Abstract
BackgroundSurvivorship care plans (SCPs) are written treatment summaries and follow-up care plans that are intended to facilitate communication and coordination of care among survivors, cancer care providers, and primary care providers. A growing number of guidelines for the use of SCPs exist, yet SCP use in the United States remains limited. Limited use of SCPs may be due to poor quality of these guidelines. The purpose of the study was to evaluate the quality of guidelines for SCP use, tools that are intended to promote evidence-based medicine.MethodsWe conducted a comprehensive search of the literature using MEDLINE/PubMed, EMBASE (Excerpta Medica Database), and CINAHL (Cumulative Index to Nursing and Allied Health Literature) published through April 2014, in addition to grey literature sources and bibliographic and expert reviews. Guideline quality was assessed using the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation, 2nd edition), a tool developed by an international group of scientists to advance the quality of clinical practice guidelines. To promote consistency with extant studies using the AGREE II instrument and to clearly and unambiguously identify potentially useful guidelines for SCP use, we also summarized AGREE II scores by strongly recommending, recommending, or not recommending the guidelines that we evaluated.ResultsOf 128 documents screened, we included 16 guidelines for evaluation. We did not strongly recommend any of the 16 guidelines that we evaluated; we recommended 5 and we did not recommend 11. Overall, guidelines scored highest on clarity of presentation (i.e., guideline language, structure, and format): Guidelines were generally unambiguous in their recommendations that SCPs should be used. Guidelines scored lowest on applicability (i.e., barriers and facilitators to implementation, implementation strategies, and resource implications of applying the guideline): Few guidelines discussed facilitators and barriers to guideline application; advice and tools for implementing guidelines were vague; and none explicitly discussed resource implications of implementing the guidelines.ConclusionsGuidelines often advocated survivorship care plan use without justification or suggestions for implementation. Improved guideline quality may promote survivorship care plan use.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-015-0254-9) contains supplementary material, which is available to authorized users.
Highlights
Survivorship care plans (SCPs) are written treatment summaries and follow-up care plans that are intended to facilitate communication and coordination of care among survivors, cancer care providers, and primary care providers
To extract data from guidelines related to survivorship care plans (SCPs) use, SB developed a data extraction form based on domains specified in the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation, 2nd edition; www.agreetrust.org; domains described in detail in the analysis section), a tool developed by an international group of scientists to advance the quality of clinical practice guidelines [15]
Eleven were developed in the United States; the remaining five guidelines were developed in Canada [19], the Netherlands [20], the United Kingdom, [21,22] and Australia [23]
Summary
Survivorship care plans (SCPs) are written treatment summaries and follow-up care plans that are intended to facilitate communication and coordination of care among survivors, cancer care providers, and primary care providers. The transition from cancer treatment to follow-up care is often challenging for the nearly 15 million cancer survivors in the United States [1]. To facilitate survivors’ transitions, the Institute of Medicine (IOM) recommends that cancer care providers develop and deliver to survivors and their primary care providers survivorship care plans (SCPs). SCPs are written documents that are often developed in cancer programs and, ideally, include plans for follow-up care, such as surveillance and preventive services, and supporting information such as survivor’s diagnosis, stage, and cancer treatments received. SCPs are intended to facilitate communication and coordination of care among survivors, cancer care providers, and primary care providers [2]. Many providers develop SCPs without delivering them to survivors or their primary care providers [4]
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