Patient Priorities for Survivorship Care in Older Breast Cancer Survivors
The University of Texas Health Science Center, Houston
Summary
The objective of this study is to adapt the Patient Priorities Care (PPC) framework to breast cancer survivorship via a user-centered approach, through an iterative process in which patients and their physicians help to refine and modify the intervention. A second objective is to evaluate the feasibility and effectiveness of the adapted PPC framework in breast cancer survivorship for older adults.
Description
In the proposed project, we will use a Patient Priorities Care framework to explore older breast cancer survivors' priorities and health care preferences for high-quality breast cancer survivorship. The framework will include two components: (1) a health priorities identification session with a facilitator, and (2) an encounter with the oncology provider to discuss changes in the patient's care plan to align it with his/her priorities. Our overall hypothesis is that prioritizing patients' priorities is feasible and facilitates individualized survivorship care for older women with breast cancer…
Eligibility
- Age range
- 65–100 years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * able to write and speak English * Stage DCIS/I/II/III breast cancer diagnosis * 3 months from active cancer therapy (including first or second-line treatment chemotherapy, radiation and/or surgery, or multimodal treatment) up to 10 years since completing treatment * ≥3 documented comorbidities by chart review, or taking ≥10 medications, have ≥ 1 hospitalization over the past year, ≥ 2 emergency department visits over the past year, seen by \> 2 specialists over the past year * able to provide consent Exclusion Criteria: * currently on active cancer therapy (including f…
Interventions
- BehavioralAdapted Patient Priorities Care (PPC) approach
Step 1 is a PPC facilitation encounter, at which the facilitator will help the participant identify patient priorities, such as clarifying values (what matters most); setting meaningful, specific, and realistic outcome goals; describing healthcare preferences (care that is helpful and/or burdensome) and tradeoffs; and discussing priorities with clinicians. The participant's healthcare priorities are then documented and transmitted to clinicians, in order to facilitate changes in the patient's care plan to align it with his/her priorities. In step 2, the clinician considers patient's priorities and potential healthcare options (options might include starting or stopping treatments; adding or removing medications; ordering more or fewer tests; recommending or removing self-management tasks). In step 3, the clinician discusses care options with the participant, using strategies for aligning care with patient priorities.
- OtherUsual Care
Usual care for breast cancer survivorship includes regular visits with the oncology provider and yearly mammograms for surveillance.
Locations (3)
- UT Physicians Center for Healthy Aging BellaireBellaire, Texas
- UT Physicians Family Medicine BayshoreHouston, Texas
- Memorial Hermann Cancer CenterHouston, Texas