Factors influencing implementation of a survivorship care plan-a quantitative process evaluation of the ROGY Care trial

Belle H de Rooij, Nicole P M Ezendam, Kim A H Nicolaije, M Caroline Vos, Johanna M A Pijnenborg, Dorry Boll, Roy F P M Kruitwagen, Lonneke V van de Poll-Franse, Belle H de Rooij, Nicole P M Ezendam, Kim A H Nicolaije, M Caroline Vos, Johanna M A Pijnenborg, Dorry Boll, Roy F P M Kruitwagen, Lonneke V van de Poll-Franse

Abstract

Purpose: The aim of this study is to investigate the factors that influence implementation of Survivorship Care Plans (SCPs) in the intervention arm of the ROGY Care trial by (1) assessing the level of SCP receipt in the ROGY Care trial and (2) identifying patient- and provider-level factors that influence SCP receipt.

Methods: Between 2011 and 2015, a pragmatic cluster randomized-controlled-trial was conducted on the effects of automatically generated SCPs. Endometrial (N = 117) and ovarian (N = 61) cancer patients were allocated to 'SCP care', as provided by their SCP care providers (N = 10). Associations between SCP receipt (self-reported SCP receipt and actually generated SCPs), patient-factors (socio-demographic-, clinical-, and personality factors), and care provider factors (profession and a-priori motivation regarding SCP provision) were tested in univariate analysis. The odds ratios of factors influencing self-reported SCP receipt were estimated with a multivariate regression model.

Results: Of all patients in the SCP care arm (N = 178), SCPs were generated by the care provider for 90 % of the patients and 70 % of the patients reported that they had received an SCP. Patients with older age, ovarian cancer, type D (distressed) personality, and patients that completed the questionnaire a longer period of time after the SCP consult were more likely to report no SCP receipt.

Conclusions: SCP receipt was influenced by patient- but not care-provider factors.

Implications for cancer survivors: Certain patient groups were less likely to report SCP receipt. Whether all patients are in need of an SCP, requires further investigation. If they do, more efforts need to be made towards the implementation of SCPs.

Keywords: Gynecologic cancer; Implementation; Information provision; Survivorship care plan.

Conflict of interest statement

Compliance with ethical standards The ROGY Care trial was centrally approved by a Medical Research Ethics Committee, as well as by each participating center [22]. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent Informed consent was obtained from all individual participants included in the study. Conflict of interest The authors declare that they have no conflict of interest. Funding The ROGY Care trial is supported with grant no. UVT 2010–4743 from the Dutch Cancer Society. Dr. Nicole Ezendam was supported by a Fellowship grant from the Dutch Cancer Society (#UVT-2014-6632).

Figures

Fig. 1
Fig. 1
Flow diagram of patients included in analysis and (first) SCP receipt in the ROGY care trial

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