Survivorship Care Plan Use Lagging

Rosemary Frei, MSc

May 2014, Vol 5, No 4 - Survivorship


Cancer centers are ramping up their efforts to create survivorship care plans (SCPs) for all of their patients. However, according to a new survey conducted in 2013, they still have far to go before January 1, 2015, when the American College of Surgeons Commission on Cancer (CoC) accreditation requirement of creating SCPs for all patients comes into effect (Birken SA, et al. J Cancer Educ. 2014 April 6. Epub ahead of print).

Of the 81 cancer centers that responded to the survey, approximately 51% indicated that they were not yet using SCPs but that they plan to use them. In addition, approximately 58% indicated that only 0% to 25% of their providers use SCPs, and approximately 47% noted that providers develop SCPs for 0% to 25% of the cancer survivors. The most common reason cited for implementing or using SCPs was the desire to comply with the CoC requirements.

“The question is, why develop a survivorship care plan if you don’t deliver it?” queried lead investigator Sarah A. Birken, PhD, MSPH, a postdoctoral fellow, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill. She noted several ways to interpret the survey results, “one is that because the CoC won’t audit survivors and PCPs [primary care providers], as long as the SCP is in the record, that is enough to meet the requirement. Another possibility is that cancer centers were just beginning to get ready for the January 2015 deadline when we conducted the survey, and if we repeated it now, we may find cancer programs are phasing in implementation, and many more are developing SCPs and delivering them to survivors and their providers.”

Approximately 45% of responders said that their centers were already using SCPs; however, 30% of them reported only an occasional use of the program and only 15% reported regular use of these plans. Membership in the National Cancer Institute’s Community Cancer Centers Program was associated with SCP use: members receive support to develop SCPs. Centers in academic programs also were more likely to use SCPs. Other significant results are shown in the Table.

“Taken together, our results suggest that support specifically intended to facilitate SCP use may promote SCP use more effectively than the nonspecific resources (eg, time, staff, training, money) that are commonly cited as determinants of SCP use,” concluded the investigators.

The team also conducted a subanalysis that confirmed the inconsistent use of SCPs across American cancer programs.

Dr Birken recently interviewed clinicians to determine what specific factors motivate them to use SCPs. She and her colleagues hope to use the results to develop programs to more effectively promote the use of SCPs.