224516 Improving treatment adherence of breast cancer multimodal patients through patient navigation

Monday, November 8, 2010

Winifred W. Thompson, PhD, MSW , Department of Behavioral Sciences and Health Education Rollins School of Public Health, Emory University Winship Cancer Institute at Grady Health System, Atlanta, GA
Ashwini Hardikar, MPH , Behavioral Sciences & Health Education, Emory University, Atlanta, GA
Paige Teller, MD , Department of Surgery, Medical University of South Carolina School of Medicine, Charleston, SC
Sheryl Gabram, MD , School of Medicine Department of Surgery Winship Cancer Institute, Emory University, Atlanta, GA
Tamara Mason, MPH, CHES , Behavioral Sciences & Health Education, Emory University, Atlanta, GA
Chryston Jones, MPH , Behavioral Sciences & Health Education, Emory University, Atlanta, GA
Kimberly Jacob Arriola, PhD, MPH , Behavioral Science and Health Education, Emory University Rollins School of Public Health, Atlanta, GA
Introduction: African American compared to white women in the U.S. are diagnosed with later stage breast cancer (BC), experience longer treatment delays, are less likely to receive/complete treatment according to recommended guidelines and have a 36% higher mortality rate. A Patient Navigation (PN) program can help patients overcome barriers to treatment adherence. As a Continuous Quality Improvement study at a large inner city cancer center hospital, this study documents the PN program's influence on compliance with two National Quality Forum (NQF) breast indicators: 1) chemotherapy discussed/administered for patients <70 years old (yo) with >1cm triple negative BC and 2) radiation therapy for patients <70 yo with Stage I-III BC treated with lumpectomy. Method: This cohort study consisted of 34 multimodal BC patients who were predominately low-income, African American, and referred to the PN program. PN services included phone support, home visits, appointment attendance, support groups and incentives. Data collection included demographics, preexisting health conditions, health risk behaviors, barriers to care and treatment recommendations. Patients were followed until treatment completion or failed compliance. Results: The standard of treatment (radiation and chemotherapy) compliance in 2006 was 74.4%, 75% respectively and the 2008 multimodal patients were 100%, 93% compliant, which was also higher than the 2008 overall BC patient adherence 95.8%, 93.7%. Conclusions: Higher rates of treatment adherence were obtained with the assistance of a PN program in at-risk, multimodal patients. These findings demonstrate the importance of PN program in eliminating barriers and disparities in the treatment of African American, multimodal BC patients.

Learning Areas:
Administer health education strategies, interventions and programs

Learning Objectives:
1. Participants will be able to define multimodality of breast cancer patients. 2. Participants will be able to identify factors that contribute to successful completion of breast cancer treatment. 3. Participants will be able to identify factors that interfere with the successful completion of breast cancer treatment. 4. Participants will be able to define a lay health model of service delivery.

Keywords: Breast Cancer Programs, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I was the Principal Investigator on the Multimodal breast cancer patient treatment adherence project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.