Kristen J Wells1, Paul C Winters2, Pascal Jean-Pierre3, Victoria Warren-Mears4, Douglas Post5, Mary Ann S Van Duyn6, Kevin Fiscella2, Julie Darnell7, Karen M Freund8. 1. Department of Psychology, San Diego State University and University of California, San Diego Moores Cancer Center, 6363 Alvarado Court, Suite 103, San Diego, CA, 92120-1863, USA. kwells@mail.sdsu.edu. 2. Family Medicine Research Programs, University of Rochester Medical Center, 1381 South Avenue, Rochester, NY, 14620, USA. 3. Department of Psychology, University of Notre Dame, 109 Haggar Hall, Notre Dame, IN, 46556, USA. 4. Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR, 97201, USA. 5. Ohio State University, 1590 North High Street, Suite 525, Columbus, OH, 43201, USA. 6. National Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, Room 6W118, Bethesda, MD, 20892, USA. 7. Division of Health Policy & Administration, School of Public Health, University of Illinois at Chicago, 1603 W. Taylor Street, Room 758, Chicago, IL, 60612, USA. 8. Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University School of Medicine, 800 Washington Street #63, Boston, MA, 02111, USA.
Abstract
PURPOSE: Despite growing popularity of patient navigation (PN) as a means to improve cancer care quality and reduce cancer-related disparities, there are few well-designed controlled trials assessing the impact of PN on patient outcomes like satisfaction with care. The present controlled study examined effect of PN on satisfaction with cancer-related care. METHODS:Patients who presented with a symptom or abnormal screening test (n = 1788) or definitive diagnosis (n = 445) of breast, cervical, colorectal, or prostate cancer from eight Patient Navigator Research Program sites were included in one of two groups: intervention (PN) or comparison (usual care or usual care plus cancer educational materials). Trained patient navigators met with intervention group participants to help them assess and identify resources to address barriers to cancer diagnostic or treatment care. Using a validated instrument, we assessed participants' satisfaction with their cancer diagnostic or treatment care up to 3 months after diagnostic resolution of a cancer-related abnormality or within 3 months of initiation of cancer treatment. RESULTS: Overall, patients reported high satisfaction with diagnostic care and cancer treatment. There were no statistically significant differences between PN and control groups in satisfaction with cancer-related care (p > 0.05). Hispanic and African American participants were less likely to report high satisfaction with cancer care when compared to White patients. Middle-aged participants with higher education, higher household income, private insurance, owning their own home, working full-time, and those whose primary language is English had higher satisfaction with cancer-related diagnostic care. CONCLUSIONS:PN had no statistically significant effect on patients' satisfaction with cancer-related care. Further research is needed to define the patient populations who might benefit from PN, content of PN that is most useful, and services that might enhance PN. TRIAL REGISTRATIONS: clinicaltrials.gov identifiers: NCT00613275 , NCT00496678 , NCT00375024 , NCT01569672.
RCT Entities:
PURPOSE: Despite growing popularity of patient navigation (PN) as a means to improve cancer care quality and reduce cancer-related disparities, there are few well-designed controlled trials assessing the impact of PN on patient outcomes like satisfaction with care. The present controlled study examined effect of PN on satisfaction with cancer-related care. METHODS:Patients who presented with a symptom or abnormal screening test (n = 1788) or definitive diagnosis (n = 445) of breast, cervical, colorectal, or prostate cancer from eight Patient Navigator Research Program sites were included in one of two groups: intervention (PN) or comparison (usual care or usual care plus cancer educational materials). Trained patient navigators met with intervention group participants to help them assess and identify resources to address barriers to cancer diagnostic or treatment care. Using a validated instrument, we assessed participants' satisfaction with their cancer diagnostic or treatment care up to 3 months after diagnostic resolution of a cancer-related abnormality or within 3 months of initiation of cancer treatment. RESULTS: Overall, patients reported high satisfaction with diagnostic care and cancer treatment. There were no statistically significant differences between PN and control groups in satisfaction with cancer-related care (p > 0.05). Hispanic and African American participants were less likely to report high satisfaction with cancer care when compared to White patients. Middle-aged participants with higher education, higher household income, private insurance, owning their own home, working full-time, and those whose primary language is English had higher satisfaction with cancer-related diagnostic care. CONCLUSIONS: PN had no statistically significant effect on patients' satisfaction with cancer-related care. Further research is needed to define the patient populations who might benefit from PN, content of PN that is most useful, and services that might enhance PN. TRIAL REGISTRATIONS: clinicaltrials.gov identifiers: NCT00613275 , NCT00496678 , NCT00375024 , NCT01569672.
Authors: Pascal Jean-Pierre; Kevin Fiscella; Karen M Freund; Jack Clark; Julie Darnell; Alan Holden; Douglas Post; Steven R Patierno; Paul C Winters Journal: Cancer Date: 2010-10-04 Impact factor: 6.860
Authors: Kristen J Wells; Cathy D Meade; Ercilia Calcano; Ji-Hyun Lee; Desiree Rivers; Richard G Roetzheim Journal: J Cancer Educ Date: 2011-12 Impact factor: 2.037
Authors: Kevin Fiscella; Sean Ransom; Pascal Jean-Pierre; David Cella; Kevin Stein; Joseph E Bauer; Rebecca Crane-Okada; Sharon Gentry; Rosalie Canosa; Tenbroeck Smith; Jean Sellers; Emilia Jankowski; Karyn Walsh Journal: Cancer Date: 2011-08 Impact factor: 6.860
Authors: Samantha Hendren; Jennifer J Griggs; Ronald M Epstein; Sharon Humiston; Sally Rousseau; Pascal Jean-Pierre; Jennifer Carroll; Amanat M Yosha; Starlene Loader; Kevin Fiscella Journal: BMC Cancer Date: 2010-10-13 Impact factor: 4.430
Authors: Kristen J Wells; Kevin Campbell; Ambuj Kumar; Tatianna Clark; Pascal Jean-Pierre Journal: Support Care Cancer Date: 2018-03-01 Impact factor: 3.603
Authors: Patricia A Valverde; Elizabeth Calhoun; Angelina Esparza; Kristen J Wells; Betsy C Risendal Journal: Transl Behav Med Date: 2018-05-23 Impact factor: 3.046
Authors: Mona N Fouad; Aras Acemgil; Sejong Bae; Andres Forero; Nedra Lisovicz; Michelle Y Martin; Gabriela R Oates; Edward E Partridge; Selwyn M Vickers Journal: J Oncol Pract Date: 2016-05-17 Impact factor: 3.840
Authors: Pascal Jean-Pierre; Ying Cheng; Kristen J Wells; Karen M Freund; Frederick R Snyder; Kevin Fiscella; Alan E Holden; Electra D Paskett; Donald J Dudley; Melissa A Simon; Patricia A Valverde Journal: Cancer Date: 2016-02-05 Impact factor: 6.860
Authors: A R Gagliardi; G Honein-AbouHaidar; T Stuart-McEwan; J Smylie; A Arnaout; J Seely; F C Wright; M J Dobrow; M C Brouwers; K Bukhanov; D R McCready Journal: Eur J Cancer Care (Engl) Date: 2017-06-21 Impact factor: 2.520