ASPO Abstracts
Multimorbidity and the receipt of cancer survivorship care plans: Findings from the 2020 Behavioral Risk Factor Surveillance System survey
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Purpose: To examine the association between multimorbidity (two or more chronic conditions) and the receipt of a survivorship care plan (SCP) in a nationally representative sample of cancer survivors, and to investigate whether this association differs by survivors' major source of health care. Methods: Participants were United States adults with a self-reported history of cancer who were not currently receiving cancer treatment (n=7,337) and were part of cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System. Receipt of an SCP was defined as having received a written or printed summary of all cancer treatments received and instructions for follow-up care. Multimorbidity was assessed using counts from a set of self-reported chronic conditions (cardiovascular disease, asthma, chronic obstructive pulmonary disease, arthritis, depressive disorder, kidney disease, diabetes, and obesity), and categorized as 0, 1, 2, or 3+ chronic conditions based on the sample distribution. Multivariable logistic regression models assessed the association between multimorbidity and the receipt of an SCP, adjusting for several potentially confounding variables. Results: Most study participants were 65 years or older (62%), women (58%), non-Hispanic White (83%), and presented with 1 chronic condition (30%). Arthritis (48%), obesity (34%), and depressive disorder (22%) were the three most common comorbid conditions. Nearly half (45%) of participants reported having received an SCP. Participants with 3+ comorbid conditions were less likely to have received an SCP (aOR: 0.76, CI: 0.60-0.96) as compared to those without multimorbidity. Multimorbidity was associated with a lower likelihood of receiving an SCP (aOR: 0.72, CI: 0.53-0.96 for 3+ comorbid conditions) among participants whose care was mostly managed by primary care physicians, but not for those whose care was managed by specialist doctors. Conclusion: Our findings suggest an inverse association between multimorbidity and the receipt of an SCP among cancer survivors. Since several major professional organizations recommend that all cancer survivors receive SCPs, further studies are needed to elucidate contextual factors associated with healthcare providers' delivery of SCPs to patients with multimorbidity.
Keywords: multimorbidity, treatment summaries, primary care provider