Personalizing post-treatment cancer care: a cross-sectional survey of the needs and preferences of well survivors of breast cancer

• Published in: Current oncology (Toronto) Vol. 26; no. 2; pp. e138 - 146
• Main Authors: Kwan, J Y Y, Croke, J, Panzarella, T, Ubhi, K, Fyles, A, Koch, A, Dinniwell, R, Levin, W, McCready, D, Chung, C, Liu, F, Bender, J L
• Format: Journal Article
• Language: English
• Published: Canada Multimed Inc 01.04.2019
• Subjects: Aftercare; Aged; Breast Neoplasms; Cancer Survivors; Female; Humans; Information Seeking Behavior; Internet; Middle Aged; Original; Physician-Patient Relations; Specialization; Surveys and Questionnaires; Telemedicine; supportive care needs; follow-up; survivorship; preferences; Breast cancer; virtual care
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3747/co.26.4131

Improved treatments resulting in a rising number of survivors of breast cancer (bca) calls for optimization of current specialist-based follow-up care. In the present study, we evaluated well survivors of bca with respect to their supportive care needs and attitudes toward follow-up with various care providers, in varying settings, or mediated by technology (for example, videoconference or e-mail). A cross-sectional paper survey of well survivors of early-stage pT1-2N0 bca undergoing posttreatment follow-up was completed. Descriptive and univariable logistic regression analyses were performed to examine associations between survivor characteristics, supportive care needs, and perceived satisfaction with follow-up options. Qualitative responses were analyzed using conventional content analysis. The 190 well survivors of bca who participated (79% response rate) had an average age of 63 ± 10 years. Median time since first follow-up was 21 months. Most had high perceived satisfaction with in-person specialist care (96%, 177 of 185). The second most accepted model was shared care involving specialist and primary care provider follow-up (54%, 102 of 190). Other models received less than 50% perceived satisfaction. Factors associated with higher perceived satisfaction with non-specialist care or virtual follow-up by a specialist included less formal education ( < 0.01) and more met supportive care needs ( < 0.05). Concerns with virtual follow-up included the perceived impersonal nature of virtual care, potential for inadequate care, and confidentiality. Well survivors of bca want specialists involved in their follow-up care. Compared with virtual follow-up, in-person follow-up is perceived as more reassuring. Certain survivor characteristics (for example, met supportive care needs) might signal survivor readiness for virtual or non-specialist follow-up. Future work should examine multi-stakeholder perspectives about barriers to and facilitators of shared multimodal follow-up care.