Factors influencing implementation of a survivorship care plan\u2014a quantitative process evaluation of the ROGY Care trial

Belle H De Rooij,Johanna M A Pijnenborg,Kim A H Nicolaije,Roy F P M Kruitwagen,Lonneke V Van De Poll-Franse,M Caroline Vos,Dorry Boll,Nicole P M Ezendam

doi:10.1007/s11764-016-0562-3

Abstract

PurposeThe aim of this study is to investigate the factors that influence implementation of Survivorship Care Plans (SCPs) in the intervention arm of the ROGY Care trial by (1) assessing the level of SCP receipt in the ROGY Care trial and (2) identifying patient- and provider-level factors that influence SCP receipt.MethodsBetween 2011 and 2015, a pragmatic cluster randomized-controlled-trial was conducted on the effects of automatically generated SCPs. Endometrial (N = 117) and ovarian (N = 61) cancer patients were allocated to ‘SCP care’, as provided by their SCP care providers (N = 10). Associations between SCP receipt (self-reported SCP receipt and actually generated SCPs), patient-factors (socio-demographic-, clinical-, and personality factors), and care provider factors (profession and a-priori motivation regarding SCP provision) were tested in univariate analysis. The odds ratios of factors influencing self-reported SCP receipt were estimated with a multivariate regression model.ResultsOf all patients in the SCP care arm (N = 178), SCPs were generated by the care provider for 90 % of the patients and 70 % of the patients reported that they had received an SCP. Patients with older age, ovarian cancer, type D (distressed) personality, and patients that completed the questionnaire a longer period of time after the SCP consult were more likely to report no SCP receipt.ConclusionsSCP receipt was influenced by patient- but not care-provider factors.Implications for cancer survivorsCertain patient groups were less likely to report SCP receipt. Whether all patients are in need of an SCP, requires further investigation. If they do, more efforts need to be made towards the implementation of SCPs.

Highlights

In 2006, the American Institute of Medicine (IOM) and the Dutch Health Council advocated Survivorship care plans (SCPs) as a standard of care for all cancer patients [1, 2]
Patient and Survivorship Care Plans (SCPs) care provider factors related to SCP receipt
No SCP care provider factors were associated with first SCP receipt (Table 2)

Summary

Introduction

SCPs aim to promote cancer survivors’ follow-up care and outcomes [1]. Since the IOM’s recommendations, implementation and dissemination of SCPs in clinical practice have been low and inconsistent [3,4,5,6]. Our recently published study of the pragmatic clusterrandomized ROGY Care trial [7] was accompanied by an. J Cancer Surviv (2017) 11:64–73 editorial declaring the need for more attention to implementation of SCPs [8]. The ROGY Care study contributes to the small number of clinical trials that have evaluated the effects of SCPs on patient reported outcomes [9,10,11]. The pragmatic nature of the ROGY Care trial provides the unique opportunity to evaluate implementation of SCPs in clinical practice

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