It has been well documented that a confluence of many factors, including low-socioeconomic status, contribute to health disparities and worse outcomes in minority patients with cancer. Strategies that partnered community-based health workers with low-income and minority patients with cancer resulted in improvements in patients’ quality of life, greater engagement in their own care, fewer hospital visits, and reduced emergency room use. These interventions may be an effective and sustainable way to ensure equitable cancer care, according to a randomized study by Patel et al that will be presented during the 2021 ASCO Quality Care Symposium (Abstract 1).
Study Methodology
The researchers conducted interviews with 160 newly diagnosed patients (80 in the intervention cohort and 80 in the control cohort) to assess their health-related quality of life and patient activation and obtained claims data for health-care use. There were no differences in demographic or clinical factors across the two groups. The majority of participants were non-White (74%) and female (53%), and the mean age was 57 years. The most common diagnoses were breast (31%) and lung (21%) cancers, and the majority of patients were diagnosed with stage III or IV disease (63%).
The researchers used regression models to evaluate differences in health-related quality of life (validated Functional Assessment of Cancer Therapy–General) scores and patient activation (validated Patient Activation Measure) scores between the groups over time, and exact Poisson regression–adjusted for length of follow-up to compare emergency department and hospitalization utilization.
Results
The researchers found that at 4 months, the intervention group had greater improvements in their quality of life compared to those in the control group (difference in difference: 9.56, P < .001), greater change in patient activation (difference in difference: 12.43, P < .001)), and lower acute care use (hospital visits (1.10 [1.53] ± 1.83 [1.31], P = .02) and emergency department use (1.2 [2.82] vs 3.47 [3.62], P = .03).
“Integration of community-based interventions into cancer care for low-income and minority populations may be a more effective and sustainable way to ensure equitable cancer care,” concluded the study authors.
Perspective
Julie R. Gralow, MD, FACP, FASCO
“Strategies that provide patients with support and resources within their communities may provide an opportunity to improve quality of life and improve patient engagement in their own care among minority and low-income patients with cancer, and may help reduce care disparities,” said ASCO’s Chief Medical Officer and Executive Vice President Julie R. Gralow, MD, FACP, FASCO.
Disclosure: Funding for this study was provided by the National Institutes of Health. For full disclosures of the study authors, visit coi.asco.org.
