Health-E-NC project receives University Cancer Research Fund support to improve cancer survivorship
| August 09, 2012 | |
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Researchers from UNC’s schools of public health, medicine and nursing received more than $200,000 in funding from the University Cancer Research Fund (UCRF) for two related projects that aim to improve both cancer survivorship and communications between primary care providers and oncologists.The researchers are affiliated with Health-E-NC, a statewide effort to improve cancer outcomes sponsored by UNC Lineberger Comprehensive Cancer Center and the UCRF.
Dr. Stephanie Wheeler
“These projects extend prior work funded by Health-E-NC which documented that quality of breast cancer survivorship care may be better among survivors enrolled in primary care medical homes through Community Care of North Carolina (CCNC),” said Stephanie Wheeler, PhD, assistant professor of health policy and management at UNC Gillings School of Global Public Health and one of the project investigators. The two coordinated projects will develop and evaluate a comprehensive approach to integrating primary and specialty oncology survivorship care for patients with breast, colorectal, lung and prostate cancer and their families and caregivers. They also will provide critical pilot data for a subsequent randomized trial to test the effectiveness of coordinated and shared survivorship care in improving patient-centered outcomes and will develop individualized survivorship care plans and systems for delivering the plans to patients and primary care providers.Plan development and delivery are pressing clinical needs at UNC and beyond. The Institute of Medicine’s 2005 report, From Cancer Patient to Cancer Survivor: Lost in Transition identified the “essential components of survivorship care” as: (1) prevention of recurrence, new primary cancers or late effects of treatment; (2) surveillance for recurrence, metastases, new primary cancers, and physical or psychosocial late effects of treatment; (3) interventions for physical, psychosocial and practical consequences of cancer and its treatment; and (4) coordination of care to execute prevention, surveillance, and interventions, specifically between survivors’ primary care providers and oncologists.
The IOM document highlighted highlights the important role of care coordination for the cancer survivor, which should include the interdisciplinary oncology team (surgery, medical oncology, radiation, nursing and other supportive services) and the patient’s primary care provider. Care coordination, especially important as active cancer treatment ends, is the means by which prevention, surveillance and other interventions are implemented. Yet it has been fraught with communication problems, including those related to clarifying the roles of the oncologist and primary care provider in survivorship care. “Clearly, primary care providers have an important role to play in the transition from cancer patient to cancer survivor,” Wheeler said. “Helping survivors and their caregivers effectively navigate this transition requires ensuring that communication is clear and consistent, that provider roles are delineated effectively, and that patient-centered strategies are used, including developing individualized survivorship care plans.”The American College of Surgeons will require survivorship care plans by 2015.
The University Cancer Research Fund has gone to great links to support such efforts, Wheeler said. Other project investigators are Deborah K. Mayer, PhD, RN; and Gary Asher, MD, MPH, Ronald Chen, MD, MPH, Laura Hanson, MD, and Donald L. Rosenstein, MD.
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