Engaging Care Partners In Breast Cancer Care And Communication.

JOURNAL OF CLINICAL ONCOLOGY(2019)

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摘要
11614 Background: Family is often overlooked in cancer care. Little is known about the patient preferences for involving family in communication, whether preferences may be elicited and supported at the point of care, and impact on care quality. Methods: We conducted a two-group pilot randomized controlled trial (NCT03283553) of patients on active treatment for breast cancer and the “care partner” who accompanies them to routine visits (n = 132 dyads). Intervention dyads (n = 69) completed a self-administered checklist to clarify the care partner role, establish a shared visit agenda, and facilitate access to the electronic health record (MyChart) patient portal. Control dyads (n = 63) received usual care. Intervention acceptability and short-term effects were assessed from post-visit surveys and MyChart utilization at 6 weeks. Results: At baseline, most patients (89.4%) but few care partners (1.5%) were registered for MyChart. Most patients (79.4%) wanted their care partner to have access to their records and 39.4% of care partners reported accessing it in the past year using the patient’s account login/password. In completing the checklist, intervention patients and care partners identified an active communication role for the care partner and similar issues for the visit agenda: topics most frequently selected were treatment goals/expectations (75.4% & 66.7%, respectively), symptoms/side effects (73.9% & 62.3%) and chances of cancer recurrence/spread (49.3% & 44.9%). More than 90% of intervention participants reported that completing the checklist was easy, useful, and recommended it to others. At 6 weeks, intervention (vs control) care partners were more likely to be registered for MyChart (75.4 % vs 1.6%; p < 0.001), to have logged in (43.5% vs 0%; p < 0.001) and viewed clinical visit notes (30.4% vs 0%; p < 0.001), but no more likely to have exchanged direct messages with the clinical team (1.5% vs 0%; p = 0.175). No difference in patient MyChart registration, use, or messaging was found at 6 weeks, but intervention patients more often viewed clinical visit notes (50.7% vs 9.5%; p < 0.001). Conclusions: A self-administered patient-family communication intervention affected online practices of patients and cancer care partners. Follow-up continues. Clinical trial information: NCT03283553.
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