Effect of patient navigation on satisfaction with cancer-related care

Kristen J Wells; Paul C Winters; Pascal Jean-Pierre; Victoria Warren-Mears; Douglas Post; Mary Ann S Van Duyn; Kevin Fiscella; Julie Darnell; Karen M Freund; Patient Navigation Research Program Investigators

doi:10.1007/s00520-015-2946-8

Effect of patient navigation on satisfaction with cancer-related care

Support Care Cancer. 2016 Apr;24(4):1729-53. doi: 10.1007/s00520-015-2946-8. Epub 2015 Oct 5.

Authors

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; Patient Navigation Research Program Investigators

Collaborators

Patient Navigation Research Program Investigators:
Martha Hare, Mollie Howerton, Ken Chu, Emmanuel Taylor, Mary Ann Van Duyn, Paul Young, Frederick Snyder, Kathy Parillo, Karen Freund, Tracy Battaglia, Sharon Bak, Bonnie Sherman, Sarah Karon, Richard Kalish, Nisha Thrakar, James Taylor, Stephen Tringale, Patrick Egan, Barbara Lottero, Walter Phinney, Peter Raich, Elizabeth Whitley, Patricia Valverde, Diane Fairclough, William Thorland, Lina Escobar, Kristin Kilbourn, Besty Risendahl, Rachel Everhart, Evelinn Borrayo, Tim Byers, Hermenia Arambula, Inna Pines, Carol Spitz, Jesus Tovar, Steven Patierno, Lisa Alexander, Paul Levine, Heather Young, Heather Hoffman, Nancy LaVerda, Larisa Caicedo, William Funderburk, Elmer Huerta, Jeanne Mandelblatt, Jennifer Eng-Wong, Sandra Swain, Wayne Frederick, Felicia Buadoo-Adade, Richard Roetzheim, Cathy Meade, Kristen Wells, Ercilia Calcano, Ji-Hyun Lee, William Fulp, Marlene Rivera, Victoria Warren-Mears, Matthew Town, Jenine Dankovchik, Meagan Cahn, Robert H Lurie, Steven Rosen, Melissa Simon, Narissa Nonzee, June McKoy, Electra Paskett, Douglas Post, Mira Katz, David Murray, Cathy Tatum, Cecilia DeGraffinreid, Gregory Young, Melissa Gorsline, Elizabeth Calhoun, Julie Darnell, Julia Shklovskaya, Mickey Eder, Young Cho, Talar Markossian, Kevin Fiscella, Samantha Hendren, Jennifer Carroll, Ronald Epstein, Jennifer Griggs, Sharon Humiston, Pascal Jean-Pierre, Starlene Loader, Vi Luong, Sally Rousseau, Charcy Salamone, Michele Sanders, Bonnie Schwartzbauer, Amanat Yosha, Donald Dudley, Joan Drake, Kevin Hall, Alan Holden, Anand Karnard, Amelie Ramirez, Jennie Quinlan, Pam Saegert

Affiliations

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.

Keywords: Cancer-related care; Disparities; Patient navigation; Patient navigator; Patient satisfaction.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Female
Humans
Male
Middle Aged
Neoplasms / therapy*
Patient Navigation / methods*
Patient Satisfaction

Associated data

ClinicalTrials.gov/NCT00375024
ClinicalTrials.gov/NCT00496678
ClinicalTrials.gov/NCT00613275
ClinicalTrials.gov/NCT01569672

Abstract

Publication types

MeSH terms

Associated data

Grants and funding