Childhood Cancer Survivors’ Adherence to Healthcare Recommendations Made Through a Distance-Delivered Survivorship Program

Abstract

Joseph Elliot Alchin,1,2 Christina Signorelli,1,2 Jordana Kathleen McLoone,1,2 Claire Elizabeth Wakefield,1,2 Joanna Elizabeth Fardell,1,2 Karen Johnston,1 Richard J Cohn1,2 1Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia; 2School of Women’s and Children’s Health,UNSW Medicine, University of New South Wales, Sydney, NSW, AustraliaCorrespondence: Christina Signorelli, Kids Cancer Centre, Level 1 South, Sydney Children’s Hospital, High St, Randwick, NSW, 2031, Australia, Tel [phone], Fax [phone], Email [email protected]: Ongoing survivorship care allows childhood cancer survivors the opportunity to address treatment-related health problems and improve their quality of life. However, many survivors do not adhere to their healthcare professionals’ recommendations and the factors supporting their adherence remain unclear.Patients and Methods: Long-term childhood cancer survivors completed the “Re-engage” program, which assessed survivors’ heath needs and provided individualised recommendations for health interventions and surveillance developed by an expert multi-disciplinary team (MDT). We measured survivors’ recall of, and adherence to, their individualised healthcare recommendations at one and six months post-intervention. We conducted a series of univariate negative binomial regressions to investigate factors associated with the total number of recommendations that were correctly recalled and adhered to.Results: We analysed the data of 25 childhood cancer survivors who participated in Re-engage (mean age = 31.9 years). On average, survivors were provided with 6.6 recommendations (range = 1– 11). Survivors accurately recalled receiving 3.0 recommendations at one month post-intervention and 1.9 at six months. Survivors had adhered to an average of 1.3 recommendations by six-month follow-up. In total, 56% of participants reported that they did not adhere to any recommendations. By six-month follow-up, greater adherence to MDT recommendations was associated with having a history of a second cancer (B = 1.391; 95% confidence interval [CI], 0.686 to 2.097; p

Keywords

• childhood cancer
• survivorship
• surveillance
• adherence
• model of care
• late effects
• recall