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Rehab a.o'rourke

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Rehab a.o'rourke Rehab a.o'rourke Presentation Transcript

  • Cancer Survivorship: A New Beginning Arlene O’Rourke APRN
  • Core Components of a Survivorship Care Plan
    • Treatment Summary
    • Follow-up Plan of Care
  • Treatment Summary
    • Demographics/Contact information
    • Care providers, treatment location, contact information of facility
    • Disease specifics
    • Diagnosis, Pathology, Stage of disease
    View slide
  • Treatment Summary
    • Treatment specifics
    • Surgery: date, procedure, persistent and/or possible late effects
    • Chemotherapy/biotherapy: dates, regimen, clinical trials, agents, doses, supportive care, persistent or possible late effects
    • Hormonal therapy: dates, agents, doses, persistent and possible late effects
    • Radiation: dates, sites, type, dose, persistent or possible late effects
    • Symptoms to report
    View slide
  • Follow-Up Care Plan
    • Cancer surveillance visit and test schedule
    • Acute/long term toxicity/expected course of recovery
    • Actual and potential late effects and screening recommendations
    • Subspecialty referrals including psychosocial
    • General health promotion
    • Cancer related resources
  • Guidelines
    • ASCO-www.asco.org
    • NCCN-www.nccn.org/professionals/physician.gls/ f.guidelines.asp
    • Livestrong-www.livestrongcareplan.org
    • Journey Forward- www.journeyforward.org
  • The Survivorship Visit
    • Comprehensive-medical/surgical/family history, psychosocial status, ROS, PE, current health behaviors
    • Evaluate
    • Educate
    • Intervene
    • for potential and actual late effects, disease prevention and health promotion
  • Models of Care
    • Shared Model
    • Risk Based follow-up
    • Disease specific clinics
    • Institution-based programs
  • Barriers to Survivorship Care
    • Finances
    • Educated and dedicated personnel
    • Lack of acceptance and/or integration with disease- based or general oncology programs or practice
    • Space
    • Complexity of survivorship care
    • Lack of clear, evidenced-based guidelines on proper management
    • Limited knowledge of evolving management of co-morbidities
  • Issues to Consider
    • The ideal model for survivorship care does not exist at this time
    • Models may be different in academic medical centers where care is often diseased-based and community cancer programs where 80-85% of patients receive care
    • Care plans must eliminate redundant and unnecessary care
    • Must assure excellent cancer follow up care and general primary care- outcome improvement
  • Why Cancer Survivor Clinics?
    • Increasing numbers of cancer survivors
    • Complex care required by cancer survivors
    • The need for the oncology community to educate patients and providers about survivorship issues to adequately transition cancer survivors back to their PCPs
    • Supply and demand
  • Future Directions
    • Improve the quality of life for patients and their families with a diagnosis of cancer
    • Develop community based interdisciplinary cancer survivorship program to support and care for the patient and family.
    • Alleviate the burden of cancer care in long-term survivors to reflect the decreasing supply of oncologists and primary care providers
    • Perform research that demonstrates improvement in outcomes associated with cancer survivorship clinic care