Use of Survivorship Care Plans in the United States: Associations With Survivorship Care
Use of Survivorship Care Plans in the United States: Associations With Survivorship Care
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DOI：
10.1093/jnci/djt258
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发表时间：
2013-10-01
影响因子：
10.3
通讯作者：
Rowland, Julia H.
中科院分区：
文献类型：
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作者：
Forsythe, Laura P.;Parry, Carla;Rowland, Julia H.
生存护理计划(SCP)，包括治疗总结和后续计划，旨在促进癌症治疗后护理的协调；然而，对于肿瘤学家向初级保健医生(PCP)提供这些文件的情况知之甚少。本研究比较了自我报告的肿瘤学家提供的治疗摘要和PCP接收的治疗摘要和后续计划，描述了向PCP报告一致提供这些文件的肿瘤学家的特征，并检查了PCP接收这些文件与生存护理之间的关系。对具有全国代表性的内科肿瘤学家样本(1130名)和PCP(1020名)进行了关于乳腺癌和结肠癌幸存者的后续护理的调查。所有的统计检验都是双面的。多变量回归模型确定了与肿瘤学家向PCP提供治疗总结和SCP相关的因素(总是/几乎总是VS不太频繁)。近一半的肿瘤学家报告总是/几乎总是提供治疗总结，而20.2%的人报告总是/几乎总是提供SCP(治疗总结随访计划)。大约三分之一的初级保健医生表示总是/几乎总是接受治疗摘要；13.4%的报告总是/几乎总是接受初级保健计划。报告接受癌症远期和远期影响培训和使用电子病历的肿瘤学家更有可能报告SCP供应(P<；0.05)。与既没有收到治疗总结也没有收到SCP相比，接受PCP的SCP与更好的PCP报告的护理协调、医生-医生沟通以及对生存护理知识的信心相关(P<；0.05)。向PCP提供SCP可以增强生存护理协调、医生-医生沟通和PCP信心。然而，要实现在肿瘤学家和初级保健医生之间共享SCP的实施，将需要取得相当大的进展。
Survivorship care plans (SCPs), including a treatment summary and follow-up plan, intend to promote coordination of posttreatment cancer care; yet, little is known about the provision of these documents by oncologists to primary care physicians (PCPs). This study compared self-reported oncologist provision and PCP receipt of treatment summaries and follow-up plans, characterized oncologists who reported consistent provision of these documents to PCPs, and examined associations between PCP receipt of these documents and survivorship care.A nationally representative sample of medical oncologists (n 1130) and PCPs (n 1020) were surveyed regarding follow-up care for breast and colon cancer survivors. All statistical tests were two-sided. Multivariable regression models identified factors associated with oncologist provision of treatment summaries and SCPs to PCPs (always/almost always vs less frequent).Nearly half of oncologists reported always/almost always providing treatment summaries, whereas 20.2% reported always/almost always providing SCPs (treatment summary follow-up plan). Approximately one-third of PCPs indicated always/almost always receiving treatment summaries; 13.4% reported always/almost always receiving SCPs. Oncologists who reported training in late- and long-term effects of cancer and use of electronic medical records were more likely to report SCP provision (P < .05). PCP receipt of SCPs was associated with better PCP-reported care coordination, physicianphysician communication, and confidence in survivorship care knowledge compared to receipt of neither treatment summaries nor SCPs (P < .05).Providing SCPs to PCPs may enhance survivorship care coordination, physicianphysician communication, and PCP confidence. However, considerable progress will be necessary to achieve implementation of sharing SCPs among oncologists and PCPs.