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

J. Y. Y. Kwan, J. Croke, T. Panzarella, K. Ubhi, A. Fyles, A. Koch, R. Dinniwell, W. Levin, D. McCready, C. Chung, F. Liu, J. L. Bender

Abstract


Background 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).

Methods 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.

Results 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 (p < 0.01) and more met supportive care needs (p < 0.05). Concerns with virtual follow-up included the perceived impersonal nature of virtual care, potential for inadequate care, and confidentiality.

Conclusions Well survivors of bca want specialists involved in their follow-up care. Compared with virtual followup, 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.


Keywords


Breast cancer; follow-up; survivorship; supportive care needs; preferences; virtual care

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DOI: http://dx.doi.org/10.3747/co.26.4131






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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)