Abstract
Abstract To facilitate best practice in clinical surveillance and follow-up care for survivors, the Institute of Medicine, the Commission on Cancer, and the American Society of Clinical Oncology advise that cancer survivors be provided with personalized treatment summaries and Survivorship Care Plans (SCP). While efforts by leading organization (i.e., NCCN, ASCO and ACS) to define the SCP components, and efficacy and effectiveness are ongoing; we seem to agree that SCP implementation is patient centered. As we make strides in addressing quality oncology follow-up care and as we build the science and practice of SCP, we have the unique opportunity to attend to health equity and reduce health disparities at this very foundation of SCP research and implementation. Ethnic minorities comprise 36% of the US population and about 20% of the new cancer patient and survivor population, and their representations are increasing. Ethnic minority cancer survivors: 1) have more co-occurring illness and poor survival, 2) are at greater risk for aggressive and second cancers and metastases, 3) experience unfavorable survivorship outcomes. Yet, ethnic minorities are understudied in cancer survivorship research. Therefore, enhancing the clinical, cultural and linguistic responsiveness of the SCP is timely and necessary. Shared care medical delivery models combined with community and contextual frameworks that engage multisectoral stakeholders including oncology, specialty and primary care providers, researchers, administrators and advocates can help inform diversity inclusion and health equity considerations in SCP, specifically, and in quality patient care, in general. In this presentation, the gaps will be presented including: Information on late effects, phase of post-treatment window of vulnerability; randomized controlled or non-randomized trials; research considering ethnicity, age, gender, socioeconomic and language factors; implementation; access and cost concerns; integration of specialty (e.g. nutritional or genetic counseling) primary and integrative care Built on survivor input, consensus review and diverse stakeholder evaluation, the COH SCP templates were structured to attempt to enhance clinical, cultural and linguistic responsiveness by including: an emphasis on integrative, patient-centered care; a preamble to increase knowledge and usability; health history elements (e.g., chronic conditions, medications); health advisories (vaccines, nutrition); symptom management and self care; HRQOL (identifying sources of distress, spirituality); and local community and national resources. In summary as scientist-advocates, we anticipate the SCP will: 1) educate and activate survivors into their medical care and self care, and provide affirmation to survivors about their cancer survivorship experience. 2) Inform survivors about their treatment and potential negative treatment effects to increase adherence to surveillance for side effects, second cancers and metastasis, and follow-up care. 3) Assist in symptom management and self care. 4) Bring awareness and engagement in health advisories and quality of life enhancements. 5) Facilitate provider-provider interaction and patient-provider communication for enhanced integrative and quality care for all. Citation Format: Kimlin Tam Ashing. Patient centered treatment summaries and survivorship care plans: enhancing clinical and linguistic responsiveness [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr ES5-3.
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