Health
Care sequence models with follow-up improve breast cancer advance directive completion rates
The results show that most patient groups are time-sensitive by using appropriate information / care / patient / time (4R care sequence) care planning and delivery models in combination with health educator follow-up. Improved proactive (AD) completion rate Results of studies presented at the 2022 ASCO Annual Meeting.
AD is an important aspect of care planning, but there is a lack of effective tools to improve AD rates in patients undergoing breast cancer surgery.
This quality improvement project conducted a 4R oncology intervention at a community-based center. The intervention consisted of a multimodal 4R care sequence plan with a follow-up workflow. Patients with newly diagnosed non-metastatic breast cancer (140 patients) who were undergoing surgical treatment between October 2019 and September 2020 received conventional treatment. Patients (141 patients) who received surgical treatment between October 2020 and September 2021 received 4R oncology intervention. AD completion rates were compared between cohorts.
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Baseline demographic and clinical features were balanced across cohorts.
AD completion rate improved from 15% with normal care to 73.8% with intervention (P <.01).
Interventions stratified by patient characteristics were associated with improved AD completion in Caucasians (76% vs. 16%). P <.01), Asian or Pacific Islanders (80% vs 17%; P <.01), and black (79% vs 17%; P = .019) Patient. It did not reach significance among Hispanic patients (27% vs 5%) or patients of other ethnic groups (67% vs 20%), probably due to the small sample size.
No significant trend in AD completion between intervention cohorts, stratified by level of distress, was observed among patients with high or low levels of distress.
The authors of the study concluded that providing a 4R care sequence with follow-up by health educators improved AD completion in breast cancer patients undergoing surgical treatment. This type of intervention may be an effective tool to ensure a standardized delivery of equitable care.
Disclosure: Some authors have declared partnerships with biotechnology, pharmaceutical, and / or device companies. See the original reference for a complete list of disclosures.
reference
Ossowski S, Lyon L, Linehan ES, etc. Increased advance directive completion within 4R oncology models of preoperative breast cancer patients in racially diverse patient populations.. JClin Oncol. 2022; 40 (suppl 16; abstr e13511). doi: 10.1200 / JCO.2022.40.16_suppl.e13511
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