Year: 2015
Type: editorial
Abstract: Although survivorship care plans (SCPs) have been recommended for the last decade, implementation and dissemination has been slow, low, and sporadic. In the accompanying article, Nicolaije et al report on the longitudinal effectiveness of SCPs. This is the fourth publication from the Registrationsystem Oncological Gynecology (ROGY) program, which electronically generates an SCP for women with gynecologic malignancies in the Netherlands. Previously, Nicolaije et al documented the degree of dissatisfaction of information provided for women with endometrial cancer, concluding that SCPs could address many of these unmet needs. They conducted a pragmatic cluster randomized controlled trial in 12 institutions in which half used the ROGY system to create and deliver an individualized SCP and half received usual care for patients ending treatment between 2011 and 2012. This study contributes to a growing number of randomized controlled trials of SCP effectiveness. These and other studies have primarily assessed the effects of SCPs on distal outcomes, such as patient satisfaction with care. They tend not to address the more proximal, process-related outcomes that we might expect SCPs to influence (eg, knowledge, communication, and care coordination) or how SCPs are implemented. In this sense, the standards to which we hold studies of SCP effectiveness diverge from standards for other innovations in cancer care. For example, studies of the effectiveness of a cancer drug report on its indications, mode of administration, dose, frequency, adverse effects, and response rates; we take these into account when evaluating their results. In contrast, SCP effectiveness studies rarely define the information that SCPs contain, how they are developed and delivered, whether survivors or primary care providers (PCPs) receive and use them, whether and how frequently they are updated, and whether SCPs have any negative effects. Without this information, SCP effectiveness studies cannot be compared or contrasted, and they cannot inform future implementation and dissemination efforts. Moreover, omitting this information exposes SCP effectiveness studies to the possibility that outcomes are the result not of the inherent (in)effectiveness of SCPs but rather of poor or inconsistent SCP implementation (type III error).
Source: Journal of Clinical Oncology
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1915955486