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Showing content from https://pubmed.ncbi.nlm.nih.gov/23045541/ below:

A cluster randomized trial evaluating the efficacy of patient navigation in improving quality of diagnostic care for patients with breast or colorectal cancer abnormalities

Randomized Controlled Trial

Affiliations

• ¹ University of South Florida, 12901 Bruce B. Downs Blvd., MDC 27, Tampa, FL 33612, USA. kwells1@health.usf.edu

• PMID: 23045541
• PMCID: PMC3511588
• DOI: 10.1158/1055-9965.EPI-12-0448

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Randomized Controlled Trial

Kristen J Wells et al. Cancer Epidemiol Biomarkers Prev. 2012 Oct.

• ¹ University of South Florida, 12901 Bruce B. Downs Blvd., MDC 27, Tampa, FL 33612, USA. kwells1@health.usf.edu

• PMID: 23045541
• PMCID: PMC3511588
• DOI: 10.1158/1055-9965.EPI-12-0448

Item in Clipboard

Background: This study examines efficacy of a lay patient navigation (PN) program aimed to reduce time between a cancer abnormality and definitive diagnosis among racially/ethnically diverse and medically underserved populations of Tampa Bay, Florida.

Methods: Using a cluster randomized design, the study consisted of 11 clinics (six navigated; five control). Patients were navigated from time of a breast or colorectal abnormality to diagnostic resolution, and to completion of cancer treatment. Using a generalized mixed-effects model to assess intervention effects, we examined: (i) length of time between abnormality and definitive diagnosis, and (ii) receipt of definitive diagnosis within the 6-month minimum follow-up period.

Results: A total of 1,267 patients participated (588 navigated; 679 control). We also included data from an additional 309 chart abstractions (139 navigated arm; 170 control arm) that assessed outcomes at baseline. PN did not have a significant effect on time to diagnostic resolution in multivariable analysis that adjusted for race-ethnicity, language, insurance status, marital status, and cancer site (P = 0.16). Although more navigated patients achieved diagnostic resolution by 180 days, results were not statistically significant (74.5% navigated vs. 68.5% control, P = 0.07).

Conclusions: PN did not impact the overall time to completion of diagnostic care or the number of patients who reached diagnostic resolution of a cancer abnormality. Further evaluation of PN programs applied to other patient populations across the cancer continuum is necessary to gain a better perspective on its effectiveness.

Impact: PN programs may not impact timely resolution of an abnormality suspicious of breast or colorectal cancer.

2012 AACR

PubMed Disclaimer

The authors have no conflict of interest to disclose.

Tampa PNRP Flow of Participants

Tampa PNRP Flow of Participants

Tampa PNRP Flow of Participants

Diagnostic Resolution Over Time for…

Diagnostic Resolution Over Time for Navigated and Control Participants

Diagnostic Resolution Over Time for Navigated and Control Participants

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  Lee JH, Fulp W, Wells KJ, Meade CD, Calcano E, Roetzheim R. Lee JH, et al. PLoS One. 2013 Sep 16;8(9):e74542. doi: 10.1371/journal.pone.0074542. eCollection 2013. PLoS One. 2013. PMID: 24066145 Free PMC article. Clinical Trial.

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• Patient navigation and time to diagnostic resolution: results for a cluster randomized trial evaluating the efficacy of patient navigation among patients with breast cancer screening abnormalities, Tampa, FL.

  Lee JH, Fulp W, Wells KJ, Meade CD, Calcano E, Roetzheim R. Lee JH, et al. PLoS One. 2013 Sep 16;8(9):e74542. doi: 10.1371/journal.pone.0074542. eCollection 2013. PLoS One. 2013. PMID: 24066145 Free PMC article. Clinical Trial.

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