Effective Provider Communication Yields Better Cancer Outcomes, Lower Costs

Due to the complexity of treating cancer, how providers communicate essential information to their patients is crucial to improving health outcomes and lowering costs, according to a new study published in the Journal of National Comprehensive Cancer Network (JNCCN).

To highlight the pivotal role of patient-provider communication in cancer care, the American Cancer Society released a report tracking the association between patient communication satisfaction and health outcomes.

Researchers used data from the Medical Expenditure Panel Survey (MEPS) from 2008 through 2014 to analyze outcomes for 4588 cancer survivors. Survivors were stratified into 2 age groups: 2257 were between 18 to 64 years old and 2331 were 65 years and older.

Using a 4-point scale, patients reported their communication satisfaction ranging from “never” to “always” on whether providers:

1. Listened carefully.

2. Explained things in a way that was easy to understand.

3. Showed respect for what the respondent had to say.

4. Spent enough time with the respondent.

Communication satisfaction was measured by the Consumer Assessment of Healthcare Providers and Systems, in conjunction with the MEPS data. The researchers also factored in a global 0-to-10 satisfaction rating scale into a composite score that was tracked across 12 months. Outcomes were measured based on the number of emergency department visits, office visits, and total health care spending (including medication and out-of-pocket costs).

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Across all ages, patients with better baseline health reported higher satisfaction levels. The researchers noted that this suggests more complex circumstances negatively impacted patients’ perception of communication. Additionally, patients with more comorbidities reported lower satisfaction ratings, indicating the need to focus more on coordinating care across the health care team.

“The anxiety that accompanies cancer diagnosis and receipt of complex information about treatments, costs, and prognosis may render patients more sensitive to what they perceive as particularly good care or communication,” the authors wrote in the study.

Providers should steer attention to fears of recurrence and long-term survival that may arise in survivors at the end of their treatment as well, the authors noted.

According to the study results, communication satisfaction appeared to be most lacking among patients with complex circumstances who may need it the most.

“This could be due to many factors, including time constraints, competing priorities, and increasingly complex cancer therapies,” Crystal Denlinger, MD, FACP, chief of GI Medical Oncology at Fox Chase Cancer Center, chair of the NCCN Clinical Practices Guidelines in Oncology Panel on Survivorship, said in a statement. “This study highlights the need for additional research into how to tailor the health care experience both during and after cancer treatment, in order to communicate effectively.”

When providers are more effective in their communication, patients are more likely to follow medical recommendations and protocols, leading to fewer office visits and, subsequently, lower health care costs, the authors noted.

In addition to health outcomes, provider communication can also affect a patient’s financial stress. A previous study published in Cancer pointed to the importance of discussions surrounding the financial burden of cancer treatment. In a survey of patients with breast cancer, respondents reported lack of communication from their providers to address the financial hardships they faced related to their treatment.

To overcome time constraints as a barrier, the authors of the JNCCN study recommended that providers delegate both clinical and communication duties to colleagues as needed and potentially employ electronic communication as an option.

“Communication needs vary from patient to patient,” lead author Ashish Rai, PhD, Surveillance and Health Services, American Cancer Society, said in the press release. “While time constraints do pose a challenge, the amount of time spent is only 1 of the attributes of effective communication. By tailoring their communication strategy to a patient’s specific needs, providers may be able to communicate more effectively in the same amount of time.”

References

Rai A, Han X, Zheng Z, et al. Determinants and outcomes of satisfaction with healthcare provider communication among cancer survivors. Journal of the National Comprehensive Cancer Network. 2018. Doi: 10.6004/jnccn.2018.7034

Better Doctor/Patient Communication Means Better Outcomes in Cancer Care, According to a Report in JNCCN. NCCN’s website. https://www.nccn.org/about/news/newsinfo.aspx?NewsID=1127. Accessed August 14, 2018.