Provincial Survivorship Forum 2014
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1 Provincial Survivorship Forum 2014 Dr. Frances Wong BCCA-Fraser Valley Centre September 22, 2014
2 From diagnosis until end of life Diagnosis and Staging Treatment with Intent to Cure Palliative Treatment Disease Free Remission Managed Chronic or Intermittent Disease Treatment Failure Recurrence/ Second Primary Survivorship Death from Cancer Richard Doll, University of British Columbia
3 From diagnosis until end of life Diagnosis and Staging Treatment with Intent to Cure Palliative Treatment Disease Free Remission Managed Chronic or Intermittent Disease Treatment Failure Recurrence/ Second Primary Survivorship Death from Cancer Richard Doll, University of British Columbia
4 Survivorship Care Institute of Medicine (IOM) USA Essential components: Prevention of recurrent and new cancers, & of other late effects Surveillance for cancer spread, recurrence, or second cancers Assessment of medical and psychosocial late effects Intervention for consequences of cancer & its treatment Coordination between specialists & primary care
5 From diagnosis until end of life Diagnosis and Staging Treatment with Intent to Cure Palliative Treatment Survivorship Care Plan Disease Free Remission Managed Chronic or Intermittent Disease Treatment Failure Recurrence/ Second Primary Survivorship Death from Cancer Richard Doll, University of British Columbia
6 Survivorship Care Institute of Medicine (IOM) USA Elements to include in a Survivorship Care Plan: Cancer type, treatments received & their potential consequences Specific information about the timing & content of recommended follow-up Recommendations regarding preventive practices & how to maintain health & well-being Information on legal protections regarding employmet The availability of psychoscial services in the community
7 Survivorship Care Plans Resources & tools presented by Drs Fryer, Campbell, and Cormie Survivorship Care Plan contents Presented by Dr. Arminee Kazanjian Research projects conducted at BCCA- Fraser Valley Centre: Process of providing SCP
8 Breast Cancer Survivorship: South Asian Women s Understanding of the Follow-up care & their perspectives & preferences for information post-treatment Savitri-Singh-Carlson, LeeAnn Martin, Sonia Kim Anh Nguyen Colleen Sherriff, Gurpreet Oshan BC Cancer Foundation
9 Breast Cancer Survivorship: South Asian Women s Understanding of the Follow-up care & their perspectives & preferences for information post-treatment 24 participants for qualitative inquiry Focused group & individual interviews Perceptions of contents similar to other Canadian studies Mindful of Quiet acceptance Conducting a psychological assessment of depression & distress important
10 Breast Cancer Survivorship Care tailored to South Asian Women Savitri Singh-Carlson, Sonia Kim Anh Nguyen Colleen Sherriff, Gurpreet Oshan BC Cancer Foundation
11 Breast Cancer Survivorship Care tailored to South Asian Women 257 questionnairs sent to SA breast cancer survivors Compared with similar questionnairs sent to a predominantly Caucasian cohort Post-treatment effects & social emotional impacts similar cross ethnicity High compliance rate regarding adjuvant hormonal therapy and visiting family physicians as planned Cultural insights, such as the importance of family, influence survivorship care
12 Implementation & Evaluation of a Breast Cancer Survivorship Care program tailored to SA Women Savitri Singh-Carlson, Sonia Kim Anh Nguyen Colleen Sherriff, Kris Trevillion, Gurpreet Oshan BC Cancer Foundation
13 Implementation & Evaluation of a Breast Cancer Survivorship Care program tailored to SA Women Survivorship Care Plan Template and resource package designed & translated Diagnosis & treatment section in plain language Resources English and Punjabi language Includes Letter From Your Oncologist summary of main message Nurses prepared the individualized SCP package Nurses delivered the SCP with interpreter assistance Information on sexuality & mental health presented in a culturally acceptable manner Copies of SCPs followed by questionnaires sent to family doctors
14 Implementation & Evaluation of a Breast Cancer Survivorship Care program tailored to SA Women Knowledge gained about SCP implementation for breast cancer patients Data is being analyzed Resource intensive to deliver SCP for all discharged patients SCP has been implemented only at some cancer centres SCP is not implemented as standard care at BCCA
15 Sustainable implementation of Survivorship Care Plans Arminee Kazanjian, Helena Daudt Mara Long, Angela Bedard, Devon Poznanski Colleen Sherriff, Joy Bunsko Canadian Centre for Applied Research in Cancer Control (ARCC)
16 Sustainable implementation of Survivorship Care Plans To compare two approaches of SCP implementation Breast cancer patients at discharge when adjuvant therapies are completed at cancer centre SCP template based on one designed for SA study Conventional arm: nurse prepared tx summary Innovative arm: self prepared treatment summary
17 Sustainable implementation of Survivorship Care Plans 17 innovative, 16 conventional participants enrolled Only 9 innovative and 14 conventional participants discharged Only 5 innovative and 11 conventional participants completed the post SCP Continuity of Care questionnaires
18 Sustainable implementation of Survivorship Care Plans At discharge: Conventional participants (>50%) indicated a lack of understandings with the name of their cancer and available support resources Innovative participants (25%) had questions and wanted to talk to someone After discharge: Both reported some degree of dissatisfaction with knowledge of communication between cancer centre and family doctor
19 Sustainable implementation of Survivorship Care Plans Nursing resource required Average 41 minutes to prepare treatment summaries Similar SCP appointment time (approx. 60 minutes) For innovative participants Only 4/8 prepared own treatment summaries: 2 completely and 2 partially
20 Information to support women completing treatment for newly diagnosed Ovarian Cancer Lee Ann Martin, Arminee Kazanjian Marilyn Paradis, Angela Bedard, Devon Poznanski Ovarian Cancer Canada (Tracy Kolwich)
21 Information to support women completing treatment for newly diagnosed Ovarian Cancer Starting September 2013, every patient completing chemotherapy is provided with survivorship information package (YANA) and Letter from Your Oncologist Patient Continuity of Care Questionnaire sent to 104 patients before implementation (historical cohort) and after implementation (new information cohort)
22 Summary Plenty of guidelines of what needs to be done Lack of resources to implement what is ideal Research and feedback from survivors needed regarding the most efficient ways of implementation of SCP
23
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