Poster Presentation Cancer Survivorship 2019

Centralised specialist cancer survivorship assessment clinic (cisco) for patients with early breast cancer or dcis   (#132)

Beth Ivimey 1 , Sandra Avery 1 , Geoff Delaney 1 , Afaf Girgis 2 , Ivana Durcinoska 2 , Peter Smith 1 , Gui Xiong 1 , Andrew Knight 3 , Eugene Moylan 1 , Gregory Webb 1 , Kylie Smith 1 , Danielle Peterman 1 , Ashanya Malalasekera 1 , Eng-Siew Koh 1
  1. Liverpool Hospital, Liverpool, NSW, Australia
  2. Ingham Institute of Applied Medical Research, liverpool, NSW, Australia
  3. Academic General Practic Unit, Fairfield Hospital, Fairfield, NSW, Australia

A Centralised Specialist Cancer Survivorship (CISCO) clinic for patients with Early Breast Cancer and DCIS: preliminary results of an implementation study  

Beth Ivimey1, Sandra Avery1, Geoff Delaney1,2,3, Afaf Girgis2,3, Ivana Durcinoska2,3, Peter Smith3,

Gui Xiong1, Andrew Knight3,4, Eugene Moylan1, Gregory Webb1, Kylie Smith1, Danielle Peterman1, Ashanya Malalasekera1, Eng-Siew Koh1,2,3.

 

 

  1. Cancer Therapy Centre, Bankstown and Liverpool Hospitals, NSW, Australia
  2. Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
  3. University of New South Wales, NSW, Australia
  4. Academic General Practice Unit, Fairfield Hospital, NSW, Australia

 

Aims

The Patient-Reported Outcome Measures for Personalized Treatment and Care (PROMPT-Care) project aimed to capture PROs, including validated screening tools for distress, symptoms, and unmet needs, supporting clinical decisions and patient self-management. The CISCO assessment clinic utilises this model by developing and implementing a systematic, centralised model of shared survivorship care. We aim to assess the feasibility of a fully integrated electronic treatment summary and survivorship care plan (SCP), including PROMPT-Care assessments, within oncology Electronic Medical Records (EMR). 

 

Methods

Patients with EBC and/or DCIS having completed adjuvant chemotherapy and/or radiotherapy (RT) were eligible for a baseline and follow-up CISCO consultations 6-9 months later. Patients were asked to complete their baseline  assessments prior to the initial CISCO assessment and then monthly. A treatment summary was generated from the oncology EMR.

The CISCO clinic is co-staffed by a Haemato-oncologist and nurse coordinator who undertake comprehensive consultations incorporating post-treatment physical and supportive care needs, actioned allied health/community referrals and confirmed follow-up investigations. Assessments were incorporated live during the consult into an electronic SCP, which was provided to the patient and their GP. Feedback will be sought from patients, referring specialists and GPs regarding SCP content / process.

Results

To date, of n=26 patients referred, 14 subsequently declined participation . Of n=10 assessed at baseline, median age 61 years, n=7 underwent RT, n=2 chemo-radiation, and n=5 were receiving endocrine therapy. One NESB patient attended the initial CISCO consultation and completed PROMPT-Care1 assessments. The most common symptoms described were fatigue, scan anxiety, fear of cancer recurrence and weight issues. Monthly PROMPT-Care completion compliance was variable .

Conclusions

 embed electronic PROs within the oncology EMR, and generate ‘live’, dynamic survivorship care plans within the context of a comprehensive survivorship consultation. If successful, outcomes from the CISCO model will aid scalability and implementation to other survivor cohorts.