Patient-provider communication during post-treatment breast cancer care: Findings from a pilot project

91 Background: Patient-provider communication is essential to delivering high quality cancer care, including post-treatment when survivors have many complex care needs. In this study, we used data collected for quality improvement from a small, feasibility sample to examine patient perceptions of provider communication and inform the development of a new Oncology Survivorship Clinic model. Methods: As part of a pilot project conducted at Kaiser Permanente Northern California (KPNC), we surveyed 51 breast cancer patients post-treatment. The survey included a communication measure from the 2011 Medical Expenditure Panel Survey (MEPS) Experiences with Cancer survey evaluating provider discussions of: surveillance for recurrence; late or long-term treatment effects; healthy lifestyle behaviors; and emotional or social needs. We also examined reports of the six core functions of patient-centered communication (i.e. managing uncertainty, responding to emotions, making decisions, fostering healing relationships, enabling self-management, and exchanging information) using a measure from the Health Information Trends Survey (HINTS) survey. Part of the purpose was to evaluate acceptability of a new Oncology Survivorship Clinic utilizing non-physician providers. Results: The sample included 51 breast cancer patients surveyed in 2016 within six months of treatment completion. Overall, sizable proportions received detailed communication about surveillance (65%), treatment side effects (46%), emotional needs (41%), and healthy lifestyles (71%) and the majority received patient-centered communication (range: 60-73% based on core function). Particular gaps were noted related to provider communication about treatment side effects (54%), emotional/social needs (59%), managing uncertainty (35%), and responding to emotions (40%). Conclusions: Our very preliminary findings suggest that the majority of women had positive communication experiences, including with non-physician providers. However, clear communications gaps existed underscoring future avenues for research and care delivery interventions to address the comprehensive needs of breast cancer patients.