Johns Hopkins University, Baltimore, MD
Vered Stearns, Amanda Montanari, Jennifer Y. Sheng, Janelle Coughlin
Background: Cancer treatments often result in unfavorable early and late side effects that impact quality of life. Many forms of cancer, including some types of breast cancer, are also associated with obesity, which may be mediated by lifestyle behaviors. Providing comprehensive cancer treatment and prevention requires assessment and management of both behavioral and psychosocial domains. We initiated a quality improvement project to determine the feasibility of collecting patient-reported outcomes electronically and to identify behavioral and psychosocial needs and interests of women with early stage breast cancer (ESBC) receiving treatment at Johns Hopkins. Methods: We reviewed the outpatient schedules of 2 medical oncologists at different Johns Hopkins sites and identified 169 patients with ESBC who completed a lumpectomy or mastectomy. Using the electronic medical records (EMR) patient portal and/or email, we sent messages to women approximately 3 days prior to an oncology visit with a survey link to a behavioral battery. The battery included assessment of behavioral/psychosocial domains including: nutrition/eating behaviors, weight, pain, substance use, sleep, mental health, sexual health). Women were also asked if they desired additional information on specific behaviors. Results: A total of 100 women responded to the survey (59% response rate). Mean Age = 58.35 years (SD 11.54, range 33-78); 12% Asian, 18% Black, 68% White; 80% married; Mean BMI = 27.8 kg/m2 (SD 6.56). Main results are shown in the table. Behaviors most frequently identified as concerns that patients wanted additional resources for included nutrition (14%) and sleep (11%). Conclusions: Use of the patient portal to gauge patient concerns is feasible, and may help identify the most pressing issues of patients prior to scheduled visits. Our results will be used to develop an EMR-based dashboard and strategies for early interventions to improve wellness and survival outcomes in patients with ESBC.
Behavior | % with concern |
---|---|
Fast food > 3 times a week | 6 |
Soda consumption, 3-4 times a week | 3 |
< 3 servings of fruit/vegetables per day | 65, 46 |
Overweight (BMI 25-29.9 kg/m2), Obese (BMI > 30 kg/m2) | 31, 31 |
< 150 minutes of moderate or vigorous physical activity | 63 |
Pain in prior week | 81 |
> 3 alcoholic beverages per week | 22 |
Insomnia, Excessive daytime sleepiness | 37, 15 |
At least one sexual function concern, Dissatisfied with sexual function | 77, 28 |
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