Active Breast Cancer Treatment
Conditions
Keywords
breast cancer
Brief summary
This study evaluates a multi-component communication intervention in the outpatient setting to strengthen communication among patients being actively treated for breast cancer and their support network of family members and friends. The intervention comprises: 1.) a patient-family agenda-setting checklist completed immediately before a regularly scheduled oncology visit, 2.) facilitated registration for the patient portal (for patient and family member, as desired by the patient), and 3.) education (as relevant) on access to clinician electronic visit notes. The study team will conduct a two-group randomized trial to examine feasibility of the protocol and to compare quality of communication with oncology providers, understanding of patient's cancer, confidence in managing patient's care and satisfaction with cancer care between patient-companion dyads who are in the intervention group (n=60) and patient-companion dyads who receive usual medical oncology care (n=60).
Detailed description
Breast cancer is the most common cancer among survivors in the US. Most patients with breast cancer receive help from family in making complex decisions about treatment, handling logistically demanding care coordination, and managing symptoms and side effects. Although family members (as defined by each patient) play a vital role in cancer care, they are not formally recognized or assessed in care delivery, and their need for information and support is typically unmet. Lack of attention to family in care delivery is an important gap that too often leaves families without adequate information about patient health and treatments. This may prevent families and patients from engaging in open conversations, cause them unnecessary anxiety, and negatively affect the quality of cancer care and delivery. Communication is particularly important in cancer care, as the optimal course of action is determined through longitudinal discussion of prognosis, treatments, and patient goals, preferences, and concerns. Strategies to improve communication for serious illnesses such as cancer have been developed, but typically target a specific decision, conversation, or setting, most often the inpatient hospital. There is growing agreement that communication among patients, families, and providers should be initiated early and continue throughout the disease trajectory. However, little is known about how to provide both patients and families with access to timely information about patient health and mechanisms to communicate directly with health care providers, as proposed in this study. The goal of this study is to test a multicomponent intervention to strengthen communication and longitudinal partnerships among women with breast cancer and their family members. Recent work by the study team has demonstrated the feasibility, acceptability, and benefit of intervention components which will be combined into a single model of care. The study team's preliminary studies indicate that clarifying patient and family expectations regarding the role of family and providing family with timely and comprehensive information about patient health (as desired by the patient) leads to more effective family involvement, more frequent patient-family-provider interactions, more patient-centered communication, and greater preparedness to manage care. This study will evaluate the feasibility of delivering a multicomponent communication intervention in the outpatient setting comprising: 1.) a patient-family agenda-setting checklist completed immediately before a regularly scheduled medical oncology visit with a participating medical oncologist, 2.) facilitated registration for the patient portal (for patient and family member, as desired by the patient), and 3.) education (as relevant) on access to doctor's electronic visit notes. The study will focus on patients who typically attend medical oncology visits with a family member or trusted friend who are already present and involved in communication. This study will enroll up to 132 patients who are on active treatment for breast cancer, up to 132 family member/friend companions and up to 14 medical oncology providers. The study team will compare patients and companions who are in the intervention group (n=60 dyads) with patients and companions who are in the control group and receive usual medical oncology care (n=60 dyads). This study will compare quality of communication with medical oncology providers, understanding of patient's cancer, confidence in managing patient's care, satisfaction with cancer care, and symptoms of anxiety after 3 months, 9 months, and 12 months of follow-up.
Interventions
OTHERChecklist, MyChart, OpenNotes
1\) Patient-family agenda-setting checklist, 2) Facilitated proxy registration for MyChart, and 3) Education on access to doctor's electronic visit notes.
OTHERUsual Care
Routine medical oncology care
Sponsors
Susan G. Komen Breast Cancer Foundation
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Caregiver, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Medical oncology patient: Established patient of participating medical oncologist greater than 18 years of age, have a diagnosis of early stage or advanced breast cancer, are receiving active systemic therapy (in the form of IV adjuvant systemic therapy if early stage), are English speaking, able to provide informed consent themselves, and identify a family member who they would like to include in their care. 2. Care partner: Family member (e.g. spouse, adult child, parent, adult sibling or other relative) or unpaid friend who regularly accompanies patient to medical oncology visits. 3. Medical oncology provider: Practicing medical oncology provider at a participating clinic who provides care to patients with breast cancer.
Exclusion criteria
1. Medical oncology patients: Younger than 18 years, pregnant, not being treated for breast cancer, do not attend medical oncology visits with family member or unpaid friend or unwilling for their family member or unpaid friend to be contacted. 2. Care partner: Paid non-family member who accompanies patient to visits.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Between-group Differences in Care Partner Anxiety at 9-months | 9 months | Outcome was measured using the Generalized Anxiety Disorder 2-item questionnaire (GAD-2), a well-established 2-item instrument that asks about symptoms of anxiety in a two-week recall period from 0 (not at all) to 3 (nearly every day). Full range is 0-6 with higher scores indicating more anxiety. Symptoms of anxiety refer to a cutpoint of 3+ on the GAD-2. |
| Between-group Differences in Care Partner Complete Illness Understanding at 9-months | 9 months | Illness understanding was measured by 4 questions regarding knowledge that is considered to be essential to making informed treatment decisions in serious illness, including: 1.) understanding of illness, 2.) knowledge of disease status, 3.) awareness of disease state, and 4.) expectation of duration of life. We summed responses to each item (coded 1 or 0 to reflect the presence or absence of understanding), yielding a score ranging from 0 to 4. Participants with perfect scores reflecting complete illness understanding (4 of 4 correct responses) were compared to all others. |
| Between-group Differences in Care Partner Satisfaction With Cancer Care at 9-months | 9 months | Outcome was measured with the short-form 10-item version of the FAMCARE (Family Satisfaction with Cancer Care) questionnaire, a validated multi-item instrument that was developed to assess family perspective on cancer care. Respondents are asked to rate 10 items that relate to emotional support, personalization of care, support of decision-making, accessibility, and coordination. Response categories include very satisfied (2 points), satisfied (1 point), or not satisfied (0 points), and the 10-items may be summed to yield a total score (range: 0 to 20) with higher scores reflecting greater satisfaction. |
| Between-group Differences in Patient Complete Illness Understanding at 9-months | 9 months | Illness understanding was measured by 4 questions regarding knowledge that is considered to be essential to making informed treatment decisions in serious illness, including: 1.) understanding of illness, 2.) knowledge of disease status, 3.) awareness of disease state, and 4.) expectation of duration of life. We summed responses to each item (coded 1 or 0 to reflect the presence or absence of understanding), yielding a score ranging from 0 to 4. Participants with perfect scores reflecting complete illness understanding (4 of 4 correct responses) were compared to all others. |
| Between-group Differences in Mean Patient Satisfaction With Cancer Care at 9-months | 9 months | Outcome was measured with the short-form 10-item version of the Family Satisfaction with Cancer Care (FAMCARE) questionnaire, a validated multi-item instrument that was developed to assess family perspective on cancer care. Respondents are asked to rate 10 items that relate to emotional support, personalization of care, support of decision-making, accessibility, and coordination. Response categories include very satisfied (2 points), satisfied (1 point), or not satisfied (0 points), and the 10-items may be summed to yield a total score (range: 0 to 20) with higher scores reflecting greater satisfaction. |
| Between-group Differences in Patient Anxiety at 9-months | 9 months | Outcome was measured using the Generalized Anxiety Disorder 2-item questionnaire (GAD-2), a well-established 2-item instrument that asks about symptoms of anxiety in a two-week recall period from 0 (not at all) to 3 (nearly every day). Full range is 0-6 with higher scores indicating more anxiety. Symptoms of anxiety refer to a cutpoint of 3+ on the GAD-2. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Between-group Differences in Care Partner Quality of Communication at 9-months | 9 months | Outcome was measured using the Quality of Communication (QC) Scale, a validated 10-item instrument to assess quality of communication between the participant and the medical oncology team. The scale for each item is from 0 ('Worst you can imagine') to 10 ('Best you can imagine'). Full range is 0-100 with higher scores indicating higher perceived quality of communication. |
| Between-group Differences in Patient Quality of Communication at 9-months | 9 months | Outcome was measured using the Quality of Communication (QC) Scale, a validated 10-item instrument to assess quality of communication between the participant and the medical oncology team. The scale for each item is from 0 ('Worst you can imagine') to 10 ('Best you can imagine'). Full range is 0-100 with higher scores indicating higher perceived quality of communication. |
Countries
United States
Participant flow
Recruitment details
Patients of participating clinicians who were in active treatment for early stage or advanced breast cancer were mailed letters describing the study 3 weeks before their next scheduled visit. Patients who did not opt out by mail were contacted by research staff to discuss study procedures and administer a screening interview.
Participants by arm
| Arm | Count |
|---|---|
| Multicomponent Intervention 1.) A one-page paper-pencil agenda setting checklist completed immediately before a regularly scheduled medical oncology visit to elicit and align patient and companion perspectives regarding issues to discuss with the provider, and to stimulate discussion about the role of the companion in the visit, 2.) facilitated registration for the patient portal (for patient and family member, as desired by the patient), and 3.) education (as relevant) on access to doctor's electronic visit notes. | 69 |
| Usual Care Care as usual with the medical oncologist. | 63 |
| Total | 132 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Care Partner Participant Flow | Discontinued because patient death | 5 | 11 |
| Care Partner Participant Flow | Lost to Follow-up | 1 | 1 |
| Care Partner Participant Flow | Withdrawal by Subject | 4 | 3 |
| Patient Participant Flow | Death | 5 | 10 |
| Patient Participant Flow | Lost to Follow-up | 1 | 1 |
| Patient Participant Flow | Withdrawal by Subject | 4 | 2 |
Baseline characteristics
| Characteristic | Multicomponent Intervention | Usual Care | Total |
|---|---|---|---|
| Age, Continuous Care Partner age | 54.0 years STANDARD_DEVIATION 13.79 | 54.0 years STANDARD_DEVIATION 13.5 | 54 years STANDARD_DEVIATION 13.61 |
| Age, Continuous Patient age | 55.1 years STANDARD_DEVIATION 13.4 | 52.9 years STANDARD_DEVIATION 14.5 | 54.1 years STANDARD_DEVIATION 13.9 |
| Breast Cancer Disease Stage Early Stage Breast Cancer | 35 Participants | 37 Participants | 72 Participants |
| Breast Cancer Disease Stage Metastatic Breast Cancer | 34 Participants | 26 Participants | 60 Participants |
| Ethnicity (NIH/OMB) Care Partner Ethnicity Hispanic or Latino | 2 Participants | 3 Participants | 5 Participants |
| Ethnicity (NIH/OMB) Care Partner Ethnicity Not Hispanic or Latino | 65 Participants | 60 Participants | 125 Participants |
| Ethnicity (NIH/OMB) Care Partner Ethnicity Unknown or Not Reported | 2 Participants | 0 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Patient Ethnicity Hispanic or Latino | 4 Participants | 3 Participants | 7 Participants |
| Ethnicity (NIH/OMB) Patient Ethnicity Not Hispanic or Latino | 64 Participants | 60 Participants | 124 Participants |
| Ethnicity (NIH/OMB) Patient Ethnicity Unknown or Not Reported | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Care Partner Race American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Care Partner Race Asian | 1 Participants | 3 Participants | 4 Participants |
| Race (NIH/OMB) Care Partner Race Black or African American | 11 Participants | 16 Participants | 27 Participants |
| Race (NIH/OMB) Care Partner Race More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Care Partner Race Native Hawaiian or Other Pacific Islander | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Care Partner Race Unknown or Not Reported | 2 Participants | 3 Participants | 5 Participants |
| Race (NIH/OMB) Care Partner Race White | 55 Participants | 40 Participants | 95 Participants |
| Race (NIH/OMB) Patient Race American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Patient Race Asian | 1 Participants | 2 Participants | 3 Participants |
| Race (NIH/OMB) Patient Race Black or African American | 12 Participants | 14 Participants | 26 Participants |
| Race (NIH/OMB) Patient Race More than one race | 1 Participants | 3 Participants | 4 Participants |
| Race (NIH/OMB) Patient Race Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Patient Race Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Patient Race White | 55 Participants | 44 Participants | 99 Participants |
| Region of Enrollment United States | 69 Participants | 63 Participants | 132 Participants |
| Sex: Female, Male Care Partner sex Female | 28 Participants | 18 Participants | 46 Participants |
| Sex: Female, Male Care Partner sex Male | 41 Participants | 45 Participants | 86 Participants |
| Sex: Female, Male Patient sex Female | 68 Participants | 63 Participants | 131 Participants |
| Sex: Female, Male Patient sex Male | 1 Participants | 0 Participants | 1 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 5 / 69 | 10 / 63 |
| other Total, other adverse events | 0 / 69 | 0 / 63 |
| serious Total, serious adverse events | 0 / 69 | 0 / 63 |
Outcome results
Primary
Between-group Differences in Care Partner Anxiety at 9-months
Outcome was measured using the Generalized Anxiety Disorder 2-item questionnaire (GAD-2), a well-established 2-item instrument that asks about symptoms of anxiety in a two-week recall period from 0 (not at all) to 3 (nearly every day). Full range is 0-6 with higher scores indicating more anxiety. Symptoms of anxiety refer to a cutpoint of 3+ on the GAD-2.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Care Partner Anxiety at 9-months | Symptoms of Anxiety at 9-Months | 8 Participants |
| Multicomponent Intervention | Between-group Differences in Care Partner Anxiety at 9-months | No Symptoms of Anxiety at 9-Months | 55 Participants |
| Usual Care | Between-group Differences in Care Partner Anxiety at 9-months | Symptoms of Anxiety at 9-Months | 10 Participants |
| Usual Care | Between-group Differences in Care Partner Anxiety at 9-months | No Symptoms of Anxiety at 9-Months | 45 Participants |
Comparison: Symptoms of anxiety at 9 months were compared to baseline using logistic regression models estimated with generalized estimating equations (GEE) and an exchangeable correlation specification. Each model included group assignment, time (9 months versus baseline), their interaction, and covariates.p-value: 0.405Regression, Logistic
Primary
Between-group Differences in Care Partner Complete Illness Understanding at 9-months
Illness understanding was measured by 4 questions regarding knowledge that is considered to be essential to making informed treatment decisions in serious illness, including: 1.) understanding of illness, 2.) knowledge of disease status, 3.) awareness of disease state, and 4.) expectation of duration of life. We summed responses to each item (coded 1 or 0 to reflect the presence or absence of understanding), yielding a score ranging from 0 to 4. Participants with perfect scores reflecting complete illness understanding (4 of 4 correct responses) were compared to all others.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Care Partner Complete Illness Understanding at 9-months | Complete Illness Understanding at 9-Months | 44 Participants |
| Multicomponent Intervention | Between-group Differences in Care Partner Complete Illness Understanding at 9-months | Not Complete Illness Understanding at 9-Months | 19 Participants |
| Usual Care | Between-group Differences in Care Partner Complete Illness Understanding at 9-months | Complete Illness Understanding at 9-Months | 39 Participants |
| Usual Care | Between-group Differences in Care Partner Complete Illness Understanding at 9-months | Not Complete Illness Understanding at 9-Months | 16 Participants |
Comparison: Complete illness understanding at 9 months was compared to baseline using logistic regression models estimated with generalized estimating equations (GEE) and an exchangeable correlation specification. Each model included group assignment, time (9 months versus baseline), their interaction, and covariates.p-value: 0.532Regression, Logistic
Primary
Between-group Differences in Care Partner Satisfaction With Cancer Care at 9-months
Outcome was measured with the short-form 10-item version of the FAMCARE (Family Satisfaction with Cancer Care) questionnaire, a validated multi-item instrument that was developed to assess family perspective on cancer care. Respondents are asked to rate 10 items that relate to emotional support, personalization of care, support of decision-making, accessibility, and coordination. Response categories include very satisfied (2 points), satisfied (1 point), or not satisfied (0 points), and the 10-items may be summed to yield a total score (range: 0 to 20) with higher scores reflecting greater satisfaction.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Care Partner Satisfaction With Cancer Care at 9-months | 15.7 score on a scale | Standard Deviation 4.4 |
| Usual Care | Between-group Differences in Care Partner Satisfaction With Cancer Care at 9-months | 15.4 score on a scale | Standard Deviation 5.5 |
Comparison: Satisfaction with cancer care at 9 months was compared to baseline using linear regression models with the difference in the score as the outcome and a term for group assignment as the main independent variable.p-value: 0.108Regression, Linear
Primary
Between-group Differences in Mean Patient Satisfaction With Cancer Care at 9-months
Outcome was measured with the short-form 10-item version of the Family Satisfaction with Cancer Care (FAMCARE) questionnaire, a validated multi-item instrument that was developed to assess family perspective on cancer care. Respondents are asked to rate 10 items that relate to emotional support, personalization of care, support of decision-making, accessibility, and coordination. Response categories include very satisfied (2 points), satisfied (1 point), or not satisfied (0 points), and the 10-items may be summed to yield a total score (range: 0 to 20) with higher scores reflecting greater satisfaction.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Mean Patient Satisfaction With Cancer Care at 9-months | 16.9 score on a scale | Standard Deviation 3.9 |
| Usual Care | Between-group Differences in Mean Patient Satisfaction With Cancer Care at 9-months | 15.4 score on a scale | Standard Deviation 5.4 |
Comparison: Satisfaction with cancer care at 9 months was compared to baseline using linear regression models with the difference in the score as the outcome and a term for group assignment as the main independent variable.p-value: 0.555Regression, Linear
Primary
Between-group Differences in Patient Anxiety at 9-months
Outcome was measured using the Generalized Anxiety Disorder 2-item questionnaire (GAD-2), a well-established 2-item instrument that asks about symptoms of anxiety in a two-week recall period from 0 (not at all) to 3 (nearly every day). Full range is 0-6 with higher scores indicating more anxiety. Symptoms of anxiety refer to a cutpoint of 3+ on the GAD-2.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Patient Anxiety at 9-months | Symptoms of Anxiety at 9-Months | 7 Participants |
| Multicomponent Intervention | Between-group Differences in Patient Anxiety at 9-months | No Symptoms of Anxiety at 9-Months | 56 Participants |
| Usual Care | Between-group Differences in Patient Anxiety at 9-months | Symptoms of Anxiety at 9-Months | 8 Participants |
| Usual Care | Between-group Differences in Patient Anxiety at 9-months | No Symptoms of Anxiety at 9-Months | 47 Participants |
Comparison: Symptoms of anxiety at 9 months were compared to baseline using logistic regression models estimated with generalized estimating equations (GEE) and an exchangeable correlation specification. Each model included group assignment, time (9 months versus baseline), their interaction, and covariates.p-value: 0.619Regression, Logistic
Primary
Between-group Differences in Patient Complete Illness Understanding at 9-months
Illness understanding was measured by 4 questions regarding knowledge that is considered to be essential to making informed treatment decisions in serious illness, including: 1.) understanding of illness, 2.) knowledge of disease status, 3.) awareness of disease state, and 4.) expectation of duration of life. We summed responses to each item (coded 1 or 0 to reflect the presence or absence of understanding), yielding a score ranging from 0 to 4. Participants with perfect scores reflecting complete illness understanding (4 of 4 correct responses) were compared to all others.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Patient Complete Illness Understanding at 9-months | Complete Illness Understanding at 9-Months | 42 Participants |
| Multicomponent Intervention | Between-group Differences in Patient Complete Illness Understanding at 9-months | Not Complete Illness Understanding at 9-Months | 21 Participants |
| Usual Care | Between-group Differences in Patient Complete Illness Understanding at 9-months | Complete Illness Understanding at 9-Months | 38 Participants |
| Usual Care | Between-group Differences in Patient Complete Illness Understanding at 9-months | Not Complete Illness Understanding at 9-Months | 17 Participants |
Comparison: Complete illness understanding at 9 months was compared to baseline using logistic regression models estimated with generalized estimating equations (GEE) and an exchangeable correlation specification. Each model included group assignment, time (9 months versus baseline), their interaction, and covariates.p-value: 0.264Regression, Logistic
Secondary
Between-group Differences in Care Partner Quality of Communication at 9-months
Outcome was measured using the Quality of Communication (QC) Scale, a validated 10-item instrument to assess quality of communication between the participant and the medical oncology team. The scale for each item is from 0 ('Worst you can imagine') to 10 ('Best you can imagine'). Full range is 0-100 with higher scores indicating higher perceived quality of communication.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Care Partner Quality of Communication at 9-months | 90.3 units on a scale | Standard Deviation 10.3 |
| Usual Care | Between-group Differences in Care Partner Quality of Communication at 9-months | 86.2 units on a scale | Standard Deviation 15.9 |
Comparison: Quality of communication at 9 months was compared to baseline using linear regression models with the difference in the score as the outcome and a term for group assignment as the main independent variable.p-value: 0.872Regression, Linear
Secondary
Between-group Differences in Patient Quality of Communication at 9-months
Outcome was measured using the Quality of Communication (QC) Scale, a validated 10-item instrument to assess quality of communication between the participant and the medical oncology team. The scale for each item is from 0 ('Worst you can imagine') to 10 ('Best you can imagine'). Full range is 0-100 with higher scores indicating higher perceived quality of communication.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Patient Quality of Communication at 9-months | 89.8 units on a scale | Standard Deviation 11.6 |
| Usual Care | Between-group Differences in Patient Quality of Communication at 9-months | 88.0 units on a scale | Standard Deviation 18.7 |
Comparison: Quality of communication at 9 months was compared to baseline using linear regression models with the difference in the score as the outcome and a term for group assignment as the main independent variable.p-value: 0.412Regression, Linear
Post Hoc
Between-group Differences in Care Partner Exchange of Direct Messages in the Patient Portal at 9-months
Patient portal use was assessed from date and time-stamped interactions reflecting the frequency, timing, and type of patient portal interactions. Use of the patient portal refers to interactions between enrollment and up to 40-weeks post-enrollment.
Time frame: 9 months
Population: The analysis sample includes the care partners who logged in to the patient portal at least once during 9 month follow up period.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Care Partner Exchange of Direct Messages in the Patient Portal at 9-months | Care Partner Exchanged a Direct Message by 9-months | 3 Participants |
| Multicomponent Intervention | Between-group Differences in Care Partner Exchange of Direct Messages in the Patient Portal at 9-months | Care Partner Did Not Exchange a Direct Message by 9-months | 46 Participants |
| Usual Care | Between-group Differences in Care Partner Exchange of Direct Messages in the Patient Portal at 9-months | Care Partner Exchanged a Direct Message by 9-months | 0 Participants |
| Usual Care | Between-group Differences in Care Partner Exchange of Direct Messages in the Patient Portal at 9-months | Care Partner Did Not Exchange a Direct Message by 9-months | 1 Participants |
p-value: 0.247Fisher Exact
Post Hoc
Between-group Differences in Care Partner Registration for Shared Access to the Patient Portal at 9-months
Care partner registration for shared access to the patient portal was assessed at baseline and nine-months post-enrollment.
Time frame: 9 months
Population: The analysis sample includes the 118 patient-care-partner dyads with complete assessments at 9-months.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Care Partner Registration for Shared Access to the Patient Portal at 9-months | Care Partner Registered by 9 Months | 49 Participants |
| Multicomponent Intervention | Between-group Differences in Care Partner Registration for Shared Access to the Patient Portal at 9-months | Care Partner Did Not Register by 9 Months | 14 Participants |
| Usual Care | Between-group Differences in Care Partner Registration for Shared Access to the Patient Portal at 9-months | Care Partner Registered by 9 Months | 1 Participants |
| Usual Care | Between-group Differences in Care Partner Registration for Shared Access to the Patient Portal at 9-months | Care Partner Did Not Register by 9 Months | 54 Participants |
p-value: <0.001Fisher Exact
Post Hoc
Between-group Differences in Care Partner Views of Clinical Visit Notes in the Patient Portal at 9-months
Patient portal use was assessed from date and time-stamped interactions reflecting the frequency, timing, and type of patient portal interactions. Use of the patient portal refers to interactions between enrollment and up to 40-weeks post-enrollment.
Time frame: 9 months
Population: The analysis sample includes the care partners who logged in to the patient portal at least once during 9 month follow up period.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Care Partner Views of Clinical Visit Notes in the Patient Portal at 9-months | Care Partner Viewed a Clinical Visit Note by 9-months | 30 Participants |
| Multicomponent Intervention | Between-group Differences in Care Partner Views of Clinical Visit Notes in the Patient Portal at 9-months | Care Partner Did Not View a Clinical Visit Note by 9-months | 19 Participants |
| Usual Care | Between-group Differences in Care Partner Views of Clinical Visit Notes in the Patient Portal at 9-months | Care Partner Viewed a Clinical Visit Note by 9-months | 0 Participants |
| Usual Care | Between-group Differences in Care Partner Views of Clinical Visit Notes in the Patient Portal at 9-months | Care Partner Did Not View a Clinical Visit Note by 9-months | 1 Participants |
p-value: <0.001Fisher Exact
Post Hoc
Between-group Differences in Patient Exchange of Direct Messages in the Patient Portal at 9-months
Patient portal use was assessed from date and time-stamped interactions reflecting the frequency, timing, and type of patient portal interactions. Use of the patient portal refers to interactions between enrollment and up to 40-weeks post-enrollment.
Time frame: 9 months
Population: The analysis sample includes the patients who logged in to the patient portal at least once during 9 month follow up period.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Patient Exchange of Direct Messages in the Patient Portal at 9-months | Patient Exchanged a Direct Message by 9-months | 52 Participants |
| Multicomponent Intervention | Between-group Differences in Patient Exchange of Direct Messages in the Patient Portal at 9-months | Patient Did Not Exchange a Direct Message by 9-months | 8 Participants |
| Usual Care | Between-group Differences in Patient Exchange of Direct Messages in the Patient Portal at 9-months | Patient Exchanged a Direct Message by 9-months | 38 Participants |
| Usual Care | Between-group Differences in Patient Exchange of Direct Messages in the Patient Portal at 9-months | Patient Did Not Exchange a Direct Message by 9-months | 12 Participants |
p-value: 0.128Fisher Exact
Post Hoc
Between-group Differences in Patient Views of Clinical Visit Notes in the Patient Portal at 9-months
Patient portal use was assessed from date and time-stamped interactions reflecting the frequency, timing, and type of patient portal interactions.Use of the patient portal refers to interactions between enrollment and up to 40-weeks post-enrollment.
Time frame: 9 months
Population: The analysis sample includes the patients who used a patient portal feature at least once during 9 month follow up period.
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Multicomponent Intervention | Between-group Differences in Patient Views of Clinical Visit Notes in the Patient Portal at 9-months | Patient Viewed a Clinical Visit Note by 9-months | 38 Participants |
| Multicomponent Intervention | Between-group Differences in Patient Views of Clinical Visit Notes in the Patient Portal at 9-months | Patient Did Not View a Clinical Visit Note by 9-months | 22 Participants |
| Usual Care | Between-group Differences in Patient Views of Clinical Visit Notes in the Patient Portal at 9-months | Patient Viewed a Clinical Visit Note by 9-months | 18 Participants |
| Usual Care | Between-group Differences in Patient Views of Clinical Visit Notes in the Patient Portal at 9-months | Patient Did Not View a Clinical Visit Note by 9-months | 32 Participants |
p-value: 0.003Fisher Exact