 plans at the academic site specified follow-up visits. All guidelines recommend PSA testing every 6–12 months for 5 years, then annually. For the first 5 years, 90% of plans were guideline-concordant, 8% suggested oversurveillance, and 2% were incomplete. In men receiving ADT, ACS and ASCO recommend bone density imaging and NCCN recommends testosterone levels. Of 77 men on ADT, 1% were recommended bone density imaging and 16% testosterone level testing. Conclusions: While care plan content is more complete for demographic and treatment summary information, both sites had gaps in reporting posttreatment symptoms and ADT-related testing recommendations. These findings highlight the need to improve the quality of information in care plans, which are important in communicating appropriate follow-up recommendations to patients and primary care physicians.
AB - Background: Survivorship care plans contain important information for patients and primary care physicians regarding appropriate care for cancer survivors after treatment. We describe the completeness of prostate cancer survivorship care plans and evaluate the concordance of follow-up recommendations with guidelines. Methods: We analyzed 119 prostate cancer survivorship care plans from one academic and one community cancer center, abstracting demographics, cancer/treatment details, and follow-up recommendations. Follow-up recommendations were compared with the American Cancer Society (ACS), American Society of Clinical Oncology (ASCO), and National Comprehensive Cancer Network (NCCN) guidelines. Results: Content in >90% of plans included cancer TNM stage; prostate-specific antigen (PSA) at diagnosis; radiation treatment details (98% of men received radiation); and PSA monitoring recommendations. Potential treatment-specific side effects were listed for 82% of men who had surgery, 86% who received androgen deprivation therapy (ADT), and 97% who underwent radiation. The presence of posttreatment symptoms was noted in 71% of plans. Regarding surveillance follow-up, all guidelines recommend an annual digital rectal exam (DRE). No plans specified DRE. However, all 71 plans at the community site recommended at least annual follow-up visits with urology, radiation oncology, and primary care. Only 2/48 plans at the academic site specified follow-up visits. All guidelines recommend PSA testing every 6–12 months for 5 years, then annually. For the first 5 years, 90% of plans were guideline-concordant, 8% suggested oversurveillance, and 2% were incomplete. In men receiving ADT, ACS and ASCO recommend bone density imaging and NCCN recommends testosterone levels. Of 77 men on ADT, 1% were recommended bone density imaging and 16% testosterone level testing. Conclusions: While care plan content is more complete for demographic and treatment summary information, both sites had gaps in reporting posttreatment symptoms and ADT-related testing recommendations. These findings highlight the need to improve the quality of information in care plans, which are important in communicating appropriate follow-up recommendations to patients and primary care physicians.
KW - cancer guidelines
KW - cancer survivorship
KW - prostate cancer
KW - survivorship care plans
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U2 - 10.1002/pros.24116
DO - 10.1002/pros.24116
M3 - Article
C2 - 33755233
AN - SCOPUS:85102902836
SN - 0270-4137
VL - 81
SP - 398
EP - 406
JO - Prostate
JF - Prostate
IS - 7
ER -