MP51-10 PROSTATE CANCER NAVIGATION AND TIME TO TREATMENT

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life & Shared Decision Making II1 Apr 2018MP51-10 PROSTATE CANCER NAVIGATION AND TIME TO TREATMENT Emily C. Serrell, Moritz Hansen, Andrew Perry, Melanie Feinberg, Tracy Robbins, Scot Remick, Lisa Beaule, Tom Kinkead, Paul K.J. Han, and Jesse D. Sammon Emily C. SerrellEmily C. Serrell More articles by this author , Moritz HansenMoritz Hansen More articles by this author , Andrew PerryAndrew Perry More articles by this author , Melanie FeinbergMelanie Feinberg More articles by this author , Tracy RobbinsTracy Robbins More articles by this author , Scot RemickScot Remick More articles by this author , Lisa BeauleLisa Beaule More articles by this author , Tom KinkeadTom Kinkead More articles by this author , Paul K.J. HanPaul K.J. Han More articles by this author , and Jesse D. SammonJesse D. Sammon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1641AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patient navigation has been shown to decrease time to diagnosis and treatment of several solid-organ malignancies. However, little is known about the effect of navigation on prostate cancer care. In 2008 our health system developed a navigation program to reduce barriers to treatment and facilitate shared decision making in a prostate cancer population. We hypothesized that navigation would decrease time to treatment or decision of active surveillance. METHODS All men diagnosed with localized prostate cancer between 2009 and 2015 were abstracted from a multi-specialty tumor registry. Duration from diagnosis to treatment or decision of surveillance was divided into quartiles. Multivariable regression analyses and Cox proportional hazards regressions controlling for patient-, disease-, and system-level factors were performed. Interaction terms evaluated the relationship between navigation, time to treatment, and patient- and disease- factors. RESULTS Of the patient population (n=1,587), 85% of men were navigated, and the median duration from diagnosis to treatment decision was 77 days (IQR: 49-110). In the top quartile of time to care (n=410), median duration was 140 days (IQR: 120-183). Factors associated with time to treatment are in Table. Navigation was significantly associated with longer time to treatment (OR=1.65, 95% CI 1.12-2.45). Interaction terms demonstrated that the relationships between navigation and time to care was independent and not moderated by cancer risk, travel distance, income, insurance, or treatment type. CONCLUSIONS The patient navigator identified and removed potential barriers to prostate cancer care. Notwithstanding, navigation was associated with longer time to treatment. This may reflect clinically appropriate delays associated with greater shared decision-making and consultation with multiple specialists. Unlike other solid-organ cancers, time to treatment may not be the ideal metric for evaluating navigation in prostate cancer; shared decision-making, patient satisfaction, and psychosocial outcomes may be more appropriate. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e688-e689 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Emily C. Serrell More articles by this author Moritz Hansen More articles by this author Andrew Perry More articles by this author Melanie Feinberg More articles by this author Tracy Robbins More articles by this author Scot Remick More articles by this author Lisa Beaule More articles by this author Tom Kinkead More articles by this author Paul K.J. Han More articles by this author Jesse D. Sammon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...