E45: Access to results of patient reported outcome surveys did not improve longitudinal patient reported outcomes in breast cancer patients

ePoster Abstract Author(s)

Sudheer Vemuru, MD

Resident
University of Colorado Anschutz Medical Center
Aurora, Colorado, United States

Author(s)

LH

Laura Helmkamp, MS

Biostatistician
University of Colorado School of Medicine, Adult & Child Center for Outcomes Research & Delivery Science, United States
MA

Monica Adams, MA

Graduate Research Assistant
University of Colorado Denver, United States
KC

Kathryn L. Colborn, PhD

Associate Professor
University of Colorado School of Medicine, Adult & Child Center for Outcomes Research & Delivery Science, United States
HP

Hannah Parris, MPH

Instructor
University of Colorado School of Medicine, United States
VH

Victoria Huynh, MD

Resident
University of Colorado School of Medicine, Department of Surgery, United States
MH

Madeline Huey, MD

Resident
University of Colorado School of Medicine, Department of Surgery, United States
NC

Nicole Christian, MD

Assistant Professor
University of Colorado School of Medicine, Department of Surgery, United States
GA

Gretchen Ahrendt, MD

Professor
University of Colorado School of Medicine, Department of Surgery
Aurora, Colorado, United States
CL

Clara Lee, MD, MPP

Professor
University of North Carolina School of Medicine, Department of Surgery, United States
SK

Simon Kim, MD, MPH

Professor
University of Colorado School of Medicine, Department of Surgery, United States

Submitter(s)

DM

Daniel Matlock, MD

Professor
University of Colorado School of Medicine, Department of Medicine, United States

Author(s)

EC

Ethan Cumbler, MD

Professor
University of Colorado Anschutz Medical Campus, United States
ST

Sarah E.A. Tevis, MD

Associate Professor
University of Colorado School of Medicine, United States

Introduction: Patient reported outcome (PRO) measures can be important indicators of quality of life among breast cancer patients. While several factors may influence longitudinal PROs, it is not known how providing patients with access to PRO results may affect future PROs. In this randomized-controlled trial, we sought to evaluate how providing patients with PRO results impacted longitudinal PROs and utilization of support services.

Methods: Newly diagnosed stage 0-III female breast cancer patients seen at an academic breast surgery clinic between June 2019 and March 2023 were invited to participate in a longitudinal PRO study. Enrolled patients received the BREAST-Q preoperative module, a validated PRO tool measuring domains of wellbeing in breast cancer patients including satisfaction with breasts, psychosocial wellbeing, physical wellbeing, and sexual wellbeing. Patients then received the BREAST-Q postoperative module gauging these domains at regular intervals after surgery. Patients were randomized to the intervention group, who received a graph of PRO results charted over time with each completed module, or the control group, who did not receive PRO results. The outcomes of interest were: 1) differences in scores from baseline to 12 months after surgery for each domain and 2) utilization rates for support services such as mental health, social work, sexual health consultation, and rehabilitation therapy. Mixed effects models with a random effect to account for clustering of patients within surgeon were used to estimate differences over time between the two arms.

Results: The cohort included 346 patients, 162 in the intervention group and 184 in the control group. The groups were well balanced across all collected demographic, disease, and treatment variables. Of the 291 patients with at least one year elapsed since surgery, 109 patients completed both the baseline and 12-month postoperative modules (37.5% response rate). One year after surgery, there were significantly greater increases in the control group for psychosocial wellbeing and satisfaction with breasts compared to the intervention group (Table 1). After controlling for surgeon, there were no differences between groups for physical or sexual wellbeing or utilization of any support services.

Conclusions:

In this randomized-controlled trial, providing patients with access to their PRO results did not improve longitudinal PRO scores or utilization of support services. Further work is needed to identify interventions that are effective in generating positive longitudinal impacts on PROs.

Learning Objectives:

Upon completion, participant will be able to define patient-reported outcomes and explain how they impact breast cancer patients.
Upon completion, participant will be able to demonstrate how access to results of patient-reported outcome questionnaires impact future scores.
Upon completion, participant will be able to demonstrate how access to results of patient-reported outcome questionnaires impact subsequent use of mental health services, social work, and physical and sexual therapies.