240812 Patient-clinician information engagement improves adherence to colorectal cancer surveillance after curative treatment: Results from a longitudinal study

Monday, October 31, 2011: 4:30 PM

Andy Tan, MBBS, MPH, MBA , Annenberg School for Communication at University of Pennsylvania, Philadelphia, PA
Mihaela Moldovan-Johnson, PhD , Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
Sarah Parvanta, MPH , Annenberg School of Communication, University of Pennsylvania, Philadelphia, PA
Stacy W. Gray, MD, MA , Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, MA
Katrina Armstrong, MD, MSCE , Director, Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
Robert Hornik, PhD , Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
Background: Cancer surveillance after curative treatment for colorectal cancer (CRC) patients is recommended to detect early cancer recurrences or new primary lesions. While CRC surveillance can improve overall survival, a substantial proportion of CRC patients do not undergo cancer surveillance. The patient-centered communication framework proposes that patient-clinician interaction can positively influence cancer patients' short and long-term health outcomes. However, communication between patients and their clinicians has thus far not been studied as a determinant for patients undergoing cancer surveillance after curative treatment.

Objective: To determine whether baseline patient clinician information engagement (PCIE) predicts CRC patients' subsequent self-reported adherence to recommended surveillance procedures.

Methods: The study was a longitudinal survey among Pennsylvanian patients diagnosed with colorectal, breast, or prostate cancer in 2005. CRC patients who were eligible for surveillance and participated in both the baseline and one-year follow-up surveys were included in this analysis (n=305). The outcome measure was participants' self-reported adherence to guideline-recommended frequency of physical examinations, CEA testing, and colonoscopy in the 12 months preceding the follow-up survey.

Results: Controlling for potential confounders, higher PCIE at baseline predicted increased odds of CRC patients reporting adherence to recommended surveillance at one-year follow-up (OR=2.38, SE=.78, p-value=.008). Other significant predictors of adhering to recommended surveillance were higher education level, Stage II or III cancer, and frequency of CRC-related physician visits.

Conclusions: Greater patient engagement with clinicians about cancer-related information improved CRC patients' subsequent adherence to recommended surveillance. This finding has important implications for encouraging increased patient-physician communication among CRC patients.

Learning Areas:
Communication and informatics
Other professions or practice related to public health
Social and behavioral sciences

Learning Objectives:
1. Describe the concept of patient-clinician information engagement (PCIE) in a population-based sample of cancer patients. 2. Analyze the relationship between colorectal cancer patients' information engagement with their clinicians and subsequent adherence to cancer surveillance. 3. Discuss the clinical and research implications of the association between PCIE and adherence to cancer surveillance.

Keywords: Communication Effects, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I formulated the research question, performed the statistical analyses, and prepared the abstract for submission.
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.