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

Curr Oncol. 2019 Apr;26(2):e138-e146. doi: 10.3747/co.26.4131. Epub 2019 Apr 1.

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 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.

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

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aftercare*
  • Aged
  • Breast Neoplasms*
  • Cancer Survivors*
  • Female
  • Humans
  • Information Seeking Behavior
  • Internet
  • Middle Aged
  • Physician-Patient Relations
  • Specialization
  • Surveys and Questionnaires
  • Telemedicine