Comparing Enrolees with Non-Enrolees of Cancer-Patient Navigation at End of Life

Abstract

Background Cancer-patient navigators who are oncology nurses support and connect patients to resources

Population surveillance of navigation frequency and palliative care contact before death among cancer patients

“…Whether a person was navigated or not varied considerably by cancer diagnosis (Park, Johnston, Urquhart, Walsh, & McCallum, 2018). However, our study indicated that once persons see a navigator, their navigation frequency did not vary by cancer diagnosis (Table 1), but their palliative care contact rate did not vary by cancer diagnosis (Table 2).…”

“…Among the study patients who died of cancer and were navigated, 32.8% had a palliative care contact with the cancer patient navigator. Given that only 40% of the cancer decedents were navigated (Park, Johnston, Urquhart, Walsh, & McCallum, 2018), this means that only 13.1% (32.8% multiplied by 0.4) of the persons dying of cancer had a palliative care contact with a navigator. This rate is low compared to the palliative care program enrolment rates for cancer decedents reported elsewhere.…”

“…In our study, having only one (versus more than one) navigation record increased with age indicating that the navigators were less likely to be involved with older cancer patients over a longer time period. Furthermore, as age increased, patients were also less likely to be navigated (Park, Johnston, Urquhart, Walsh, & McCallum, 2018), thus placing them in double jeopardy: less likely to be navigated and, when navigated, they were more likely to be navigated for only a short time (a month or less). Duthie, Strohschein and Loiselle (2017) report that as age increases those diagnosed with cancer are more likely to have multi-morbidities that add to the complexity of their care, which influences their treatment options, prognosis, and care needs.…”

“…Longitudinal data are available for persons approaching the end of their life. Recently, we compared navigated to non-navigated patients who had been diagnosed with cancer (Park, Johnston, Urquhart, Walsh, & McCallum, 2018). This study builds on that work by investigating only those patients who were navigated to determine navigation frequency and palliative care contact rates.…”

“…There have been population-based studies of enrolment in palliative care programs by persons dying of cancer (Gao, Johnston, Lavergne, & McIntyre, 2011;Craigs, West, Hurlow, Bennett, & Ziegler, 2018). However, this study and its companion paper (Park, Johnston, Urquhart, Walsh, & McCallum, 2018) are the first to use a population-based approach to examine the role of the cancer patient navigator in palliative care.…”