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Article Title

Patient-Provider Communication During Posttreatment Breast Cancer Care: Findings From a Kaiser Permanente Northern California Pilot Project

Publication Date

8-10-2017

Keywords

cancer, communication, patients, providers, quality improvement

Abstract

Background: Patient-provider communication is essential to delivering high-quality cancer care, including posttreatment when survivors have many complex care needs. In this study, we used data collected for quality improvement from a small feasibility sample to examine patient perceptions of provider communication and inform the development of a new Oncology Survivorship Clinic model.

Methods: As part of a pilot project conducted at Kaiser Permanente Northern California, we surveyed 51 breast cancer patients posttreatment. The survey included a communication measure from the 2011 Medical Expenditure Panel Survey: Experiences with Cancer Survivorship Supplement evaluating provider discussions of: 1) surveillance for recurrence, 2) late or long-term treatment effects, 3) healthy lifestyle behaviors, and 4) emotional or social needs. We also examined reports of the 6 core functions of patient-centered communication (ie, managing uncertainty, responding to emotions, making decisions, fostering healing relationships, enabling self-management, exchanging information) using a measure from the Health Information National Trends Survey 4: Cycle 4. Part of the purpose was to evaluate acceptability of a new Oncology Survivorship Clinic utilizing nonphysician providers.

Results: The sample included 51 breast cancer patients surveyed in 2016 within 6 months of treatment completion. All women were stage 0–3. Overall, sizable proportions received detailed communication about surveillance (65%), treatment side effects (46%), emotional needs (41%) and healthy lifestyles (71%), and the majority received patient-centered communication (range: 60%–73% based on core function). Particular gaps were noted related to provider communication about treatment side effects (54%), emotional/social needs (59%), managing uncertainty (35%) and responding to emotions (40%).

Conclusion: Our very preliminary findings suggest that the majority of women had positive communication experiences, including with nonphysician providers. However, clear communications gaps existed, underscoring future avenues for research and care delivery interventions to address the needs of breast cancer patients more comprehensively.

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