Approximately 60% of patients with cancer undergo radiation therapy as part of their care, notes Ronald Chen, MD, MPH, an associate professor in the Department of Radiation Oncology at the University of North Carolina at Chapel Hill and lead author on the paper presenting the new SCP template.
The American College of Surgeons Commission on Cancer (CoC) mandates that as of January 1, 2015, cancer centers were providing SCPs to 10% of eligible patients upon completion of curative-intent cancer treatment.1 By January 1, 2017, half of all eligible patients must receive SCPs—and by January 1, 2019, all eligible patients—must receive SCPs upon completion of curative-intent cancer treatment, in order for cancer centers to maintain accreditation.1
But a March 2014 survey of ASTRO members indicates that although “almost all providers follow their patients after treatment,” only 53% are aware of the CoC’s SCP accreditation requirements benchmark for 2015.1
Only 40% of radiation therapy programs surveyed are completing SCPs for curative patients, the survey found, and fewer than 20% provide SCPs to patients undergoing palliative care.1 Components of information included in SCPs are frequently provided to patients after radiation therapy, the survey found, such as summaries of treatment, contact information for providers and ancillary services, or a summary of further tests, side effects, preventive and health-promoting behaviors, and surveillance recommendations, but typically, less than 60% of patients receive such information.1
And while 91% of SCPs that are completed are provided to patients, only 22% are provided to their primary care providers.1 The survey identified 3 key barriers to SCP implementation: cost, duplication of SCP efforts provided by multiple cancer care providers, and a lack of consensus or professional guidelines.1
Existing SCP templates are frequently deemed to be poorly suited for radiation therapy follow-up.1 Other barriers to SCP implementation include reimbursement issues and patient adherence.1 One-quarter of survey respondents also identified “unclear benefits” as a barrier to SCP implementation, reflecting the scare available evidence base for how SCPs affect patient outcomes.
Respondents reported that incorporating survivorship care planning into electronic medical records would be useful.1 But to date, the vast majority of respondents (79%) report using internally developed SCP outlines. This situation means that patients will not likely receive equivalent survivorship care advice and information.1
The new ASTRO template should help change that situation, and help practices meet CoC accreditation benchmarks. It was designed to streamline preparation of patient-focused long-term survivor care following radiotherapy.2