The voice of the breast cancer survivor: Implementation of survivorship needs assessment in an integrated health system.

Abstract

e24180 Background: The population of breast cancer survivors in the US has reached 3.8 million in 2022. In times of standardized and guideline driven oncologic treatment, individual patients continue to have multitude of unique needs that may impact their long-term survival outcomes. To address whether assessment of patient needs is feasible and leads to actionable findings, we implemented a breast cancer survivor needs assessment with standardized documentation of actions taken in the electronic medical record. Methods: An adapted NCCN evaluation tool (Coleman Tool) was used in survivorship visits to assess the feasibility of needs assessment from January 2022 to June 2022 as part of a quality improvement project. The assessment was done either electronically via secure health portal prior to the visit or in person at the time of the visit. Patient, tumor, treatment characteristics as well as needs identified, and actions taken were abstracted from the electronic medical record. Fisher’s exact test used for comparisons. Results: Patients were ethnically diverse (43% White, 39% Asian, 13% Hispanic, African American 4%), English speaking (82%), and employed (50.5%). The median time from cancer diagnosis to needs assessment was 884 days. Most of the patients had Stage 1A (38.2%), were ER (91.7%) and PR (77.8%) positive and HER2 negative (73.7%). The majority underwent lumpectomy (66.4%), had radiation therapy (67.7%) and hormonal therapy (81.6%). Only 32.3% received chemotherapy. Most patients received some form of needs assessment (202 of 217, 94.0%), with 59 (29.2%) receiving pre-appointment electronic assessments with a 42.4% response rate. Major domains of needs reported by patients and actions taken are mentioned below in the table. Both pre and at visit assessments noted a high degree of treatment and physical needs that lead to subsequent actions (p value of 1.00 and 0.04 respectively). Conclusions: An adapted NCCN Needs Assessment Tool (Coleman Tool) is a practical and feasible method of assessing breast cancer survivors’ needs. The assessment can be done pre or at visit and can lead to actions which improve survivorship care. [Table: see text]