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Can patient navigation improve receipt of recommended breast cancer care? Evidence from the National Patient Navigation Research Program.

ABSTRACT: Poor and underserved women face barriers in receiving timely and appropriate breast cancer care. Patient navigators help individuals overcome these barriers, but little is known about whether patient navigation improves quality of care. The purpose of this study is to examine whether navigated women with breast cancer are more likely to receive recommended standard breast cancer care.Women with breast cancer who participated in the national Patient Navigation Research Program were examined to determine whether the care they received included the following: initiation of antiestrogen therapy in patients with hormone receptor-positive breast cancer; initiation of postlumpectomy radiation therapy; and initiation of chemotherapy in women younger than age 70 years with triple-negative tumors more than 1 cm. This is a secondary analysis of a multicenter quasi-experimental study funded by the National Cancer Institute to evaluate patient navigation. Multiple logistic regression was performed to compare differences in receipt of care between navigated and non-navigated participants.Among participants eligible for antiestrogen therapy, navigated participants (n = 380) had a statistically significant higher likelihood of receiving antiestrogen therapy compared with non-navigated controls (n = 381; odds ratio [OR], 1.73; P = .004) in a multivariable analysis. Among the participants eligible for radiation therapy after lumpectomy, navigated participants (n = 255) were no more likely to receive radiation (OR, 1.42; P = .22) than control participants (n = 297).We demonstrate that navigated participants were more likely than non-navigated participants to receive antiestrogen therapy. Future studies are required to determine the full impact patient navigation may have on ensuring that vulnerable populations receive quality care.

SUBMITTER: Ko NY

PROVIDER: S-EPMC4145185 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Can patient navigation improve receipt of recommended breast cancer care? Evidence from the National Patient Navigation Research Program.

Ko Naomi Y NY Darnell Julie S JS Calhoun Elizabeth E Freund Karen M KM Wells Kristin J KJ Shapiro Charles L CL Dudley Donald J DJ Patierno Steven R SR Fiscella Kevin K Raich Peter P Battaglia Tracy A TA

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20140728 25

<h4>Purpose</h4>Poor and underserved women face barriers in receiving timely and appropriate breast cancer care. Patient navigators help individuals overcome these barriers, but little is known about whether patient navigation improves quality of care. The purpose of this study is to examine whether navigated women with breast cancer are more likely to receive recommended standard breast cancer care.<h4>Patients and methods</h4>Women with breast cancer who participated in the national Patient Na ...[more]

PMID: 25071111

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Project description:BackgroundBirthing individuals experience significant physical and psychosocial transitions during the postpartum period. Despite amplified health needs, many individuals do not successfully transition from obstetric to primary care. Patient navigation provides a patient-centered solution that has been applied to other health care specialties resulting in improved care coordination and patient engagement for populations in greatest need. Our objective was to understand primary care clinician perspectives regarding the role of navigators in improving postpartum care for individuals with low income.MethodsIn this qualitative investigation, we conducted focus groups with primary care clinicians from family and internal medicine specialties. Semistructured interview guides addressed clinician perceptions of navigator roles during the postpartum period and recommendations for navigator training. Focus group discussions were digitally recorded, transcribed, and analyzed via a constant comparative method.ResultsTwenty-eight primary care clinicians, including 26 physicians and 2 advanced practice registered nurses, participated in 8 focus groups. Participants reported favorable attitudes toward implementation of a postpartum patient navigation program. Themes regarding useful navigation services included streamlining obstetric to primary care transition, enhancing visit effectiveness, creating personalized postpartum care, and providing patient- and clinician-focused education. Recommendations for navigator training included education on basic medical concerns that are common in the postpartum period, health information privacy and electronic health record use, health care systems, and community resources.Clinical Trial Registration number: NCT03922334.ConclusionsPrimary care clinicians were highly receptive to the concept of patient navigation as a process to improve health in the postpartum period through enhanced care coordination and improved patient knowledge, engagement, and self-efficacy.

Dataset Information

Can patient navigation improve receipt of recommended breast cancer care? Evidence from the National Patient Navigation Research Program.

Publications

Can patient navigation improve receipt of recommended breast cancer care? Evidence from the National Patient Navigation Research Program.

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