MedicalResearch.com Interview with:
Manali Patel MD MPH
Assistant Professor of Medicine, Oncology
Palo Alto Veterans Affairs Health Care System
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In prior work, many patients with advanced stages of cancer report a lack of understanding of their prognosis and receipt of care that differs from their preferences.
These gaps in care delivery along with the unsustainable rise in healthcare spending at the end-of-life and professional healthcare provider shortages led our team to consider new ways to deliver cancer care for patients. Based on input from focus groups with patients, caregivers, oncology care providers and healthcare payers, we designed a novel model of cancer care to address these gaps in care delivery. The intervention consisted of a well-trained lay health worker to assist patients with understanding and communicating their goals of care with their oncology providers and caregivers.
We found that patients who received the six-month intervention reported greater satisfaction with the care they received and their decision-making, had higher rates of hospice use, lower acute care use, and 95% lower total healthcare expenditures in the last month of life. The intervention resulted in nearly $3 million dollars in healthcare savings.
MedicalResearch.com: What should readers take away from your report?
Response: Lay health workers can assist patients with understanding and communicating their goals of care with their healthcare providers. Better communication can improve patient-reported outcomes and result in higher-value cancer care delivery at the end-of-life.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future research should evaluate whether these results are generalizable to other patient populations suffering from cancer and other serious illnesses.
Patel MI, Sundaram V, Desai M, et al. Effect of a Lay Health Worker Intervention on Goals-of-Care Documentation and on Health Care Use, Costs, and Satisfaction Among Patients With CancerA Randomized Clinical Trial. JAMA Oncol. Published online July 26, 2018. doi:10.1001/jamaoncol.2018.2446
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