Personalization Improved Survivorship Care Plan Adherence in Breast Cancer Patients

A randomized trial showed that personalized care plans and one-on-one counseling can improve adherence to survivorship plans among low-income breast cancer survivors. The results will be presented at the upcoming American Society of Clinical Oncology (ASCO) Cancer Survivorship Symposium in San Francisco.

Rose C. Maly, MD, of the David Geffen School of Medicine at UCLA, presented the study, and said during a press call that there is little data on the actual implementation of survivorship care plans. Low-income survivors in particular often face challenges with regard to accessing care.

The new study randomized 212 low-income women with stage 0–III breast cancer to either usual care or a survivorship intervention. The intervention involved a questionnaire to highlight specific needs-such as hot flashes, sexual dysfunction, weight gain, and other issues-with personalized recommendations based on that questionnaire. The women in the intervention group also received an hour-long counseling session with a survivorship care nurse, in which the women were coached to ask their physicians to help implement a survivorship plan.

There were 105 women in the control group and 107 in the intervention group. Adherence to care plans was measured with quarterly adherence surveys and a follow-up interview at 12 months after the intervention.

The control group had a 51.1% adherence rate, compared with 60.6% in the intervention group (P = .045). Also, the women reported better physician implementation of their plans, at 52.6% in the control group and 64.6% in the intervention group (P = .015). Maly said the improvement in adherence remained significant even after controlling for a number of potentially confounding factors.

Merry-Jennifer Markham, MD, of the University of Florida College of Medicine and an ASCO expert who was not involved with the study, noted that there are over 14.5 million cancer survivors in the United States today, and that number is expected to increase beyond 19 million within a decade.

“There is no standard best way to implement these [survivorship] plans in order to improve patient outcomes,” Markham said. “I think it’s the combination-the survivorship care plan and the one-on-one counseling … that may be the key to improved survivorship outcomes.”