Survivorship care plan assessment checklist (SCPAC): A tool to evaluate breast cancer survivorship care plans.

Abstract

6117 Background: Breast cancer survivors are at risk for recurrence and late effects. Fragmented survivorship care, including poor communication with PCPs, precludes optimal prevention, detection, and management. The Institute of Medicine (IOM) called for provision of survivorship care plans (SCPs) at end of cancer therapy in order to improve care coordination, and provided guidelines for essential components. Many institutions provide SCPs, but heterogeneity between documents makes it difficult to assess comparability, completeness, and to develop outcomes studies taking these into account. We developed a tool to allow rating of SCP concordance with IOM recommendations and facilitate research. Methods: An interdisciplinary team (Oncologist, NPs, Psychologists) derived a checklist assessing presence/absence of IOM-recommended SCP components. An iterative process of item review and mapping to recommendations was performed until consensus. Dual raters then used this tool to independently assess 65 completed SCPs (11 different formats) from 13 cancer centers and community affiliates within the LIVESTRONG Survivorship Centers of Excellence to assess reliability. Results: The final measure contained 92 items covering 2 subscales: 1) treatment summary (TS), and 2) care plan (CP). TS subscale consisted of 13 informational domains summarizing cancer therapy, including toxicities, psychosocial care, genetic testing. CP subscale had 10 domains: 4 detailed possible long-term effects; 4, surveillance and additional testing; 2, referrals and health promotion. For the TS subscale, inter-rater reliability within TSs was good (M kappa = 0.76, [SD = 0.12]; range = 0.42-0.97), as was reliability across total scores (r = 0.96). For the CP subscale, inter-rater reliability was also good (M kappa = 0.66 [0.16]; range = 0.33-1.0), as was reliability across total scores (r = 0.91). Conclusions: Concordance with IOM recommendations for SCP information can be easily and reliably assessed with the SCPAC. The SCPAC allows evaluation of SCP fidelity to IOM recommendations, comparison of differing SCPs, and should facilitate research and insights into the utility of SCPs including their various information types.