Introduction of treatment summaries and holistic needs assessments for teenagers and young adults after cancer treatment in Scotland: a national feasibility study.


Year:

Session type:

Theme:

Angela Edgar1,Nicola Davison1,Simita Kumar1,Bernadine Wilkie1,Jeff White2
1NHS Lothian,2NHS Greater Glasgow and Clyde

Abstract

Background

The Scottish Government recommends that all teenagers and young adults (TYA) treated for cancer, receive a Treatment Summary (TS) and Holistic Needs Assessment (HNA) to aid communication, education, self-management and identify areas of concern. The objectives of this study were: i) To determine the feasibility of implementing TS and HNA for Scottish TYA after cancer treatment; and ii) to share the TS with health professionals to improve communication and engagement.

Method

Scottish TYA (16-24 years) completing cancer treatment, between April 2016 -April 2017, were identified at the weekly National TYA Multidisciplinary Team (TYA MDT) meeting. Treatment Summaries and HNA were completed and distributed to patients and health professionals.

Results

Of 83 eligible patients, 51 were recruited (response rate 61%); 26 (51%) males, median (range) age 22 (16 – 25) years. Among non-recruits: 2 relocated, 1 relapsed, lead consultant deemed the process ‘not relevant’ (n=6), or did not respond (n=23). Cancer diagnoses: germ cell tumours (39%), lymphomas (27%) and bone tumours (14%) over represented; carcinoma (8%), melanoma (2%) and CNS tumours (2%) under-represented.

Conclusion

Treatment Summaries and Holistic Needs Assessments were completed for almost two thirds of TYA identified after cancer treatment. Recruitment failure was due largely to consultant disengagement. Based on incidence data, current pathways do not allow identification of almost half of patients at the end of treatment. Completion of TS/HNA is labour intense and adequate time and training must be provided. By sharing Treatment Summaries we have improved communication and engagement with Primary Care and provided clear pathways for referral of patients to hospital when problems arise.