Metastatic breast cancer, also called stage 4 breast cancer, is an advanced form of the disease that has spread from the breast to other parts of the body. Yet nearly one in three people in the United States who have it miss treatment appointments, delay or even discontinue their treatment altogether. These missed appointments are typically related to financial problems, social isolation, limited insurance, transportation challenges and other issues.
“Some people have to make a choice between maybe feeding their children and filling a prescription for their cancer treatment. And then there are the costs of time away from work, or maybe they don’t have a vehicle that’s dependable or they’re dependent on public transportation, which has limitations.”Jamie Myers, Ph.D., FAAN, Research Associate Professor at the University of Kansas School of Nursing
“So there are a lot of barriers that can have an impact on care,” said Jamie Myers, Ph.D., FAAN, research associate professor at the University of Kansas School of Nursing.
When someone facing those barriers struggles to keep up with their treatment plan, they increase their risk of dying or of the disease progressing.
With the support of a new grant awarded by the National Comprehensive Cancer Network Oncology Research Program and funded by Pfizer External Research and Grants, Myers is leading a project at KU Medical Center to devise a way to improve adherence to treatment for these patients.
Myers and her colleagues aim to design and pilot a way to integrate the services of Gateway to Hope with the treatment of metastatic breast cancer patients at The University of Kansas Cancer Center who are experiencing financial and social hardship. Gateway to Hope is a not-for-profit organization that provides community navigation for breast cancer patients, which includes financial assistance, connections with resources such as transportation and food banks, and social support.
During the first year of the project, the researchers will map out how patients are currently referred for financial and support services and identify breakdowns in those processes. They will also measure current adherence to treatment by analyzing electronic medical record data on missed appointments in metastatic breast cancer patients at KU Cancer Center.
“Our vision is, could there be a way for people who would most likely be eligible for Gateway to Hope services to be identified systematically through information that’s in the electronic medical record?” said Myers, who is the principal investigator on the grant.
Myers and her colleagues plan to identify what she termed “automatic triggers” in the electronic medical record that could be used to signal when a patient is at risk for dropping out of their treatment and might benefit from a referral. She cited having Medicaid as insurance or checking certain items on a social determinants of health screening tool as possible triggers for referrals to Gateway to Hope.
The second year of the project will involve implementing the new system for Gateway to Hope referrals at KU Cancer Center’s location in Westwood for eligible patients with metastatic breast cancer. The researchers will then measure the outcomes for 40 of these patients, tracking their adherence to appointments and medication, their reported quality of life and their satisfaction with community navigation provided by Gateway to Hope.
If their pilot project is successful, the goal would be to expand to other KU Cancer Center sites, Myers said, and potentially one day expand to the member facilities of the Masonic Cancer Alliance. “This model of care could be something that other cancer centers might have an interest in replicating,” she said.
(Newswise/HG)