Prospective, Randomized Control Trial Investigating the Impact of a Physician-Communicated Radiation Therapy Plan Review on Breast Cancer Patient-Reported Satisfaction

Brandon A. Dyer, Chin-Shang Li, Megan E Daly, Arta M Monjazeb, Jyoti S. Mayadev

Research output: Contribution to journalArticle

Abstract

Purpose: Patients with breast cancer face complex medical decision-making. We investigated the impact of a physician-communicated, patient-specific radiation therapy (RT) plan review on patient-reported outcomes (PROs) for patients with breast cancer receiving adjuvant RT in a prospective randomized trial. Methods and materials: Patients with stage I-III breast cancer treated with adjuvant RT were prospectively randomized to a standard nondetailed review (Arm A) versus an in-depth, individualized RT plan review during week 1 of RT (Arm B). Plan review included visualization of the treatment plan, RT doses, beam arrangements, normal tissue doses, and dose/volume constraints. Patient-reported satisfaction was assessed using a subset of the Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction questionnaire related to physician communication (PC), technical competency (TC), confidence and trust (C&T), and overall satisfaction (OS). The difference in mean scores at baseline, week 1, and the end of RT were assessed. Results: From March 2014 to March 2016, 64 patients with breast cancer (37 in Arm A; 27 in Arm B) were randomized and completed all 3 surveys. Mean baseline scores for PC, TC, C&T, and OS mean were 2.73 (standard deviation [SD], 0.71), 2.66 (SD, 0.86), 2.56 (SD, 0.98), and 2.27 (SD, 0.88), respectively, with high baseline scores in both arms. There was no difference in baseline-reported communication indicators between the arms. There were no significant differences among the 3 time points for PC, TC, C&T, or OS (P = .63, .53, 0.52, and 0.71, respectively). Conclusions: We report the first randomized trial evaluating the impact of in-depth RT plan review on PROs during breast radiation. Both baseline and postintervention scores were high for all domains. Detailed patient assessment, understanding of communication types, and information processing may be necessary to determine subtle PRO differences. Further investigations of PROs could potentially direct and optimize physician and patient communication during RT.

Original languageEnglish (US)
JournalPractical Radiation Oncology
DOIs
StatePublished - Jan 1 2019

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Patient Satisfaction
Radiotherapy
Breast Neoplasms
Physicians
Arm
Communication
Automatic Data Processing
Breast
Chronic Disease
Therapeutics
Radiation
Patient Reported Outcome Measures

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Prospective, Randomized Control Trial Investigating the Impact of a Physician-Communicated Radiation Therapy Plan Review on Breast Cancer Patient-Reported Satisfaction",
abstract = "Purpose: Patients with breast cancer face complex medical decision-making. We investigated the impact of a physician-communicated, patient-specific radiation therapy (RT) plan review on patient-reported outcomes (PROs) for patients with breast cancer receiving adjuvant RT in a prospective randomized trial. Methods and materials: Patients with stage I-III breast cancer treated with adjuvant RT were prospectively randomized to a standard nondetailed review (Arm A) versus an in-depth, individualized RT plan review during week 1 of RT (Arm B). Plan review included visualization of the treatment plan, RT doses, beam arrangements, normal tissue doses, and dose/volume constraints. Patient-reported satisfaction was assessed using a subset of the Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction questionnaire related to physician communication (PC), technical competency (TC), confidence and trust (C&T), and overall satisfaction (OS). The difference in mean scores at baseline, week 1, and the end of RT were assessed. Results: From March 2014 to March 2016, 64 patients with breast cancer (37 in Arm A; 27 in Arm B) were randomized and completed all 3 surveys. Mean baseline scores for PC, TC, C&T, and OS mean were 2.73 (standard deviation [SD], 0.71), 2.66 (SD, 0.86), 2.56 (SD, 0.98), and 2.27 (SD, 0.88), respectively, with high baseline scores in both arms. There was no difference in baseline-reported communication indicators between the arms. There were no significant differences among the 3 time points for PC, TC, C&T, or OS (P = .63, .53, 0.52, and 0.71, respectively). Conclusions: We report the first randomized trial evaluating the impact of in-depth RT plan review on PROs during breast radiation. Both baseline and postintervention scores were high for all domains. Detailed patient assessment, understanding of communication types, and information processing may be necessary to determine subtle PRO differences. Further investigations of PROs could potentially direct and optimize physician and patient communication during RT.",
author = "Dyer, {Brandon A.} and Chin-Shang Li and Daly, {Megan E} and Monjazeb, {Arta M} and Mayadev, {Jyoti S.}",
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journal = "Practical Radiation Oncology",
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T1 - Prospective, Randomized Control Trial Investigating the Impact of a Physician-Communicated Radiation Therapy Plan Review on Breast Cancer Patient-Reported Satisfaction

AU - Dyer, Brandon A.

AU - Li, Chin-Shang

AU - Daly, Megan E

AU - Monjazeb, Arta M

AU - Mayadev, Jyoti S.

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Y1 - 2019/1/1

N2 - Purpose: Patients with breast cancer face complex medical decision-making. We investigated the impact of a physician-communicated, patient-specific radiation therapy (RT) plan review on patient-reported outcomes (PROs) for patients with breast cancer receiving adjuvant RT in a prospective randomized trial. Methods and materials: Patients with stage I-III breast cancer treated with adjuvant RT were prospectively randomized to a standard nondetailed review (Arm A) versus an in-depth, individualized RT plan review during week 1 of RT (Arm B). Plan review included visualization of the treatment plan, RT doses, beam arrangements, normal tissue doses, and dose/volume constraints. Patient-reported satisfaction was assessed using a subset of the Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction questionnaire related to physician communication (PC), technical competency (TC), confidence and trust (C&T), and overall satisfaction (OS). The difference in mean scores at baseline, week 1, and the end of RT were assessed. Results: From March 2014 to March 2016, 64 patients with breast cancer (37 in Arm A; 27 in Arm B) were randomized and completed all 3 surveys. Mean baseline scores for PC, TC, C&T, and OS mean were 2.73 (standard deviation [SD], 0.71), 2.66 (SD, 0.86), 2.56 (SD, 0.98), and 2.27 (SD, 0.88), respectively, with high baseline scores in both arms. There was no difference in baseline-reported communication indicators between the arms. There were no significant differences among the 3 time points for PC, TC, C&T, or OS (P = .63, .53, 0.52, and 0.71, respectively). Conclusions: We report the first randomized trial evaluating the impact of in-depth RT plan review on PROs during breast radiation. Both baseline and postintervention scores were high for all domains. Detailed patient assessment, understanding of communication types, and information processing may be necessary to determine subtle PRO differences. Further investigations of PROs could potentially direct and optimize physician and patient communication during RT.

AB - Purpose: Patients with breast cancer face complex medical decision-making. We investigated the impact of a physician-communicated, patient-specific radiation therapy (RT) plan review on patient-reported outcomes (PROs) for patients with breast cancer receiving adjuvant RT in a prospective randomized trial. Methods and materials: Patients with stage I-III breast cancer treated with adjuvant RT were prospectively randomized to a standard nondetailed review (Arm A) versus an in-depth, individualized RT plan review during week 1 of RT (Arm B). Plan review included visualization of the treatment plan, RT doses, beam arrangements, normal tissue doses, and dose/volume constraints. Patient-reported satisfaction was assessed using a subset of the Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - Patient Satisfaction questionnaire related to physician communication (PC), technical competency (TC), confidence and trust (C&T), and overall satisfaction (OS). The difference in mean scores at baseline, week 1, and the end of RT were assessed. Results: From March 2014 to March 2016, 64 patients with breast cancer (37 in Arm A; 27 in Arm B) were randomized and completed all 3 surveys. Mean baseline scores for PC, TC, C&T, and OS mean were 2.73 (standard deviation [SD], 0.71), 2.66 (SD, 0.86), 2.56 (SD, 0.98), and 2.27 (SD, 0.88), respectively, with high baseline scores in both arms. There was no difference in baseline-reported communication indicators between the arms. There were no significant differences among the 3 time points for PC, TC, C&T, or OS (P = .63, .53, 0.52, and 0.71, respectively). Conclusions: We report the first randomized trial evaluating the impact of in-depth RT plan review on PROs during breast radiation. Both baseline and postintervention scores were high for all domains. Detailed patient assessment, understanding of communication types, and information processing may be necessary to determine subtle PRO differences. Further investigations of PROs could potentially direct and optimize physician and patient communication during RT.

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