[Author Name]. (2014, June). [Title of Presentation]. Podium presentation at the 7th Biennial Cancer Survivorship Research Conference, Atlanta, GA.

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1 June 18-20, 2014 Atlanta, Georgia Please Note: Reference to material from the following presentation should be acknowledged by citing the author, title of the presentation, and title of the conference as shown below. [Author Name]. (2014, June). [Title of Presentation]. Podium presentation at the 7th Biennial Cancer Survivorship Research Conference, Atlanta, GA.

2

3 Cancer Survivorship Guidelines in the Netherlands Miranda Velthuis, advisor guidelines 2

4 The Netherlands

5 Healthcare in the Netherlands covered by two statutory forms of insurance: Zorgverzekeringswet (Zvw): basic insurance covers common medical care everyone has to take out their own basic healthcare insurance (basisverzekering) Algemene Wet Bijzondere Ziektekosten (AWBZ) covers long-term nursing and care automatically insured by the government

6 Cancer (care) in the Netherlands Almost 17 million inhabitants people newly diagnosed with cancer in 2012 Increasing number of cancer survivors in in 2020 in NL Cancer treatment - Medical: inpatient / daycare / outpatient clinic hospitals ) - (After)care: hospitals, rehabilitation centres, psychooncologic centres, primary care (physiotherapist, psychologist, etc.), etc.

7 After undergoing treatment, every patient is to be given an aftercare plan, including information about Physical and psychological effects of the disease and / or treatment Desirability and form of FU programme Reconsideration moment Follow up programmes are to be divised for all types of tumours This programme should be imbedded by means of professional guidelines

8 Cancer Survivorship Guidelines in the Netherlands Cancer survivorship care (IKNL, 2011) Detection psychosocial distress (IKNL, 2010) Cancer rehabilitation (IKNL, 2011)

9 Guideline Cancer survivorship care

10 Implementation Cancer survivorship care plan in nurse-led cancer FU care ( ) Three hospitals SCP implemented in nurse led FU care Conclusion: SCP was succesfully implemented: -All continue renewal FU care -PT and professionals are satisfied Most important recommendations: - Develop hospital-wide policy for aftercare / SCP - Sufficient people and resources, Involve nurse specialists / specialized nurses - Settle aftercare / SCP in protocols / pathways - Cooperation / relocation primary care is optional See poster Hellendoorn et al.

11 SCP automatically generated out of Registration System Oncological Gynecology (ROGY Care) Tailored information based on personal patient and disease data (diagnosis, treatment, possible short-term and long-term effects and aftercare) plus Distress Thermometer Pragmatic RCT: usual care versus SCP care 12 hospitals in South of the Netherlands Results (longitudinal: baseline, 6 and 12 months) n=221 endometrial cancer (prof. Lonneke van de Poll)

12 Follow-up by General Practitioner instead of medical specialist Prospective study to explore the potential role of the GP in the follow-up of patients after curative breast and colon cancer treatment 14 GP s in the region Brielle/Westvoorne GP s received Education with regard to the follow-up Multidisciplinary team meetings with medical specialists Outcomes: experiences of patients, specialists and GP s, check whether FU was executed according the guidelines

13 Guideline Detection psychosocial distress

14 Implementation guideline Detection psychosocial distress - Measurement (baseline and evaluation) - Meetings (per region) - Tailored support in hospitals Detection Psychosocial distress with or without screenings instrument (n=76) 2,6% Most frequently implemented: (detection for all patients) 22,4% 75,0% Yes, specific cancer diagnoses Yes, all cancer diagnoses No - During chemotherapy (39/74) - Breast cancer (44/74) - Lung cancer (24/74) - Haematology (27/74) - Gastro-enterology (16/74) NPK (National Cancer Programme) )

15 Guideline Cancer rehabilitation

16 Guideline Cancer rehabilitation Diagnostic analysis prior to implementation Study period: April April 2012 Online survey professionals in oncology professionals in rehabilitation Investigational conference - 12 cancer patients/survivors In depth interviews by telephone - 19 professionals and managers in oncology, rehabilitation medicine, insurance companies

17 Detection and referral suggestions for organisation barriers and facilitators 90% suggest that nurses should screen for cancer rehabilitation Barriers and facilitators for implementation lack of time, commitment and amount of screening instruments ++adequate knowledge of (use of) screening instruments ++adequate knowledge with rehabilitation programmes ++integration of screening instruments into Electronic Medical Records

18 Modular rehabilitation programmes barriers and facilitators Barriers and facilitators for implementation ++ sufficient manpower in cancer rehabilitation ++network of cancer rehabilitation programmes and referral system insufficient finances or reimbursement and manpower for cancer rehabilitation

19 Implementation guideline Cancer rehabilitation ( ) 6 rehabilitation departments Breakthrough series collaborative model combined with knowledge brokering Important set of instruments / methods to implement nationally See poster Velthuis et al.

20 Summary and future perspectives In the Netherlands Cancer survivorship guidelines were developed Implementation has been started (partly in pilots): further dissemination needs efforts / time Future perspectives supporting implementation: National Care Standard Cancer Report Primary Care for Cancer Patients during Follow-up (Dutch Cancer Society s Signaling Committee on Cancer) Digital guide for referral

21 Thank you for your attention

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