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Multicenter Study
. 2015 Nov 1;33(31):3550-9.
doi: 10.1200/JCO.2014.60.3399. Epub 2015 Aug 24.

Impact of an Automatically Generated Cancer Survivorship Care Plan on Patient-Reported Outcomes in Routine Clinical Practice: Longitudinal Outcomes of a Pragmatic, Cluster Randomized Trial

Kim A H Nicolaije  1 , Nicole P M Ezendam  1 , M Caroline Vos  1 , Johanna M A Pijnenborg  1 , Dorry Boll  1 , Erik A Boss  1 , Ralph H M Hermans  1 , Karin C M Engelhart  1 , Joke E Haartsen  1 , Brenda M Pijlman  1 , Ingrid E A M van Loon-Baelemans  1 , Helena J M M Mertens  1 , Willem E Nolting  1 , Johannes J van Beek  1 , Jan A Roukema  1 , Wobbe P Zijlstra  1 , Roy F P M Kruitwagen  1 , Lonneke V van de Poll-Franse  2
Affiliations
Multicenter Study

Impact of an Automatically Generated Cancer Survivorship Care Plan on Patient-Reported Outcomes in Routine Clinical Practice: Longitudinal Outcomes of a Pragmatic, Cluster Randomized Trial

Kim A H Nicolaije et al. J Clin Oncol. .

Abstract

Purpose: This study was conducted to longitudinally assess the impact of an automatically generated survivorship care plan (SCP) on patient-reported outcomes in routine clinical practice. Primary outcomes were patient satisfaction with information and care. Secondary outcomes included illness perceptions and health care use.

Methods: Twelve hospitals were randomly assigned to SCP care or usual care in a pragmatic, cluster randomized trial. Newly diagnosed patients with endometrial cancer completed questionnaires after diagnosis (n = 221; 75% response), 6 months (n = 158), and 12 months (n = 147). An SCP application was built in the Web-based ROGY (Registration System Oncological Gynecology). By clicking the SCP button, a patient-tailored SCP was generated.

Results: In the SCP care arm, 74% of patients received an SCP. They reported receiving more information about their treatment (mean [M] = 57, standard deviation [SD] = 20 v M = 47, SD = 24; P = .03), other services (M = 35, SD = 22 v M = 25, SD = 22; P = .03), and different places of care (M = 27, SD = 25 v M = 23, SD = 26; P = .04) than the usual care arm (scales, 0 to 100). However, there were no differences regarding satisfaction with information or care. Patients in the SCP care arm experienced more symptoms (M = 3.3, SD = 2.0 v M = 2.6, SD = 1.6; P = .03), were more concerned about their illness (M = 4.4, SD = 2.3 v M = 3.9, SD = 2.1; P = .03), were more affected emotionally (M = 4.0, SD = 2.2 v M = 3.7, SD = 2.2; P = .046), and reported more cancer-related contact with their primary care physician (M = 1.8, SD = 2.0 v M = 1.1, SD = 0.9; P = .003) than those in the usual care arm (scale, 1 to 10). These effects did not differ over time.

Conclusion: The present trial showed no evidence of a benefit of SCPs on satisfaction with information and care. Furthermore, SCPs increased patients' concerns, emotional impact, experienced symptoms, and the amount of cancer-related contact with the primary care physician. Whether this may ultimately lead to more empowered patients should be investigated further.

Trial registration: ClinicalTrials.gov NCT01185626.

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