Rationale and Design of a Telehealth Self-Management, Shared Care Intervention for Post-treatment Survivors of Lung and Colorectal Cancer

Virginia Sun, Anne Reb, Marc Debay, Marwan Fakih, Betty Ferrell, Virginia Sun, Anne Reb, Marc Debay, Marwan Fakih, Betty Ferrell

Abstract

Survivors of lung and colorectal cancer have high post-treatment needs; the majority are older and suffer from greater comorbidities and poor quality of life (QOL). They remain underrepresented in research, leading to significant disparities in post-treatment outcomes. Personalized post-treatment follow-up care and care coordination among healthcare teams is a priority for survivors of lung and colorectal cancer. However, there are few evidence-based interventions that address survivors' post-treatment needs beyond the use of a follow-up care plan. This paper describes the rationale and design of an evidence-informed telehealth intervention that integrates shared care coordination between oncology/primary care and self-management skills building to empower post-treatment survivors of lung and colorectal cancer. The intervention design was informed by (1) contemporary published evidence on cancer survivorship, (2) our previous research in lung and colorectal cancer survivorship, (3) the chronic care self-management model (CCM), and (4) shared post-treatment follow-up care between oncology and primary care. A two-arm, parallel randomized controlled trial will determine the efficacy of the telehealth intervention to improve cancer care delivery and survivor-specific outcomes. ClinicalTrials.gov Identifier: NCT04428905.

Keywords: Cancer survivorship; Colorectal cancer; Lung cancer; Primary care; Self-efficacy; Self-management; Shared care.

Conflict of interest statement

The authors declare that they have no conflict of interest.

References

    1. Miller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, Jemal A, Kramer JL, Siegel RL. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69:363–385.
    1. Firkins J, Hansen L, Driessnack M, Dieckmann N. Quality of life in “chronic” cancer survivors: a meta-analysis. J Cancer Surviv. 2020;14(4):504–517.
    1. Brown LM, Gosdin MM, Cooke DT, Apesoa-Varano EC, Kratz AL. Health-related quality of life after lobectomy for lung cancer: conceptual framework and measurement. Ann Thorac Surg. 2020;110:1840–1846.
    1. Vu JV, Matusko N, Hendren S, Regenbogen SE, Hardiman KM. Patient-reported unmet needs in colorectal cancer survivors after treatment for curative intent. Dis Colon Rectum. 2019;62(7):815–822.
    1. Wu GX, Ituarte PHG, Ferrell B, Sun V, Erhunmwunsee L, Raz DJ, et al. Causes of death and hospitalization in long-term lung cancer survivors: a population-based appraisal. Clin Lung Cancer. 2020;21(3):204–213.
    1. Kim JY, Sun V, Raz DJ, Williams AC, Fujinami R, Reckamp K, et al. The impact of lung cancer surgery on quality of life trajectories in patients and family caregivers. Lung Cancer. 2016;101:35–39.
    1. Borneman T, Sun V, Williams AC, Fujinami R, Del Ferraro C, Burhenn PS, et al. Support for patients and family caregivers in lung cancer: educational components of an interdisciplinary palliative care intervention. J Hosp Palliat Nurs. 2015;17(4):309–318.
    1. Sun V, Kim JY, Williams AC, Raz DJ, Sampath S, Ferrell B. Quality of life and symptoms following stereotactic body radiotherapy in early-stage lung cancer patients. J Community Support Oncol. 2014;12(11):407–414.
    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30.
    1. Howlader N, Forjaz G, Mooradian MJ, Meza R, Kong CY, Cronin KA, et al. The effect of advances in lung-cancer treatment on population mortality. N Engl J Med. 2020;383(7):640–649.
    1. Swisher AK, Kennedy-Rea S, Starkey A, Duckworth A, Burkart M, Graebe G, Harper R, Yanosik MA, Hudson A (2020) Bridging the gap: identifying and meeting the needs of lung cancer survivors. J Public Health. 10.1007/s10389-020-01332-w
    1. Poghosyan H, Sheldon LK, Leveille SG, Cooley ME. Health-related quality of life after surgical treatment in patients with non-small cell lung cancer: a systematic review. Lung Cancer. 2013;81(1):11–26.
    1. Ha D, Ries AL. Characterization of dyspnea in veteran lung cancer survivors following curative-intent therapy. J Cardiopulm Rehabil Prev. 2020;40(2):120–127.
    1. Baziliansky S, Cohen M (2020) Emotion regulation and psychological distress in cancer survivors: a systematic review and meta-analysis. Stress Health. 10.1002/smi.2972
    1. Keats MR, Cui Y, DeClercq V, Grandy SA, Sweeney E, Dummer TJB. Burden of multimorbidity and polypharmacy among cancer survivors: a population-based nested case-control study. Support Care Cancer. 2021;29:713–723.
    1. Fink-Neuboeck N, Lindenmann J, Porubsky C, Fediuk M, Anegg U, Maier A, et al. Hazards of recurrence, second primary, or other tumor at ten years after surgery for non–small-cell lung cancer. Clin Lung Cancer. 2020;21(4):333–340.
    1. Miller KD, Nogueira L, Mariotto AB, Rowland JH, Yabroff KR, Alfano CM, et al. Cancer treatment and survivorship statistics, 2019. CA Cancer J Clin. 2019;69(5):363–385.
    1. Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70(3):145–164.
    1. Wiltink LM, White K, King MT, Rutherford C. Systematic review of clinical practice guidelines for colorectal and anal cancer: the extent of recommendations for managing long-term symptoms and functional impairments. Support Care Cancer. 2020;28(6):2523–2532.
    1. Simard J, Kamath S, Kircher S. Survivorship guidance for patients with colorectal cancer. Curr Treat Options in Oncol. 2019;20(5):38.
    1. Sun V, Wendel CS, Demark-Wahnefried W, Grant M, McMullen CK, Bulkley JE, et al. Diet and behavior modifications by long-term rectal cancer survivors to manage bowel dysfunction-associated symptoms. Nutr Cancer. 2019;71(1):89–99.
    1. Sun V, Grant M, Wendel CS, McMullen CK, Bulkley JE, Altschuler A, et al. Dietary and behavioral adjustments to manage bowel dysfunction after surgery in long-term colorectal cancer survivors. Ann Surg Oncol. 2015;22(13):4317–4324.
    1. Yoon S, Chua TB, Tan IB, Matchar D, Ong MEH, Tan E. Living with long-term consequences: experience of follow-up care and support needs among Asian long-term colorectal cancer survivors. Psychooncology. 2020;29:1557–1563.
    1. El-Shami K, Oeffinger KC, Erb NL, Willis A, Bretsch JK, Pratt-Chapman ML, et al. American Cancer Society colorectal cancer survivorship care guidelines. CA Cancer J Clin. 2015;65(6):428–455.
    1. Bulkley JE, McMullen CK, Grant M, Wendel C, Hornbrook MC, Krouse RS. Ongoing ostomy self-care challenges of long-term rectal cancer survivors. Support Care Cancer. 2018;26(11):3933–3939.
    1. Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the chronic care model in the new millennium. Health Aff. 2009;28(1):75–85.
    1. Wagner EH, Bennett SM, Austin BT, Greene SM, Schaefer JK, Vonkorff M (2005) Finding common ground: patient-centeredness and evidence-based chronic illness care. J Altern Complement Med 11(Suppl 1):S7–S15
    1. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff. 2001;20(6):64–78.
    1. McCorkle R, Ercolano E, Lazenby M, Schulman-Green D, Schilling LS, Lorig K, et al. Self-management: enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin. 2011;61(1):50–62.
    1. Lorig KR, Holman H. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1–7.
    1. Thomson C, Johnson C. Dietary behaviors - promoting healthy eating. In: Riekert K, Ockene J, Pbert L, editors. The handbook of health behavior change. 5. New York: Springer Publishing; 2017.
    1. Nekhlyudov L, Mollica MA, Jacobsen PB, Mayer DK, Shulman LN, Geiger AM. Developing a quality of cancer survivorship care framework: implications for clinical care, research, and policy. J Natl Cancer Inst. 2019;111(11):1120–1130.
    1. Thom B, Boekhout AH, Corcoran S, Adsuar R, Oeffinger KC, McCabe MS. Advanced practice providers and survivorship care: they can deliver. J Oncol Pract. 2019;15(3):e230–e2e7.
    1. National Academies of Science, Engineering, and Medicine (2018) Long-term survivorship care after cancer treatment: proceedings of a workshop. National Academies Press, Washington, D.C.
    1. Alfano CM, Mayer DK, Bhatia S, Maher J, Scott JM, Nekhlyudov L, et al. Implementing personalized pathways for cancer follow-up care in the United States: proceedings from an American Cancer Society-American Society of Clinical Oncology summit. CA Cancer J Clin. 2019;69(3):234–247.
    1. Mayer DK, Alfano CM. Personalized risk-stratified cancer follow-up care: its potential for healthier survivors, happier clinicians, and lower costs. J Natl Cancer Inst. 2019;111(5):442–448.
    1. DeSantis CE, Miller KD, Dale W, Mohile SG, Cohen HJ, Leach CR, et al. Cancer statistics for adults aged 85 years and older, 2019. CA Cancer J Clin. 2019;69(6):452–467.
    1. Corbett T, Cummings A, Calman L, Farrington N, Fenerty V, Foster C, Richardson A, Wiseman T, Bridges J. Self-management in older people living with cancer and multi-morbidity: a systematic review and synthesis of qualitative studies. Psychooncology. 2020;29:1452–1463.
    1. Versteeg KS, Looijaard S, Slee-Valentijn MS, Verheul HMW, Maier AB, Konings I. Predicting outcome in older patients with cancer: comprehensive geriatric assessment and clinical judgment. J Geriatr Oncol. 2021;12:49–56.
    1. Mohile SG, Epstein RM, Hurria A, Heckler CE, Canin B, Culakova E, et al. Communication with older patients with cancer using geriatric assessment: a cluster-randomized clinical trial from the National Cancer Institute Community Oncology Research Program. JAMA Oncol. 2020;6(2):196–204.
    1. Mead KH, Raskin S, Willis A, Arem H, Murtaza S, Charney L, Pratt-Chapman M. Identifying patients’ priorities for quality survivorship: conceptualizing a patient-centered approach to survivorship care. J Cancer Surviv. 2020;14:939–958.
    1. Vos JAM, Wieldraaijer T, van Weert H, van Asselt KM (2020) Survivorship care for cancer patients in primary versus secondary care: a systematic review. J Cancer Surviv. 10.1007/s11764-020-00911-w
    1. Takvorian SU, Balogh E, Nass S, Valentin VL, Hoffman-Hogg L, Oyer RA, et al. Developing and sustaining an effective and resilient oncology careforce: opportunities for action. JNCI J Natl Cancer Inst. 2020;112(7):663–670.
    1. Decadt I, Goossens G, Courtens A, Daem M, Decoene E, Reymen M, et al. The advanced practice nurse (APN) in oncology: an opportunity to meet the fast evolving needs in cancer care. Belg J Med Oncol. 2020;14:93–99.
    1. Monterosso L, Platt V, Bulsara M, Berg M. Systematic review and meta-analysis of patient reported outcomes for nurse-led models of survivorship care for adult cancer patients. Cancer Treat Rev. 2019;73:62–72.
    1. Charalambous A, Wells M, Campbell P, Torrens C, Ostlund U, Oldenmenger W, et al. A scoping review of trials of interventions led or delivered by cancer nurses. Int J Nurs Stud. 2018;86:36–43.
    1. Macmillan Cancer Support (2015) Evaluation of the transforming cancer follow-up programme. . Accessed 12 Sept 2020
    1. Kim SH, Kim K, Mayer DK. Self-management intervention for adult cancer survivors after treatment: a systematic review and meta-analysis. Oncol Nurs Forum. 2017;44(6):719–728.
    1. Howell D, Mayer DK, Fielding R, Eicher M, Verdonck-de Leeuw IM, Johansen C, Soto-Perez-de-Celis E, Foster C, Chan R, Alfano CM, Hudson SV, Jefford M, Lam WWT, Loerzel V, Pravettoni G, Rammant E, Schapira L, Stein KD, Kocswara B, Global Partners for Self-Management in C (2020) Management of cancer and health after the clinic visit: a call to action for self-management in cancer care. J Natl Cancer Inst. 10.1093/jnci/djaa083
    1. Girgis A. The role of self-management in cancer survivorship care. Lancet Oncol. 2020;21(1):8–9.
    1. Institute of Medicine . Priority areas for national action: tranforming health care quality. Washington, DC: National Academies Press; 2003.
    1. Kvale EA, Huang CS, Meneses KM, Demark-Wahnefried W, Bae S, Azuero CB, et al. Patient-centered support in the survivorship care transition: outcomes from the patient-owned survivorship care plan intervention. Cancer. 2016;122(20):3232–3242.
    1. Maly RC, Liang LJ, Liu Y, Griggs JJ, Ganz PA. Randomized controlled trial of survivorship care plans among low-income, predominantly Latina breast cancer survivors. J Clin Oncol. 2017;35(16):1814–1821.
    1. Brunet J, Wurz A, Srivastava D. The process of self-management: a qualitative case study reporting on cancer survivors’ and program staff’s experiences within one self-management support intervention. Health Educ Behav. 2020;47(4):592–601.
    1. Alfano CM, Jefford M, Maher J, Birken SA, Mayer DK. Building personalized cancer follow-up care pathways in the United States: lessons learned from implementation in England, Northern Ireland, and Australia. Am Soc Clin Oncol Educ Book. 2019;39(39):625–639.
    1. National Health Service (2012) Stratified pathways of care: from concept to innovation. . Accessed 12 Sept 2020

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