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16.11.2021 | Review

Effectiveness and implementation of models of cancer survivorship care: an overview of systematic reviews

verfasst von: Raymond J. Chan, Fiona Crawford-Williams, Megan Crichton, Ria Joseph, Nicolas H. Hart, Kristi Milley, Paige Druce, Jianrong Zhang, Michael Jefford, Karolina Lisy, Jon Emery, Larissa Nekhlyudov

Erschienen in: Journal of Cancer Survivorship | Ausgabe 1/2023

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Abstract

Purpose

To critically assess the effectiveness and implementation of different models of post-treatment cancer survivorship care compared to specialist-led models of survivorship care assessed in published systematic reviews.

Methods

MEDLINE, CINAHL, Embase, and Cochrane CENTRAL databases were searched from January 2005 to May 2021. Systematic reviews that compared at least two models of cancer survivorship care were included. Article selection, data extraction, and critical appraisal were conducted independently by two authors. The models were evaluated according to cancer survivorship care domains, patient and caregiver experience, communication and decision-making, care coordination, quality of life, healthcare utilization, costs, and mortality. Barriers and facilitators to implementation were also synthesized.

Results

Twelve systematic reviews were included, capturing 53 primary studies. Effectiveness for managing survivors’ physical and psychosocial outcomes was found to be no different across models. Nurse-led and primary care provider-led models may produce cost savings to cancer survivors and healthcare systems. Barriers to the implementation of different models of care included limited resources, communication, and care coordination, while facilitators included survivor engagement, planning, and flexible services.

Conclusions

Despite evidence regarding the equivalent effectiveness of nurse-led, primary care-led, or shared care models, these models are not widely adopted, and evidence-based recommendations to guide implementation are required. Further research is needed to address effectiveness in understudied domains of care and outcomes and across different population groups.

Implications for Cancer Survivors

Rather than aiming for an optimal “one-size fits all” model of survivorship care, applying the most appropriate model in distinct contexts can improve outcomes and healthcare efficiency.

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Titel: Effectiveness and implementation of models of cancer survivorship care: an overview of systematic reviews
verfasst von: Raymond J. Chan
Fiona Crawford-Williams
Megan Crichton
Ria Joseph
Nicolas H. Hart
Kristi Milley
Paige Druce
Jianrong Zhang
Michael Jefford
Karolina Lisy
Jon Emery
Larissa Nekhlyudov
Publikationsdatum: 16.11.2021
Verlag: Springer US
Erschienen in: Journal of Cancer Survivorship / Ausgabe 1/2023
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-021-01128-1

Springer Medizin

Effectiveness and implementation of models of cancer survivorship care: an overview of systematic reviews