The Patient Navigator: Can a systematically developed online health information tool improve patient participation and outcomes related to the consultation in older patients newly diagnosed with colorectal cancer?

Abstract

Background Older cancer patients may search for health information online to prepare for their consultations. However, seeking information online can have negative effects, for instance increased anxiety due to finding incorrect or unclear information. In addition, existing online cancer information is not necessarily adapted to the needs of older patients, even though cancer is a disease often found in older individuals. Objective The aim of this study was to systematically develop, implement and evaluate an online health information tool for older cancer patients, the Patient Navigator, providing information that complements the consultation with healthcare providers. Method For the development and evaluation of the Patient Navigator, the four phases of the MRC framework were used. In the first and second phase the Patient Navigator was developed and pilot tested based on previous research and sub-studies. During the third phase the Patient Navigator was implemented in four Dutch hospitals. In the last phase, a pilot RCT was conducted to evaluate the Patient Navigator in terms of usage (observational tracking data), user experience (self-reported satisfaction, involvement, cognitive load, active control, perceived relevance of the tool), patient participation (observational data during consultation), and patient outcomes related to the consultation (questionnaire data regarding anxiety, satisfaction, and information recall). Recently diagnosed colorectal cancer patients (N = 45) were randomly assigned to the control condition (usual care) or the experimental condition (usual care + Patient Navigator). Results The Patient Navigator was well used and evaluated positively. Patients who received the Patient Navigator contributed less during the consultation by using less words than patients in the control condition and experienced less anxiety two days after the consultation than patients in the control condition. Conclusion Since the Patient Navigator was evaluated positively and decreased anxiety after the consultation, this tool is potentially a valuable addition to the consultation for patients. Usage of the Patient Navigator resulted in patients using less words during consultations, without impairing patients’ satisfaction, possibly because information needs might be fulfilled by usage of the Patient Navigator. This could create the possibility to personalize communication during consultations and respond to other patient needs.

Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature

“…Across these studies, five reported using technology other than email or telephone calls. This included Google Hangouts and WhatsApp, 95 an online patient navigation tool, 96 social media and phone applications, 97 Zoom, 98 and web‐based tool and video conferencing 99 . Four implementation and feasibility studies were also included 95,100–102 .…”

“…One study found that using caregiver navigators in combination with web‐based tools could connect participants to existing social support services, resulting in valued discussions with patients 99 . Another study indicated that using an online patient navigator tool to complement the information provided during a consultation with a health care provider resulted in increased patient satisfaction, with lower reported anxiety levels 96 . Finally, a study on navigation delivered by telemedicine (with the mode of delivery depending on patient preference) was identified as feasible and useful in a resource‐limited setting 95 .…”

“…Seven studies assessed the effects of patient navigation on psychosocial outcomes, such as quality of life, distress, satisfaction, anxiety, and depression. 96,[120][121][122][123][124][125] Two studies showed no significant effects of patient navigation on health-related quality of life or distress, 120,122 whereas the remaining five studies showed improvements in quality of life and psychological well-being after patient navigation. 96,121,[123][124][125] Studies also focused on the effects on screening knowledge, stigmas, and access to care.…”

“…96,[120][121][122][123][124][125] Two studies showed no significant effects of patient navigation on health-related quality of life or distress, 120,122 whereas the remaining five studies showed improvements in quality of life and psychological well-being after patient navigation. 96,121,[123][124][125] Studies also focused on the effects on screening knowledge, stigmas, and access to care. 114,126 Patient navigation resulted in improved access to supportive cancer care, completion of advanced care directives, and pain symptoms.…”

Improving online resources for cytoreductive surgery and HIPEC by engaging patients

“…Moreover, another recent study has provided older patients with colorectal cancer with a self-tailored online health information tool to navigate treatment options and has reported improved patient participation and decreased anxiety following consultation. 6 By providing engaging online platforms that complement consultation with providers, such decision aids provide patients with an opportunity for interactive and durable knowledge building to make well-considered medical decisions. These can serve as models for existing online medical information on CRS and HIPEC to follow.…”