Improving Health Screening Compliance Through Survivor Care Plan Visits

November 2018 Vol 9, NO 11
Evelyn Robles-Rodriguez, DNP, APN, AOCN
Roxanne Berger, LPN
Carolina Foksinski

Background: A recent needs assessment for Camden County, NJ, shows that residents’ compliance with cancer screening recommendations for colon (65%), breast (73%), and cervical (74%) cancers does not meet Healthy People 2020 guidelines. This is important, as early detection of cancers can lead to improved survival. For cancer survivors who have increased risks for secondary cancers, cancer screening is also important. According to the American Cancer Society, there are approximately 15.5 million cancer survivors in the United States. Many national oncology organizations are recommending that survivors who complete their active treatment and are treated with curative intent receive a survivorship care plan. The care plan not only summarizes the individual patient’s disease and treatment but also provides guidelines for follow-up care, healthy living recommendations, and preventive screenings. At MD Anderson Cancer Center at Cooper (MDA Cooper), visits with advanced practice providers to review these care plans are offered to patients, but it is not mandatory that they attend.

Objectives: To compare health screening compliance of MDA Cooper survivors who attended survivor care plan visits versus those who refused. To evaluate if survivorship care plan visits improve compliance with healthy living and screening recommendations.

Methods: Retrospective data were collected from 2016 to 2018 from MDA Cooper’s EMR to evaluate patients who completed active treatment and whether they attended a survivor care plan visit. Gathered data assessed compliance with screenings including mammogram, and/or colonoscopy, and/or Pap smear, and/or PSA test, as well as bone health screenings with DEXA scans. Patients who attended the care plan visits versus those who refused were compared directly, and the adjusted rates of the 2 patient groups were then analyzed.

Results: The total sample size (N = 677) comprised 2 cohorts who completed active treatment—survivors who attended the care plan visit (n = 497) and those who did not (n = 180). The patients who attended the care plan visit had an overall screening compliance rate of 61% for all applicable screenings compared with 43% for those who did not. Colonoscopy screening rates were 72%, mammography 88%, PSA 87%, Pap smear 72%, and DEXA 88% for those who attended versus 63%, 79%, 60%, 71%, and 76%, respectively, for those who did not.

Conclusion: The cohort that attended the care plan visits exhibited 18% greater overall screening compliance rates versus the cohort that did not attend the visits. As well, they had 7% higher compliance for colonoscopies and 15% higher for mammograms than their Camden County counterparts. Although Pap smear compliance was lower versus the county, >30% of the patients had outside gynecology providers, and results were not available in the EMR. Thus, survivorship care plan visits not only provide a living record of survivors’ disease and treatment but help promote healthy living and screening behaviors in cancer survivors who have completed their active treatment. Encouraging survivors to attend survivor care plan visits and emphasizing the importance of screening and prevention at these visits could lead to improvement in the early detection of other cancers in this vulnerable group.

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Last modified: November 15, 2018

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