Texas Primary Care Intervention Seeks to Improve Outcomes for Cancer Survivors

UTHealth Houston researchers are partnering with eight Texas primary care community health centers on an intervention study that seeks to improve outcomes for cancer survivors and improve primary care capacity.

Funded by a $4.8 million grant from the National Cancer Institute, the Project CASCADE initiative will focus on underinsured and uninsured patients.

CASCADE stands for Community and Academic Synergy to Improve the Delivery of Cancer Survivorship Care.

The intervention will seek to help community health center clinics improve the identification and follow-up of cancer survivors by modifying existing clinic workflows and coordinating survivor care through a designated care coordinator. It will also use Project ECHO, a telementoring strategy to improve primary care physicians’ knowledge of cancer survivorship care, recognition and management of the effects of cancer and its treatments, and communication between oncologists and the primary care team.

The investigators expect this intervention to increase rates of guideline-recommended screening for secondary cancers, primary care physicians’ knowledge of cancer survivorship care, and patient-reported experience of care coordination. Researchers will also measure adherence to National Comprehensive Cancer Network surveillance guidelines for survivors of the most prevalent cancers, including breast, colorectal, prostate, and lung cancer.

«The CASCADE Project focuses on how primary health care teams provide comprehensive, coordinated care to underserved patients who have a history of cancer,» said Bijal Balasubramanian, MBBS, Ph.D., professor of epidemiology in the School of Public Health. from UTHealth Houston. in a statement.

«Primary care is uniquely suited to providing comprehensive, coordinated care to cancer survivors because, at its core, it prioritizes, personalizes and integrates health care for all conditions, not just cancer,» added Balasubramanian, Distinguished President of the Society of Rockwell. and Health, and principal investigator of the study.

Balasubramanian, who is also co-director of the Implementation Sciences Institute at UTHealth Houston and regional dean of the Dallas School of Public Health, said 70% of cancer survivors have other chronic conditions and receive care from multiple clinical teams, which which can create gaps. in care coordination. Cancer survivors also have a higher risk of developing other cancers and chronic diseases. This, along with a growing number of cancer survivors and an expected shortage of oncology subspecialists, makes the study even more timely and significant.

The CASCADE Project is one of four U01 grants funded by the National Cancer Institute awarded in response to a special request for applications focused on addressing the primary care needs of cancer survivors.

Simon Lee, Ph.D., MPH, chair and Sosland Family Professor of Preventive Medicine at the University of Kansas, is co-principal investigator. Roxana Cruz, MD, chief innovation officer for the Texas Association of Community Health Centers, will serve as an advisor on the study.