Understanding racial/ethnic differences in breast cancer-related physical well-being: the role of patient–provider interactions

Check, Devon K.; Chawla, Neetu; Kwan, Marilyn L.; Pinheiro, Laura C.; Roh, Janise M.; Ergas, Isaac J.; Stewart, Anita L.; Kolevska, Tatjana; Ambrosone, Christine B.; Kushi, Lawrence H.

doi:10.1007/s10549-018-4776-0

Cited by 29 publications

(19 citation statements)

References 20 publications

(20 reference statements)

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“…This, in turn, would enable the timely identification of symptoms for which there are evidence‐based interventions. Our findings support attention to patient‐clinician interactions that are patient‐centered and focus on quality of life as well as effective symptom management with particular attention paid to cultural sensitivity 32,41 . Further research is needed to explore approaches to encouraging and enabling patient‐provider communication on symptom severity in ways that are actionable in real‐world clinical practice.…”

Section: Discussionsupporting

confidence: 53%

Congruence of patient‐ and clinician‐reported toxicity in women receiving chemotherapy for early breast cancer

Nyrop

Deal

Reeve

et al. 2020

Cancer

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Background The National Cancer Institute's Patient‐Reported Outcomes Version of the Common Terminology Criteria for Adverse Events, collected alongside the clinician‐reported Common Terminology Criteria for Adverse Events, enables comparisons of patient and clinician reports on treatment toxicity. Methods In a multisite study of women receiving chemotherapy for early‐stage breast cancer, symptom reports were collected on the same day from patients and their clinicians for 17 symptoms; their data were not shared with each other. The proportions of moderate, severe, or very severe patient‐reported symptom severity were compared with the proportions of clinician‐rated grade 2, 3, or 4 toxicity. Patient‐clinician agreement was assessed via κ statistics. Chi‐square tests investigated whether patient characteristics were associated with patient‐clinician agreement. Results Among 267 women, the median age was 58 years (range, 24‐83 years), and 26% were nonwhite. There was moderate scoring agreement (κ = 0.413‐0.570) for 53% of symptoms, fair agreement for 41% (κ = 0.220‐0.378), and slight agreement for 6% (κ = 0.188). For example, patient‐reported and clinician‐rated percentages were 22% and 8% for severe or very severe fatigue, 41% and 46% for moderate fatigue, 32% and 39% for mild fatigue, and 6% and 7% for none. Clinician severity scores were lower for nonwhite patients in comparison with white patients for peripheral neuropathy, nausea, arthralgia, and dyspnea. Conclusions Although clinician reporting of symptoms is common practice in oncology, there is suboptimal agreement with the gold standard of patient self‐reporting. These data provide further evidence supporting the integration of patient‐reported outcomes into oncological clinical research and clinical practice to improve monitoring of symptoms as well as timely interventions for symptoms.

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Section: Discussionsupporting

confidence: 53%

Congruence of patient‐ and clinician‐reported toxicity in women receiving chemotherapy for early breast cancer

Nyrop

Deal

Reeve

et al. 2020

Cancer

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“…For example, some research has focused support from specific types of people (e.g., family and providers), but not many have not simultaneously assessed support from multiple types of people (see [38,42] as exceptions). While it may be possible to make such comparisons via reviews, studies focusing on support provided by healthcare professionals sometimes use different terminology (e.g., information provision [43]) and/or focus on communication styles [44][45][46] rather than the support provisioned. These differences in focus may make it challenging to compare evidence regarding provider versus nonprovider support.…”

Section: Microsocial Factors Have Been Empirically Well-studied In the Context Of Cancer Survivorship And Survivalmentioning

confidence: 99%

A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival: an invited commentary

Molina

2018

Translational Behavioral Medicine

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In this article, the importance of social factors for cancer survivorship has been theoretically considered and empirically studied. This commentary and Kroenke's narrative review highlight how social network theory and methods may innovatively expand this substantive body of work. First, we add to a new understanding of cancer survivorship through: (a) discussing the delineation and differences between multiple social factors of interest across existing conceptual models; (b) characterizing their relationships to each other and to cancer survivorship through a social network lens; and (c) overall, sharing terminology and strengthening connections within this diverse body of literature. Second, we note opportunities for future research in terms of (a) simultaneous measurement of multiple social factors at different levels and (b) adaptation of designs to leverage and measure the theorized mechanisms. This commentary describes how incorporation of social network research can optimize research, practice, and policy contributions regarding cancer survival and survivorship.

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“…As expected, symptom burden was considerably lower than in previous studies in which assessments were taken after chemotherapy started. 16 , 17 , 18 , 23 , 25 We found race-based differences in reported symptoms, with White women reporting more severe distress symptoms and Black women reporting more severe symptoms typically associated with chemotherapy treatment.…”

Section: Discussionmentioning

confidence: 66%

“… 8 , 11 , 12 , 13 , 14 Several studies compared symptoms during or after chemotherapy by race/ethnicity and found mixed results. 12 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 Symptom assessment timing varied in these studies (eg, during treatment vs later in survivorship), which may explain the inconsistent findings. To our knowledge, no studies have compared differences in patient-reported symptoms before starting chemotherapy.…”

Section: Introductionmentioning

confidence: 93%

Characterization of Clinical Symptoms by Race Among Women With Early-Stage, Hormone Receptor–Positive Breast Cancer Before Starting Chemotherapy

Chehal

Kaplan

et al. 2021

JAMA Netw Open

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Key Points Question Are there symptom burden differences between Black and White women with early-stage breast cancer before starting chemotherapy? Findings In this cross-sectional observatonal study of 1338 patients from 1 cancer center, Black women reported a higher burden for symptoms typically associated with chemotherapy and lower distress than White women before chemotherapy intiation. Black patients’ baseline characteristics were associated with a significantly higher symptom burden, but this symptom burden was offset by relatively greater, unexplained reporting of physical, distress, and despair symptoms by White patients. Meaning Capturing treatment-related toxic effects by considering pretreatment symptoms may result in better-informed treatment decisions for patients.

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Understanding racial/ethnic differences in breast cancer-related physical well-being: the role of patient–provider interactions

Cited by 29 publications

References 20 publications

Congruence of patient‐ and clinician‐reported toxicity in women receiving chemotherapy for early breast cancer

Congruence of patient‐ and clinician‐reported toxicity in women receiving chemotherapy for early breast cancer

A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival: an invited commentary

Characterization of Clinical Symptoms by Race Among Women With Early-Stage, Hormone Receptor–Positive Breast Cancer Before Starting Chemotherapy

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