Age-appropriate needs-based care in an onco-primary care survivorship program for survivors of childhood, adolescent and young adult, and adult cancers
摘要
Routine assessment of cancer survivors’ needs is inconsistently performed in both primary care and oncology. Age influences survivorship needs, with younger survivors facing prolonged symptom burden and late effects, and older survivors experiencing compounded aging-related issues. We describe age-appropriate needs-based care in a university onco-primary care survivorship clinic serving adult survivors of childhood and adult cancers.
MethodsBetween November 1, 2022, and May 31, 2023, the clinic administered age-appropriate assessments during routine visits (ages ≤ 39 years: Adolescent and Young Adult Psycho-Oncology Screening Tool for Survivorship [AYA-SPOST]; ≥ 40 years: NCCN Distress Thermometer and Problem List [NCCN DTPL]). Survivors prioritized their top three concerns, and clinicians addressed them in the visit. Descriptive statistics were used to summarize priority concerns.
ResultsTwo hundred and twenty-eight patients (100%) completed age-appropriate assessments (AYA-SPOST: 112; NCCN DTPL: 116) and prioritized their concerns at their clinic visit. Leukemia (21%) and lymphoma (18%) were the most common diagnoses. Survivors ≤ 39 years old prioritized anxiety/fear (21%), sleep disturbances (14%), and worry about long-term effects (12%), while those ≥ 40 years old prioritized pain (40%), fatigue (28%), and worry/anxiety (23%). Clinicians discussed survivors’ concerns with them and made 74 referrals to supportive services.
ConclusionsWe implemented age-appropriate needs-based care in an onco-primary care clinic as part of standard care. Patients’ priority concerns helped drive clinical visits to ensure patient-centered care.
Implications for Cancer SurvivorsRoutine use of age-appropriate assessments for different stages of adulthood, with opportunities for survivors to prioritize their concerns, allows clinicians to take immediate action to help address those concerns.