Survivorship care planning, quality of life, and confidence to transition to survivorship: A randomized controlled trial with women ending treatment for breast cancer

Abstract

Purpose

The Polaris Oncology Survivorship Transition (POST) system is a computer-based program that integrates information from the electronic health record, oncology team, and the patient to produce a personalized Survivorship Care Plan. The purpose of this study was to compare the POST to treatment as usual on confidence, quality of life, and interest in mental health referrals in women ending treatment for breast cancer.

Sample

Two hundred women (100 POST, 100 treatment as usual) ending treatment for breast cancer were enrolled in a randomized controlled trial.

Design

Women randomized to the POST condition received a personalized care plan during a baseline/intervention appointment. At enrollment and baseline/intervention, a number of outcomes were examined in this study, including confidence to enter survivorship measured by the Confidence in Survivorship Index (CSI) and Quality of Life (QOL). One, three, and six month follow up assessments were also conducted.

Findings

Treatment groups did not differ in terms of QOL scores at any time points. Mean CSI scores were statistically different between POST and treatment as usual at baseline for the total CSI score and both subscales, but only for confidence in knowledge about prevention and treatment at the 1-month follow-up. All significant differences were in favor of the POST intervention as mean CSI scores were higher for participants who received the POST intervention as opposed to treatment as usual. These findings disappeared at the 3 and 6 month follow up assessments. Finally, patients who received the POST intervention were twice as likely to request mental health/social services referrals compared to women who received treatment as usual.

Implications

Oncologists may use the POST to build personalized care plans for women ending treatment for cancer, which may enhance patients’ confidence in the short term as well as encourage use of mental health resources.

Keywords:

• breast cancer
• quality of life
• self-efficacy
• survivorship care planning

Additional information

Funding

This study was supported by the National Cancer Institute to the Polaris Health Directions, Inc [Grant Number: R42CA174048; Clinical Trials Identifier: NCT02637349]. The following Oncology institutions participated in this study: University of Massachusetts Medical Health Center, and UMass Memorial Health Alliance Simon-Sinon Cancer Center. Some of the analyses have been presented at the Annual Conference of the Association for the Advancement of Cognitive Behavioral Therapy.