Michael Jefford1,2,3, Nicole Kinnane1, Paula Howell4, Linda Nolte1, Spiridoula Galetakis5, Gregory Bruce Mann6,7, Lucio Naccarella8, Julia Lai-Kwon1, Katherine Simons4, Sharon Avery9, Kate Thompson10, David Ashley11,12, Martin Haskett13, Elise Davies5, Kathryn Whitfield5. 1. Australian Cancer Survivorship Centre, A Richard Pratt Legacy, Peter MacCallum Cancer Centre, Melbourne, Australia. 2. Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia. 3. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. 4. North Eastern Melbourne Integrated Cancer Service (NEMICS), Melbourne, Australia. 5. Cancer Strategy and Development, Department of Health and Human Services, State Government of Victoria, Melbourne, Australia. 6. Department of Surgery, University of Melbourne, Melbourne, Australia. 7. The Breast Service, Royal Melbourne and Royal Women's Hospital, Melbourne, Australia. 8. Systems and Workforce Unit, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia. 9. Malignant Haematology and Stem Cell Transplantation Service, The Alfred, Melbourne, Australia. 10. ONTrac at Peter Mac, Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Australia. 11. The Andrew Love Cancer Centre, Barwon Health, Geelong, Victoria, Australia. 12. School of Medicine, Deakin University, Geelong, Victoria, Australia. 13. Peninsula Dermatology, Melbourne, Australia.
Abstract
AIM: The American Society of Clinical Oncology and US Institute of Medicine emphasize the need to trial novel models of posttreatment care, and disseminate findings. In 2011, the Victorian State Government (Australia) established the Victorian Cancer Survivorship Program (VCSP), funding six 2-year demonstration projects, targeting end of initial cancer treatment. Projects considered various models, enrolling people of differing cancer types, age and residential areas. We sought to determine common enablers of success, as well as challenges/barriers. METHODS: Throughout the duration of the projects, a formal "community of practice" met regularly to share experiences. Projects provided regular formal progress reports. An analysis framework was developed to synthesize key themes and identify critical enablers and challenges. Two external reviewers examined final project reports. Discussion with project teams clarified content. RESULTS: Survivors reported interventions to be acceptable, appropriate and effective. Strong clinical leadership was identified as a critical success factor. Workforce education was recognized as important. Partnerships with consumers, primary care and community organizations; risk stratified pathways with rapid re-access to specialist care; and early preparation for survivorship, self-management and shared care models supported positive project outcomes. Tailoring care to individual needs and predicted risks was supported. Challenges included: lack of valid assessment and prediction tools; limited evidence to support novel care models; workforce redesign; and effective engagement with community-based care and issues around survivorship terminology. CONCLUSION: The VCSP project outcomes have added to growing evidence around posttreatment care. Future projects should consider the identified enablers and challenges when designing and implementing survivorship care.
AIM: The American Society of Clinical Oncology and US Institute of Medicine emphasize the need to trial novel models of posttreatment care, and disseminate findings. In 2011, the Victorian State Government (Australia) established the Victorian Cancer Survivorship Program (VCSP), funding six 2-year demonstration projects, targeting end of initial cancer treatment. Projects considered various models, enrolling people of differing cancer types, age and residential areas. We sought to determine common enablers of success, as well as challenges/barriers. METHODS: Throughout the duration of the projects, a formal "community of practice" met regularly to share experiences. Projects provided regular formal progress reports. An analysis framework was developed to synthesize key themes and identify critical enablers and challenges. Two external reviewers examined final project reports. Discussion with project teams clarified content. RESULTS: Survivors reported interventions to be acceptable, appropriate and effective. Strong clinical leadership was identified as a critical success factor. Workforce education was recognized as important. Partnerships with consumers, primary care and community organizations; risk stratified pathways with rapid re-access to specialist care; and early preparation for survivorship, self-management and shared care models supported positive project outcomes. Tailoring care to individual needs and predicted risks was supported. Challenges included: lack of valid assessment and prediction tools; limited evidence to support novel care models; workforce redesign; and effective engagement with community-based care and issues around survivorship terminology. CONCLUSION: The VCSP project outcomes have added to growing evidence around posttreatment care. Future projects should consider the identified enablers and challenges when designing and implementing survivorship care.
Authors: Corinne R Leach; Catherine M Alfano; Jessica Potts; Lisa Gallicchio; K Robin Yabroff; Kevin C Oeffinger; Erin E Hahn; Lawrence N Shulman; Shawna V Hudson Journal: J Natl Cancer Inst Date: 2020-12-14 Impact factor: 13.506
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