Associations between receipt of a treatment summary, emotional concerns, and patterns of care among post-treatment cancer survivors.

Abstract

52 Background: Treatment summaries (TS), a critical component of survivorship care plans, were identified as a tool to improve long-term outcomes for the 12 million cancer survivors alive in the United States. Methods: In 2010, the Lance Armstrong Foundation fielded the LIVESTRONG Survey for People Affected by Cancer. Respondents were recruited through several channels including partnerships with national organizations such as ASCO. Over a 9-month period, 12,682 people completed the survey, including 3,682 post-treatment cancer survivors (PTCS). The survey addressed post-treatment concerns including receipt of TS. Full survey results were presented at the 2011 ASCO Annual Meeting. Results: Receipt of TS data was available for 3,042 PTCS: average age (50); female (65%); average time since diagnosis (6 years); received a TS (34%). PTCS who received TS reported that they were closer to time since diagnosis or since treatment ended (p < 0.01); more likely to have received chemotherapy (p < 0.01); more often receiving the majority of their health care from a medical oncologist (p < 0.05); experiencing significantly fewer (p < 0.05) post-treatment emotional concerns (including emotional distress; fears of recurrence; concerns about family risk; and appearance concerns) and were more likely to have received care; significantly less likely to say that they had “learned to live with” their concerns (p <0.05)—the most common reason among participants for not receiving care. Finally, receipt of a TS was related to higher information efficacy (p < 0.01; which appeared to mediate the relationship between receipt of a TS and fewer emotional concerns). PTCS who received a TS more often reported that their needs were met including information received about possible late-effects; care they got during treatment; and care they received after treatment. Conclusions: These results support the provision of TS to PTCS. Receipt of TS was associated with a variety of positive outcomes; however, only about one-third of PTCS received one. Future studies focused on patient perspectives on care planning tools, such as treatment summaries and care plans, can help to improve optimal survivorship care delivery.