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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
    • 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
    • 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