Use of survivorship care plans in the United States: associations with survivorship care

Abstract

Background: Survivorship care plans (SCPs), including a treatment summary and follow-up plan, intend to promote coordination of posttreatment cancer care; yet, little is known about the provision of these documents by oncologists to primary care physicians (PCPs). This study compared self-reported oncologist provision and PCP receipt of treatment summaries and follow-up plans, characterized oncologists who reported consistent provision of these documents to PCPs, and examined associations between PCP receipt of these documents and survivorship care.

Methods: A nationally representative sample of medical oncologists (n = 1130) and PCPs (n = 1020) were surveyed regarding follow-up care for breast and colon cancer survivors. All statistical tests were two-sided. Multivariable regression models identified factors associated with oncologist provision of treatment summaries and SCPs to PCPs (always/almost always vs less frequent).

Results: Nearly half of oncologists reported always/almost always providing treatment summaries, whereas 20.2% reported always/almost always providing SCPs (treatment summary + follow-up plan). Approximately one-third of PCPs indicated always/almost always receiving treatment summaries; 13.4% reported always/almost always receiving SCPs. Oncologists who reported training in late- and long-term effects of cancer and use of electronic medical records were more likely to report SCP provision (P < .05). PCP receipt of SCPs was associated with better PCP-reported care coordination, physician-physician communication, and confidence in survivorship care knowledge compared to receipt of neither treatment summaries nor SCPs (P < .05).

Conclusions: Providing SCPs to PCPs may enhance survivorship care coordination, physician-physician communication, and PCP confidence. However, considerable progress will be necessary to achieve implementation of sharing SCPs among oncologists and PCPs.

Figure 1.

Physician-reported provision and receipt of treatment summaries and survivorship care plans. Survivorship care plans are defined as a treatment summary plus follow-up care plan. Error bars reflect the 95% confidence interval for weighted estimates. Statistically significant differences between oncologists and primary care physicians (PCPs), based on χ² tests, are indicated by *P = .001 and **P < .001. All statistical tests were two-sided.

Figure 2.

Associations between primary care physician (PCP) perceptions of receipt of treatment summaries (TSs) and survivorship care plans (SCPs) and three domains of survivorship care: care coordination, physician–physician communication, and confidence in knowledge regarding survivorship care. Sample sizes range from 938 to 950 PCPs. Statistically significant differences (P < .05) based on multiple logistic regression are indicated with § (TSs vs neither), † (SCPs vs neither), and € (SCPs vs TSs). Data are adjusted for number of breast/colon cancer survivors seen per year and PCP age. Error bars reflect the 95% confidence interval for weighted estimates. All statistical tests were two-sided.