A randomized intervention involving family to improve communication in breast cancer care

Abstract

We examined the effects of a communication intervention to engage family care partners on patient portal (MyChart) use, illness understanding, satisfaction with cancer care, and symptoms of anxiety in a single-blind randomized trial of patients in treatment for breast cancer. Patient-family dyads were recruited and randomly assigned a self-administered checklist to clarify the care partner role, establish a shared visit agenda, and facilitate MyChart access (n = 63) or usual care (n = 55). Interviews administered at baseline, 3, 9 (primary endpoint), and 12 months assessed anxiety (GAD-2), mean FAMCARE satisfaction, and complete illness understanding (4 of 4 items correct). Time-stamped electronic interactions measured MyChart use. By 9 months, more intervention than control care partners registered for MyChart (77.8 % vs 1.8%; p < 0.001) and logged into the patient’s account (61.2% vs 0% of those registered; p < 0.001), but few sent messages to clinicians (6.1% vs 0%; p = 0.247). More intervention than control patients viewed clinical notes (60.3% vs 32.7%; p = 0.003). No pre-post group differences in patient or care partner symptoms of anxiety, satisfaction, or complete illness understanding were found. Intervention patients whose care partners logged into MyChart were more likely to have complete illness understanding at 9 months (changed 70.0% to 80.0% vs 69.7% to 54.6%; p = 0.03); symptoms of anxiety were numerically lower (16.7% to 6.7% vs 15.2% to 15.2%; p = 0.24) and satisfaction numerically higher (15.8–16.2 vs 18.0–17.4; p = 0.25). A brief, scalable communication intervention led to greater care partner MyChart use and increased illness understanding among patients with more engaged care partners (NCT03283553).

Effectiveness and moderators of cancer patient-caregiver dyad interventions in improving psychological distress: A systematic review and meta-analysis

“…They often focused on dyad coping 34 , 37 , 45 , 46 and communication. 31 , 39 , 40 , 42 Half of the studies examined face-to-face interventions ( k ​= ​14); five programs involved technology-based interventions, 31 , 35 , 37 , 43 , 47 while others involved telephone ( k ​= ​3).…”

The role of trust in the acceptance of adjuvant endocrine therapy in breast cancer patients

“…Mothers may be more likely to choose to take AET because they have an increased awareness of being needed. Prior studies observed an important role of patients' family members in treatment acceptance 33 . However, there is also research showing that the inner‐familiarly relationships are individual and complex, and they may be supportive as well as obstructive 34 .…”

“…Prior studies observed an important role of patients' family members in treatment acceptance. 33 However, there is also research showing that the innerfamiliarly relationships are individual and complex, and they may be supportive as well as obstructive. 34 Patients with a higher tumor stage (≥II) and, therefore, a worse prognosis tended to have a higher acceptance rate at the time of the data collection than patients with stage I BC.…”

Electronic Medical Record–Based Electronic Messaging Among Patients with Breast Cancer: A Systematic Review

“…However, no difference was detected in exchange of direct messages by patients or caretakers in the control and intervention groups. 32 The second study, also conducted by Wolff et al 33…”