Using patient navigation to improve cancer treatment satisfaction among elderly latinos in Houston

Previous research suggests patient navigation may increase compliance with cancer screening and treatment, increase patient satisfaction with treatment and decrease anxiety. In 2006, MD Anderson Cancer Center launched Facilitated Assistance Research and Outreach Services (FAROS) as part the Centers for Medicare and Medicaid Services Cancer Prevention and Treatment Demonstration project. The objective was to measurably improve cancer screening and treatment outcomes among Latino Medicare fee-for-service beneficiaries in Houston. Prospective participants were triaged, and those eligible were randomized into navigation (n=1,044) or control (n=1,040) groups in the screening (non-cancer) arm if they had not been diagnosed with cancer within five years, or into navigation (n=151) or control (n=148) groups in the treatment (cancer) arm if they had received cancer diagnosis/treatment within five years (for cancers of the breast, cervix, colon-rectum, prostate and lung). Nearly all (97.7%) participants were Latino; 58.8% were female; 74.9% were aged 65-84 years; 77.3% received high school or less education; 93.5% had household incomes below $50,000; and 53.5% reported speaking predominantly Spanish at home. There were no differences in pre-post outcomes between navigation/control group non-cancer participants with complete 12-month data for screening mammography (<= years for women 40+ years) or colonoscopy/sigmoidoscopy (<= years for men and women 50 to 75 years). Among cancer patients, however, while no baseline differences were present, 12-month post-intervention treatment satisfaction (those who were “very satisfied” or “satisfied”) was significantly higher among navigated patients v. control patients (OR: 8.5, p-value=0.047). Results suggest patient navigation may improve satisfaction with cancer treatment among vulnerable populations.