Breast cancer survivorship visits: Presenting concerns and resulting recommendations.

Abstract

e20553 Background: Survivorship care plans (SCPs) are mandated for cancer patients following initial cancer therapy. However, appropriate content, processes, and outcomes of survivorship visits are not yet defined. Neither the concerns that patients bring to these visits nor the degree to which they recall information given by providers is known. As part of a multicenter pilot study of breast cancer survivorship visits, we examined patient concerns at time of presentation for such visits, as well as patient and provider perceptions of resulting recommendations. Methods: We assessed post-treatment breast cancer survivors’ (BCSs’) survivorship concerns prior to a survivorship visit at 1 of 9 cancer centers associated with the LIVESTRONG Survivorship Center of Excellence Network. Following that visit we queried providers as to what referrals and recommendations were made during the visit. Three months later we asked patients to report what recommendations were made by providers. We then examined prevalence of patient concerns and agreement between patients and providers concerning survivorship visit recommendations for managing health. Results: 103 BCS at 9 centers participated. BCS most endorsed concerns were reducing risk of recurrence (81.4%), receipt of appropriate breast cancer follow up care (57.4%), weight loss (55.5%), risk for second cancers (54.9%), fatigue/sleep management (50.0%), and symptoms important to report to providers (50.0%). Although exercise was recommended to 63% of participants by providers, patients recalled this correctly only 79% of the time (Kappa = .16, ns). Moreover, there was a generally poor concordance between provider-reported and patient-recalled recommendations, with kappas ranging from 0.46 for recommendations about tobacco/alcohol to -0.11 for general health recommendations. Conclusions: Survivors report an array of concerns ranging from a risk of recurrence (81.4%) to concerns about peripheral neuropathy and lymphedema (51%). Survivors and providers, however, show little concordance concerning recommendations made visits. Provision of personalized survivorship care plans may improve agreement between survivors and providers concerning health recommendations.