Congress Abstracts 2006

94

FOLLOW UP CARE OF LYMPHOMA SURVIVORS IN A NURSE PRACTITIONER JOINT PRACTICE MODEL. Christine Liebertz, RN, CS, MSN, AOCN^®, Memorial Sloan-Kettering Cancer Center, New York, NY.

As treatment options for lymphoma improve and more patients are living longer, a coordinated approach to follow-up care is essential for addressing the overall health needs and quality of life of survivors. Survivors of Hodgkin's disease (HD) and Non-Hodgkin lymphoma (NHL), particularly the young adult, face the long-term physical and psychosocial effects of illness and treatment.

Depending on the treatment they receive, lymphoma survivors face not only the risk of recurrence, but also the risk for secondary cancers such as leukemia, breast, skin, and thyroid. Late treatment effects include cardiovascular, endocrine, and fertility abnormalities along with a variety of psychosocial issues including financial, marital and work related. The complexities of these patients are difficult to address during a routine followup clinic visit. As part of an overall Survivorship Program at this NCI designated cancer center, a Survivorship Nurse Practitioner (NP) was added to the lymphoma visit to better address the needs of these patients, to develop a long term care plan, and to educate survivors about appropriate intervention, followup, referrals and services that will optimize their quality of life.

HD and NHL patients two years post treatment will be part of the pilot program. The NP in this clinic performs a complete patient assessment and, as recommended by the 2005 Institute of Medicine report on Survivorship, develops a "survivorship care plan" based on national guidelines. This care plan includes recommendations for screening for recurrent disease and other cancers, information about early detection and management of treatment sequelae, and implementing positive health behaviors. Referrals are made for additional psychological, social and financial concerns.

Close monitoring and patient followup will evaluate patient's adherence to care plan recommendations along with potential barriers that may include psychosocial, financial and supportive issues. After the pilot phase, metric analysis will evaluate overall program feasibility, along with patient, NP and physician satisfaction.

As the number of survivors of lymphoma increase, it is imperative that oncology nurses and NP's have an understanding of the complexity of care needed, and the services that are available. This presentation will review our survivorship program and the medical sequelae of lymphoma therapies.