Integration of survivorship care in community oncology practice.

Abstract

33 Background: Each of the 12 million cancer survivors in the United States has unique needs, giving oncology providers the opportunity to address survivorship issues and optimize care. Minnesota Oncology, a community oncology practice, has implemented a survivorship program that evaluates patient specific issues through a series of clinic visits guided by results from the Functional Assessment of Chronic Illness Therapy (FACIT) quality of life assessment tool. Methods: Survivorship care is initiated at diagnosis. After determining the treatment plan, a one hour survivorship visit with a midlevel provider is dedicated to patient concerns and quality of life. Additionally, visits are scheduled at the time of treatment completion and 3-6 months later. The frequency and focus of visits is determined by the patient. Patients complete the FACIT assessment on an electronic tablet in the clinic, immediately prior to scheduled visits. This tool addresses physical, social, emotional and functional well-being, and takes 5-7 minutes to complete. A report of patient specific information is generated for providers to guide each visit, and ultimately to coordinate additional referrals for care. Patient satisfaction is measured at each visit and via a follow up survey. Results: A total of 152 patients (168 visits) have taken the FACIT survey from January 1 – June 30, 2012. Average FACIT general raw scores at baseline, treatment conclusion and 3-6 months following completion were 77.6 (n=121), 76.9 (n=37) and 82.3 (n=10), respectively. Median patient age was 59 (range 22-84). Breast cancer (n = 44) was the most common diagnosis seen and initial visit disease status was: stage I (n = 28), II (n = 37), III (n = 43), IV (n = 36). As a result of the surveys and/or clinic visits referrals to social work, dietician, rehab and counseling have occurred. Conclusions: Attention to survivorship issues is essential to provide comprehensive care to those affected by cancer. Early intervention should consider disease state along with patient specific factors. Following a standard method for addressing survivorship issues allows for cancer care referral coordination. Benefits of adopting a survivorship program include improvement in quality of care and patient satisfaction.