A comparison of oncology clinicians' preferences for structuring survivorship care.

Abstract

e19545 Background: Several models for survivorship care are prominent within the cancer literature; however, there is little research that examines what oncology clinicians perceive to be the best approach to caring for cancer survivors and what services survivorship programs should include. Methods: A web-based survey of all clinical staff was conducted at an NCI designated comprehensive cancer center (N = 377, 57 physicians, 31 midlevel providers, 207 oncology nurses, 27 clinicians in support services, and 55 other) with a 49.8% response rate. Chi Square and one-way ANOVAs were used to examine differences between groups in their preferences for a disease site specific, single centralized multisite clinic, and community-based shared care models for the delivery of survivorship care. Results: There were significant differences in model preference by clinician type (Χ2 = 15.355, p = 0.05). Physicians and nurses preferred to base survivor programs in disease site clinics (54.3% and 46.6% respectively), followed by a centralized multisite clinic (26.1% and 27%), with the community shared model the least preferred (19.6% and 26.4%). This was also evident in the significant preference for physicians to continue management of their patients through survivorship in their home clinics (F = 2.92, p = 0.022), as well as their relative reluctance to refer to a centralized survivorship clinic (F = 17.05, p< 0.001). All four clinician groups rated providing education about late effects, pain and symptom management, and help communicating with primary care providers as among the most important components of a survivorship program. Conclusions: The findings indicate an overall preference among clinical staff for retaining survivorship programs within the primary cancer treatment setting. This preference was consistent across disciplines. Disciplines differed, however, in their preferences for retaining survivorship programs in the site-specific clinic setting, as opposed to centralizing care in a single multisite survivor clinic. Given these differences it is critical that standardized patient outcomes be included in future evaluations of survivorship programs so that the most effective care delivery models are empirically identified. No significant financial relationships to disclose.