Survivorship care plans reduce treatment distress for BMT recipients
A recent study conducted by National Marrow Donor Program® (NMDP®)/Be The Match® based on a grant from the Patient-Centered Outcomes Research Institute (PCORI) looked at the feasibility and effectiveness of survivorship care plans (SCPs) created from a centralized registry of clinical data. [1]
Study Details and Results
The researchers enrolled 495 patients 1 – 5 years after an allogeneic transplant from 17 different transplant centers and randomized them to either an individualized SCP or standard care. The SCPs were generated using patient-specific clinical data reported to the CIBMTR® (Center for International Blood and Marrow Transplant Research®) and published guidelines for long-term follow-up of BMT survivors.[1] A total of 458 patients completed the study. The researchers measured distress specific to cancer and its treatment, knowledge of transplant exposures, health behaviors, health care utilization and health-related self-efficacy. They found that having an SCP was associated with less cancer treatment distress six months after implementing the care plan. They also found that younger patients tended to have higher levels of distress than older patients.
The future of SCPs in BMT
The Commission on Cancer implementation schedule requires SCPs for at least 75% of eligible patients in 2018. However, even with the standard in place, further study of SCPs is needed in the following areas:
- The best format and delivery for SCPs
- Their effects on clinical and patient-reported outcomes
- How best to use them to improve communication and care coordination
“Transplant survivors remain at risk for late complications and require lifelong monitoring for their prevention and management,” said Navneet Majhail, M.D., M.S., lead study author and director of the Blood & Bone Marrow Program at the Cleveland Clinic. “However, several health system, institutional, provider and patient barriers prevent them from obtaining appropriate long-term care. We strongly feel that empowering patients with knowledge and information will facilitate their survivorship care.”
Practical strategies are needed to overcome common barriers to SCP implementation, such as the time-intensive process to create meaningful, individualized SCPs. This study used the CIBMTR centralized registry of clinical data that transplant centers report patient data to for systematic development of individualized SCPs. This highlights the potential for using existing systems to make individualized SCPs feasible for all allogeneic BMT recipients.
Resources for you and your patients
In 2012, BMT experts published recommended screening and preventive practice guidelines for autologous and allogeneic transplant recipients.[2] Access the free, user-friendly guidelines in a mobile app, online or print:
For you: BeTheMatchClinical.org/guidelines
For your patients: BeTheMatch.org/careguide
About PCORI
The Patient-Centered Outcomes Research Institute (PCORI) is an independent nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. PCORI is committed to continuously seeking input from a broad range of stakeholders to guide its work
References
1. Majhail, N. S., Murphy, E. A., Laud, P., Preussler, J., Denzen, E., Adams, A., … Baker, K. S. (2017, December). Individualized Treatment Summaries and Survivorship Care Plans (SCPs) for Hematopoietic Cell Transplant (HCT) Survivors Reduces Cancer Treatment Distress in a Randomized, Multicenter Study. Paper presented at the 59th meeting of the American Society of Hematology, Atlanta, GA. Access
2. Majhail, N. S., Rizzo, J. D., Lee, S. J., Aljurf, M., Atsuta, Y., Bonfim, C., . . . Tichelli, A. (2012). Recommended Screening and Preventive Practices for Long-Term Survivors after Hematopoietic Cell Transplantation. Biology of Blood and Marrow Transplantation, 18(3), 348-371. http://dx.doi.org/10.1016/j.bbmt.2011.12.519. Access