Abstract

Survivors of lung and colorectal cancer have high post-treatment needs; the majority are older and suffer from greater comorbidities and poor quality of life (QOL). They remain underrepresented in research, leading to significant disparities in post-treatment outcomes. Personalized post-treatment follow-up care and care coordination among healthcare teams is a priority for survivors of lung and colorectal cancer. However, there are few evidence-based interventions that address survivors’ post-treatment needs beyond the use of a follow-up care plan. This paper describes the rationale and design of an evidence-informed telehealth intervention that integrates shared care coordination between oncology/primary care and self-management skills building to empower post-treatment survivors of lung and colorectal cancer. The intervention design was informed by (1) contemporary published evidence on cancer survivorship, (2) our previous research in lung and colorectal cancer survivorship, (3) the chronic care self-management model (CCM), and (4) shared post-treatment follow-up care between oncology and primary care. A two-arm, parallel randomized controlled trial will determine the efficacy of the telehealth intervention to improve cancer care delivery and survivor-specific outcomes. ClinicalTrials.govIdentifier: NCT04428905

Highlights

  • More than 16 million Americans, most over age 65, are living with a history of cancer [1]

  • Our previous research and those from the published literature suggest that lung and colorectal cancer survivors suffer from persistent long-term effects of treatment, such as dyspnea, fatigue, pain/neuropathy, bowel dysfunction, ostomy care, anxiety, depression, and distress

  • These symptoms contribute to a dramatic deterioration in post-primary treatment quality of life (QOL) [2,3,4,5,6,7,8]

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Summary

Introduction

More than 16 million Americans, most over age 65, are living with a history of cancer [1]. Our previous research and those from the published literature suggest that lung and colorectal cancer survivors suffer from persistent long-term effects of treatment, such as dyspnea, fatigue, pain/neuropathy, bowel dysfunction, ostomy care, anxiety, depression, and distress. These symptoms contribute to a dramatic deterioration in post-primary treatment quality of life (QOL) [2,3,4,5,6,7,8]. Treatment-induced late and long-term effects are common and include radiation pneumonitis, pulmonary fibrosis, post-thoracotomy pain syndrome, chemotherapy-induced peripheral neuropathy, fatigue, dyspnea, cough, and immune-related adverse events [11, 12]. Survivors who are current and former smokers are at risk for developing a second lung cancer and other smoking-related cancers, in the head and neck and urinary tract [16]

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