E-poster Presentation 2014 World Cancer Congress

Key learnings from an evaluation of statewide models of post-treatment care (#968)

Michael Jefford 1 2 3 , Linda Nolte 2 , Spiri Galetakis 4 , Sharon Avery 5 , Lucio Naccarella 6 , Kate Thompson 7 , Bruce Mann 8 , David Ashley 9 10 , Katherine Simons 11 , Martin Haskett 12 , Nicole Kinnane 2 , Paula Howell 11 , Elise Davies 4 , Kathryn Whitfield 4
  1. Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  2. Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  3. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
  4. Cancer Strategy and Development, Integrated Care Branch, Department of Health, Victoria, Melbourne, VIC, Australia
  5. Malignant Haematology and Stem Cell Transplantation Service, The Alfred, Melbourne, VIC, Australia
  6. Australian Health Workforce Institute, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
  7. OnTrack at PeterMac, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  8. The University of Melbourne Director of Breast Service, The Royal Women's Hospital , Melbourne, VIC, Australia
  9. Barwon Health Andrew Love Cancer Centre, Barwon Health , Geelong, VIC, Australia
  10. Barwon South Western Regional Integrated Cancer Services, Geelong, VIC, Australia
  11. North Eastern Melbourne Integrated Cancer Service, Melbourne, VIC, Australia
  12. Victorian Melanoma Service, The Alfred, Melbourne, VIC, Australia

Background and Context: ASCO and the IOM have emphasised the need to trial novel models of post treatment care, and to disseminate information and education about these models. In Australia in 2011 the Victorian government established the Victorian Cancer Survivorship Program (VCSP), which funded six 2-year demonstration projects, targeting people at the end of initial cancer treatment.

Aim: To build evidence on how post treatment models can best be provided: an evaluation of the VCSP.

Strategy/Tactics: The projects provided regular written progress reports. Additionally, representatives met at formal community of practice meetings. Critical enablers and challenges to effective care delivery were determined and key learnings identified. 

Programme/Policy Proces: The VCSP trialed six novel post treatment models of care, engaging various sectors of the health system and non-government organisations.

Outcomes/What was learned:Strong clinical leadership was identified as a critical factor for success. All projects recognised the need to tailor care according to individual needs and predicted risks, though acknowledged a lack of valid assessment and prediction tools. Similarly, all projects queried whether all survivors require the same level of information in treatment summaries and care plans. Projects focused on the survivor, with little focus on carers and family. Challenges include limited evidence to support different models of care, achieving effective engagement with community-based care and issues around terminology, including use of the word survivorship. An emphasis on self-management and wellness represents a reorientation of the healthcare system, with which many providers are unfamiliar. Many projects encountered delays in commencement awaiting approval from local IRB / ethics committees. Despite different health care systems, all countries face similar challenges in delivering improved survivorship care. Each of the VCSP projects has reported favourable outcomes, though almost all encountered challenges, many of which were not anticipated. Other projects should prospectively consider each of these issues.