What are survivorship care plans failing to tell men after prostate cancer treatment?
What are survivorship care plans failing to tell men after prostate cancer treatment?
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DOI：
10.1002/pros.24116
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发表时间：
2021-03-23
期刊：
影响因子：
2.8
通讯作者：
Snyder, Claire F.
中科院分区：
文献类型：
--
作者：
Choi, Youngjee;Smith, Katherine C.;Snyder, Claire F.
背景生存护理计划包含患者和初级保健医生关于治疗后癌症幸存者适当护理的重要信息。我们描述的完整性，前列腺癌生存护理计划和评估的一致性，后续的建议与guidelines.Methods我们分析了119前列腺癌生存护理计划，从一个学术和一个社区癌症中心，抽象的人口统计学，癌症/治疗的细节，和后续的建议。随访建议与美国癌症协会（ACS），美国临床肿瘤学会（ASCO），和国家综合癌症网络（NCCN）guidelines.Results的内容在>90%的计划包括癌症TNM分期，前列腺特异性抗原（PSA）诊断，放射治疗的细节（98%的男性接受放射治疗）;和PSA监测建议。82%接受手术的男性、86%接受雄激素剥夺治疗（ADT）的男性和97%接受放疗的男性列出了潜在的治疗特异性副作用。在71%的计划中注意到治疗后症状的存在。关于监测随访，所有指南都建议每年进行直肠指检（DRE）。没有计划具体说明焚毁去除率。然而，社区网站的所有71个计划都建议至少每年进行一次泌尿科、放射肿瘤学和初级保健的随访。在学术研究中心，只有2/48的计划指定了随访访视。所有指南都建议每6-12个月进行一次PSA检测，持续5年，然后每年进行一次。在前5年，90%的计划与指南一致，8%建议过度监测，2%不完整。在接受ADT的男性中，ACS和ASCO推荐骨密度成像，NCCN推荐睾酮水平。ADT的77名男子，1%的建议骨密度成像和16%的睾酮水平testing.Conclusions虽然护理计划的内容是更完整的人口和治疗摘要信息，两个网站有差距，在报告治疗后的症状和ADT相关的测试建议。这些发现强调了需要提高护理计划中的信息质量，这对于向患者和初级保健医生传达适当的后续建议非常重要。
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.