Psychosocial outcomes among cancer survivors who receive a treatment summary or survivorship care plan.

Abstract

217 Background: Treatment summaries (TSs) and survivorship care plans (SCPs) were expected to bridge patient-provider communication challenges and better address the unique needs of cancer survivors. While interest in TSs and SCPs has been growing, acceptance and implementation has been slow and findings from studies of their effectiveness have been mixed, overall. Our study examines independent associations of receipt of TSs and SCPs with psychosocial outcomes of cancer survivors. Methods: The study sample included survivors completing the 2012 LIVESTRONG Survey for People Affected by Cancer (n = 5,156). Logistic regression was used to model three distinct psychosocial outcomes: having relationship concerns (yes/no), distress (defined as a rating of 6 or higher on the NCCN Distress Thermometer), and moderate or severe cancer-specific worry (yes/no) as functions of TS receipt, SCP receipt and important confounding variables (age, sex, race/ethnicity, marital status, employment, income, education and health insurance). Results: Among cancer survivors, only 51% received a TS and only 16% received a SCP. Survivors who received a TS or SCP had significantly lower odds of relationship concerns (TS: OR = 0.62; 95% CI 0.52, 0.75; SCP: OR = 0.73; 95% CI 0.57, 0.94); distress (TS: OR = 0.74; 95% CI 0.65, 0.85; SCP: OR = 0.81; 95% CI 0.68, 0.97); and moderate or severe cancer-specific worry (TS: OR = 0.76; 95% CI: 0.67-0.85; SCP: OR = 0.78; 95% CI: 0.67-0.92). Other covariates consistently associated with psychosocial concerns included younger age, being unemployed and income ≤ $60,000. Conclusions: Many cancer survivors do not receive a TS or SCP. Receipt of either document was associated with reporting better psychosocial outcomes, suggesting that TSs and SCPs may not be reaching cancer survivors with psychosocial health problems. Survivors with psychosocial concerns may benefit from targeted survivorship care.