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Purpose We examined racial and ethnic disparities in patient-provider communication (PPC), perceived care quality, and patient activation among long-term cancer survivors. Methods In 2005 to 2006, survivors of breast, prostate, colorectal, ovarian, and endometrial cancers completed a mailed survey on cancer follow-up care. African American, Asian/Pacific Islander (Asian), Hispanic, and non-Hispanic white (white) survivors who had seen a physician for follow-up care in the past 2 years (n = 1,196) composed the analytic sample. We conducted linear and logistic regression analyses to identify racial and ethnic differences in PPC (overall communication and medical test communication), perceived care quality, and patient activation in clinical care (self-efficacy in medical decisions and perceived control). We further examined the potential contribution of PPC to racial and ethnic differences in perceived care quality and patient activation. Results Compared with white survivors (mean score, 85.16), Hispanic (mean score, 79.95) and Asian (mean score, 76.55) survivors reported poorer overall communication (P = .04 and P < .001, respectively), and Asian survivors (mean score, 79.97) reported poorer medical test communication (P = .001). Asian survivors were less likely to report high care quality (odds ratio, 0.47; 95% CI, 0.30 to 0.72) and reported lower self-efficacy in medical decisions (mean score, 74.71; P < .001) compared with white survivors (mean score, 84.22). No disparity was found in perceived control. PPC was positively associated with care quality (P < .001) and self-efficacy (P < .001). After adjusting for PPC and other covariates, when compared with whites, Asian disparities remained significant. Conclusion Asian survivors report poorer follow-up care communication and care quality. More research is needed to identify contributing factors beyond PPC, such as cultural influences and medical system factors.

14 Background: Cancer patients often have multiple chronic conditions and require complex care coordination. We compared older (ages 66+) cancer patients’ reports of their healthcare experiences based on level of multimorbidity. Methods: Data from the SEER-CAHPS combines cancer registry (Surveillance, Epidemiology, and End Results; SEER), patient experiences (Consumer Assessment of Healthcare Providers and Systems; CAHPS) and Medicare claims data. Multimorbidity was captured as: (1) the National Cancer Institute-Combined Comorbidity Index (NCCI, 16 Charlson conditions diagnosed ≤12 months prior to cancer); and (2) a Multimorbidity Burden Index (MBI), which categorizes conditions based on the impact to cancer treatment (no comorbidity, low/medium, and high). Outcomes were CAHPS patient experience measures: Doctor Communication, Getting Care Quickly, Getting Needed Care, Obtaining Prescription Drugs, Customer Service, and ratings of Overall Care, Personal Doctor, and Specialist. Multivariable linear regression provided associations of each multimorbidity measure with CAHPS measures controlling for standard case mix adjustors, years from diagnosis to survey and diagnostic stage. Results: The study cohort included 9305 cancer patients (53% male, 84% Non-Hispanic White, average age 77, average time from diagnosis 29 months), with a distribution of NCCI conditions as: 0 (cancer only), 73%; 1, 17%; ≥2, 10%. Cancer patients with NCCI = 0 and those with MBI = no comorbidity rated their Personal Doctor more negatively than those with any comorbidities ( p < 0.02). Those with NCCI ≥ 2 or MBI = low/medium reported better Doctor Communication ( p < 0.04). Those with high MBI rated their specialist physician better than those with no multimorbidity ( p = 0.04), and those with low/medium MBI reported better experiences Getting Care Quickly ( p = 0.02). No other associations were significant. Conclusions: Cancer patients with multimorbidity report better communication with their doctor and care = by = personal doctors and specialists. Increased attention to the care experiences of cancer patients with multimorbidity may lead to insights and interventions that benefit all cancer patients.

e18234Background: PCORI funds comparative clinical effectiveness research (CER) that aims to produce evidence-based information to help people make informed health care decisions and improve outcom...

6533 Background: Shared decision-making in cancer treatment is an important aspect of high-quality care and is associated with improved outcomes. However, patients have different preferences regard...

6509 Background: Clinical trials are essential for evaluating new cancer therapies, but less than 5% of adults with cancer enroll in trials. Barriers to enrollment may include patient-provider communication factors, such as lack of patient awareness or understanding about the option of participation. Methods: We surveyed a population- and practice-based sample of patients (or their surrogates) 3 to 6 months after diagnoses of lung or colorectal cancer. We assessed whether respondents learned that clinical trial participation might be an option, and if so, with whom they first discussed this possibility. We used multivariable logistic regression to assess the association of patient characteristics with clinical trial discussions and enrollment. Results: Of 7,887 respondents, 1,114 (14.1%) reported discussing clinical trial participation. Most (92.7% of participants, 75.8% of nonparticipants) learned about trials from their physicians. 287 patients (3.6% of all patients, 25.8% of trial discussants) enrolled...

6528 Background: Shared decision-making is an important component of patient-centered care and is associated with improved health outcomes. Little is known about patients’ involvement of family members in decisions about cancer treatments or whether family involvement varies by patient demographic or clinical characteristics. Methods: Data for this study were collected as part of the Cancer Care Outcomes Research and Surveillance (CanCORS) study, a large multi-regional prospective cohort study of cancer care and outcomes of lung and colorectal cancer patients. Patients were surveyed about the roles of their families in decisions about surgery, radiation, and/or chemotherapy. We used multinomial logistic regression to identify patient factors independently associated with family roles in decisions. Results: Among 5284 patients, 28.5% reported little or no family input in decisions, 22.1% reported making decisions after considering the family’s opinion, 47.9% reported the patient and family made decisions together, and 1.5% reported the family made decisions. In adjusted analyses, married, female, older, and insured patients were more likely to report making decisions with their family (all P

9130 Background: Several studies have documented the negative impact of chemotherapy on patients’ cognitive functioning. However, this concern has been understudied among non-Hodgkin Lymphoma (NHL) survivors. Methods: We analyzed survey data from a population-based study of survivors diagnosed with aggressive NHL in Los Angeles County 2-5 years prior to the study; data were collected between 2003-2005. We assessed prevalence of cognitive symptoms (CS) by a single item screener that asked if in the past 6 months survivors experienced problems with memory, attention, or concentration; if yes, we asked if they discussed the problem with a doctor. Frequency of CS was assessed by a 4 item scale that measured how often survivors experienced different CS in the past 4 weeks (none, a little, some, most, all the time). Logistic regression analyses identified correlates of reporting CS (yes/no) as well as discussion with a doctor (yes/no). Analyses were based on data from 358 survivors who had received chemotherapy and saw a doctor for follow-up care in the past year. Results: 134/358 survivors (37%) reported CS, many reporting difficulty some, most, or all the time with memory (64%), attention (58%), concentration (57%), and problem solving (46%). Survivors with higher education, who were not married/partnered, and who had more comorbidities were more likely to report CS (p

6540 Background: The Institute of Medicine recommends that the health care system consider both primary and specialty care models in delivering follow-up care to cancer survivors. Methods: Colorect...