Quality care and patient involvement in their care: Preferences for transitioning cancer follow-up care to the community.

Abstract

75 Background: The cancer survivor rate is rising and a new focus has turned to the appropriate survivorship care for this new population. Although several models of survivorship care are currently present in Canada, few studies have examined cancer patient preferences. This study compared patient preferences for direct referral back to one’s primary care practitioner (PCP) after 2-3 years of oncology specialist care versustransition through a specialized transitional clinic before exclusive follow-up by one’s PCP. The main objectives were to: (1) assess patient interest in a specialized cancer transitional clinic model, and (2) compare patient and demographic characteristics by such preferences. Methods: A cross-sectional scenario-based survey of cancer survivors who had undergone curative therapy at the Princess Margaret Cancer Centre assessed patient preferences for the transitioning of their post-treatment cancer care. Regression models compared clinico-demographic and psychosocial variables (anxiety, depression, distress) to one’s preference for transition of care. Results: Among 242 cancer survivors, 54% were male, 78% Caucasian, 43% with a college degree, median household income between 60-75K, 71% married, with a wide distribution of curable cancer sites (anal, colorectal, breast, testicular, lymphoma, head/neck, lung). 77% preferred transition through a specialized transitional clinic versus direct referral back to their family doctor. No factors were found to be related to preference for transition of care, except individuals who scored high on anxiety using the ESAS scale were significantly more likely to prefer referral to the specialized transitional clinic (p<0.05). No differences in preference were found by other clinico-demographic factors. Conclusions: A specialized transitional clinic is a preferred survivorship option in three-quarters of cancer patients. Anxiety, but not other variables, was associated with preference for the specialized clinic. This study highlights the need for individual decision-making regarding survivorship options. This individualization of transitioning may help improve patient’s perception of quality cancer care.