Do community-based patient assistance programs affect the treatment and well-being of patients with breast cancer?

Nina A. Bickell, Andrea N. Geduld, Kathie Ann Joseph, Joseph A. Sparano, M. Margaret Kemeny, Soji Oluwole, Tehillah Menes, Anitha Srinivasan, Rebeca Franco, Kezhen Fei, Howard Leventhal

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Purpose: Patients with breast cancer who need adjuvant treatments often fail to receive them. High-quality, community-based patient-assistance programs are an underused, inexpensive resource to help patients with cancer obtain needed therapy. We sought to determine whether connecting women to patient-assistance programs would reduce underuse of adjuvant therapies. Methods: We conducted a randomized trial of 374 women (190 assigned intervention [INT], 184 to usual care [UC]) with early-stage breast cancer who underwent surgery between October 2006 and August 2009. After initial needs assessment, individualized action plans were created to connect INT patients with targeted patient-assistance programs; UC patients received an informational pamphlet. Main outcome measures were receiving adjuvant treatment and obtaining help. Results: High rates of INT and UC patients received treatment: 87% INT versus 91% UC women who underwent lumpectomy received radiotherapy (P = .39); 93% INT versus 86% UC women with estrogen receptor (ER) -negative tumors ≥ 1 cm received chemotherapy ( P = .42); 92% INT versus 93% UC women with ER-positive tumors ≥ 1 cm received hormonal therapy (P = .80). Many women reported needs: 63% had informational; 55%, psychosocial; and 53%, practical needs. High rates of INT patients with needs connected with a program within 2 weeks (92%). At 6 months, INT and UC women used patient-assistance programs at similar rates (75% v 76%; P = .54). Women with informational or psychosocial needs were more likely to receive help (relative risk [RR], 1.77; 95% CI, 1.51 to 1.90 and RR, 1.37; 95% CI, 1.06 to 1.61, respectively). Conclusion: INT and UC patients received high rates of adjuvant treatment regardless of trial assignment. Patients with breast cancer who connect to relevant patient assistance programs receive useful informational and psychosocial but not practical help.

Original languageEnglish (US)
Pages (from-to)48-54
Number of pages7
JournalJournal of Oncology Practice
Volume10
Issue number1
DOIs
StatePublished - 2014
Externally publishedYes

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Breast Neoplasms
Therapeutics
Patient Care
Estrogen Receptors
Neoplasms
Pamphlets
Segmental Mastectomy
Needs Assessment
Radiotherapy
Outcome Assessment (Health Care)
Drug Therapy

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy
  • Medicine(all)

Cite this

Do community-based patient assistance programs affect the treatment and well-being of patients with breast cancer? / Bickell, Nina A.; Geduld, Andrea N.; Joseph, Kathie Ann; Sparano, Joseph A.; Kemeny, M. Margaret; Oluwole, Soji; Menes, Tehillah; Srinivasan, Anitha; Franco, Rebeca; Fei, Kezhen; Leventhal, Howard.

In: Journal of Oncology Practice, Vol. 10, No. 1, 2014, p. 48-54.

Research output: Contribution to journalArticle

Bickell, NA, Geduld, AN, Joseph, KA, Sparano, JA, Kemeny, MM, Oluwole, S, Menes, T, Srinivasan, A, Franco, R, Fei, K & Leventhal, H 2014, 'Do community-based patient assistance programs affect the treatment and well-being of patients with breast cancer?', Journal of Oncology Practice, vol. 10, no. 1, pp. 48-54. https://doi.org/10.1200/JOP.2013.000920
Bickell, Nina A. ; Geduld, Andrea N. ; Joseph, Kathie Ann ; Sparano, Joseph A. ; Kemeny, M. Margaret ; Oluwole, Soji ; Menes, Tehillah ; Srinivasan, Anitha ; Franco, Rebeca ; Fei, Kezhen ; Leventhal, Howard. / Do community-based patient assistance programs affect the treatment and well-being of patients with breast cancer?. In: Journal of Oncology Practice. 2014 ; Vol. 10, No. 1. pp. 48-54.
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abstract = "Purpose: Patients with breast cancer who need adjuvant treatments often fail to receive them. High-quality, community-based patient-assistance programs are an underused, inexpensive resource to help patients with cancer obtain needed therapy. We sought to determine whether connecting women to patient-assistance programs would reduce underuse of adjuvant therapies. Methods: We conducted a randomized trial of 374 women (190 assigned intervention [INT], 184 to usual care [UC]) with early-stage breast cancer who underwent surgery between October 2006 and August 2009. After initial needs assessment, individualized action plans were created to connect INT patients with targeted patient-assistance programs; UC patients received an informational pamphlet. Main outcome measures were receiving adjuvant treatment and obtaining help. Results: High rates of INT and UC patients received treatment: 87{\%} INT versus 91{\%} UC women who underwent lumpectomy received radiotherapy (P = .39); 93{\%} INT versus 86{\%} UC women with estrogen receptor (ER) -negative tumors ≥ 1 cm received chemotherapy ( P = .42); 92{\%} INT versus 93{\%} UC women with ER-positive tumors ≥ 1 cm received hormonal therapy (P = .80). Many women reported needs: 63{\%} had informational; 55{\%}, psychosocial; and 53{\%}, practical needs. High rates of INT patients with needs connected with a program within 2 weeks (92{\%}). At 6 months, INT and UC women used patient-assistance programs at similar rates (75{\%} v 76{\%}; P = .54). Women with informational or psychosocial needs were more likely to receive help (relative risk [RR], 1.77; 95{\%} CI, 1.51 to 1.90 and RR, 1.37; 95{\%} CI, 1.06 to 1.61, respectively). Conclusion: INT and UC patients received high rates of adjuvant treatment regardless of trial assignment. Patients with breast cancer who connect to relevant patient assistance programs receive useful informational and psychosocial but not practical help.",
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AU - Menes, Tehillah

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N2 - Purpose: Patients with breast cancer who need adjuvant treatments often fail to receive them. High-quality, community-based patient-assistance programs are an underused, inexpensive resource to help patients with cancer obtain needed therapy. We sought to determine whether connecting women to patient-assistance programs would reduce underuse of adjuvant therapies. Methods: We conducted a randomized trial of 374 women (190 assigned intervention [INT], 184 to usual care [UC]) with early-stage breast cancer who underwent surgery between October 2006 and August 2009. After initial needs assessment, individualized action plans were created to connect INT patients with targeted patient-assistance programs; UC patients received an informational pamphlet. Main outcome measures were receiving adjuvant treatment and obtaining help. Results: High rates of INT and UC patients received treatment: 87% INT versus 91% UC women who underwent lumpectomy received radiotherapy (P = .39); 93% INT versus 86% UC women with estrogen receptor (ER) -negative tumors ≥ 1 cm received chemotherapy ( P = .42); 92% INT versus 93% UC women with ER-positive tumors ≥ 1 cm received hormonal therapy (P = .80). Many women reported needs: 63% had informational; 55%, psychosocial; and 53%, practical needs. High rates of INT patients with needs connected with a program within 2 weeks (92%). At 6 months, INT and UC women used patient-assistance programs at similar rates (75% v 76%; P = .54). Women with informational or psychosocial needs were more likely to receive help (relative risk [RR], 1.77; 95% CI, 1.51 to 1.90 and RR, 1.37; 95% CI, 1.06 to 1.61, respectively). Conclusion: INT and UC patients received high rates of adjuvant treatment regardless of trial assignment. Patients with breast cancer who connect to relevant patient assistance programs receive useful informational and psychosocial but not practical help.

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