Polaris Oncology Survivor Transition (POST) System

 描述(由申请人提供)：到2015年1月，预计肿瘤护理提供者将为所有终止癌症积极治疗的个人制定生存护理计划(SCP)；然而，缺乏关于生存计划对患者、提供者或医疗保健系统的影响的系统研究。北极星肿瘤生存过渡(POST)计划是一个基于网络的系统，它整合了来自医学研究所(IOM)和美国外科医生学会(ACS)的建议，以帮助制定癌症生存计划。这是一种以患者为中心的方法，整合了肿瘤治疗团队和患者的意见。第一阶段建立并反复修改POST系统(N=25)，第二阶段将使用单盲随机对照试验(RCT)测试SCP是否影响患者和提供者的结果。将招募230名停止积极治疗的乳腺癌患者，并随机分配到正常治疗组(n=115)或岗位治疗组(n=115)。所有参与者将在1个月、3个月和6个月时由一名研究助理进行评估，而不考虑基线状态和小组分配。主要结果将包括生活质量、行动机制，如进入生存的信心，以及其他结果，如(1)心理困扰，(2)坚持医学和行为健康建议，(3)卫生保健利用，(4)患者对SCP和他们的肿瘤学家的护理的满意度，以及 (5)肿瘤科提供者和初级保健医生对岗位制度的满意度。该员额将创新临床环境，因为它是第一个产生完全反映国际移民组织建议和新的ACS 2015要求的计算机生成的量身定做的生存计划的系统；纳入来自肿瘤学提供者和患者的信息；具有随时可用的双向电子健康记录集成的“插件”；为专门支助服务提供动态的电子转诊；促进肿瘤学家和初级保健医生之间的护理协调。这项研究的影响将是重大的。如果假设得到证实，将有明确的科学证据支持将生存护理计划应用于肿瘤学临床实践。如果假说不被证实，重要的教训将指导护理规划的未来方向，包括是否未能影响结果是由于未能影响几种假想的行动机制。对该职位的商业兴趣很旺盛，因为它可以促进生存规划，改善护理，并改善对认证标准的遵守。

 DESCRIPTION (provided by applicant): By January 2015, oncology care providers will be expected to craft Survivorship Care Plans (SCPs) for all individuals ending active treatment for cancer; however, there is a lack of systematic study of the impact survivorship planning has on patients, providers, or healthcare systems. The Polaris Oncology Survivorship Transition (POST) program is a web-based system that incorporates recommendations from the Institute of Medicine (IOM) and American College of Surgeons (ACS) to assist with cancer survivorship planning. It is a patient-centered approach that integrates input from both the treating oncology team and the patient. Phase I built and iteratively modified (N=25) the POST system and Phase II will test whether the SCPs impact patient and provider outcomes using a single blind, randomized controlled trial (RCT). Breast cancer patients (n=230) transitioning out of active treatment will be recruited and randomly assigned to receive Treatment as Usual (n=115) or the POST (n=115). All participants will be assessed at 1, 3, and 6 months by a research assistant blind to baseline status and group assignment. Primary outcomes will include quality of life, mechanisms of action such as confidence in entering survivorship, and other outcomes such as (1) psychological distress, (2) adherence to medical and behavioral health recommendations, (3) health care utilization, (4) patient satisfaction with the SCP and their oncologists' care, and (5) oncology provider as well as PCP satisfaction with the POST system. The POST will innovate the clinical setting through being the first system to produce computer generated tailored survivorship plans fully reflecting IOM recommendations and the new ACS 2015 requirements; incorporating information from both the oncology provider and the patient; featuring readily available "plug in" for two-way electronic health record integration; providing dynamic, electronic referrals for specialized support services; and facilitating care coordination between the oncologist and PCP. This study's impact will be significant. If hypotheses are confirmed, clear scientific evidence will exist for supporting survivorship care planning into oncology clinical practice. If hypotheses are disconfirmed, important lessons will guide future directions for care planning, including whether failure to affect outcomes was due to failure to impact several hypothesized mechanisms of action. Commercial interest in the POST is brisk as it may facilitate survivorship planning, improve care, and improve compliance with accreditation standards.