Care delivery and patient self-management for people with primary liver cancer receiving 4R care sequence plans.

Authors

null

George Therapondos

Department of Gastroenterology and Multiorgan Transplant Institute, Oschner Medical Center, New Orleans, LA

George Therapondos , Christine B. Weldon , Lingling Du , Jonathan Mizrahi , Carol Palmer , Amanda Medina , Tyler Allan Sandow , Juan Gimenez , Ari Cohen , Michelle O'Brien , Amie Tan , Julia R. Trosman

Organizations

Department of Gastroenterology and Multiorgan Transplant Institute, Oschner Medical Center, New Orleans, LA, Center for Business Models in Healthcare, Glencoe, IL, Ochsner Medical Center, New Orleans, LA, Ochsner Health System, New Orleans, LA, Ochsner Health System, Jefferson, LA, Ochsner Health, New Orleans, LA, Genentech, Inc., South San Francisco, CA

Research Funding

Genentech

Background: The 4R Oncology Model (4R=Right information/care/patient/time) supports patient self-management1 and quality improvement.2 Here we report the impact of using 4R Care Sequence plans for patients with primary liver cancer cared for by a multi-disciplinary liver cancer team. Methods: We tested the impact of 4R care sequence plans on patient self-management and care delivery referrals at a liver cancer program via patient surveys. 4R Plans were provided to patients with primary liver cancer from Jan – Aug ’23 (4R cohort). Patient-reported data were analyzed to compare the control cohort of patients who received care pre-4R, Jan - Dec ’22 (N=42) to the 4R cohort (N=17). Statistical analysis used Fisher’s exact test. Results: Patient survey response rates: Control cohort 54% (42/78), 4R cohort 55% (17/31). Comparing the control cohort to the 4R cohort respectively, patients were male (52%, 65%), White (64%, 64%), Black (26%, 18%), average age (63.2, 64.7), and reported income less than $30,000 (45%, 53%). The 4R cohort significantly improved care delivery in three metrics, and directionally improved in the other care delivery metrics as compared to the control cohort (table). All four patient self-management metrics significantly improved in the 4R cohort vs. the control cohort (Table). Conclusions: The use of 4R Care Sequence plans for patients with primary liver cancer facilitated improvements in care delivery and patient self-management metrics. While there were directional improvements in all metrics, there is opportunity and room for additional improvements. The team will continue to work on efforts to improve these metrics and optimize the use of 4R Care Sequence plans for patients with primary liver cancer. 1. Trosman, JCOOP 2021. 2. Liu, JCOOP 2022.

Control Cohort
%
N=42
4R Cohort %
N=17
P value
Care DeliveryEmotional distress or worry assistance referral36760.005
Primary care provider referral76880.3
Practical, financial, or insurance help referral43590.2
Receipt of side-effect information before starting treatment74940.07
Receipt of printed liver cancer information671000.004
Receipt of information about cancer.net38940.0001
Patient Self-ManagementUnderstand the goal of care791000.04
Able to understand, participate in care60880.03
Felt in control of my care761000.02
Able to manage and organize one’s care36820.001

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Abstract Details

Meeting

2024 ASCO Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Pancreatic Cancer,Hepatobiliary Cancer,Neuroendocrine/Carcinoid,Small Bowel Cancer

Sub Track

Quality of Care/Quality Improvement

Citation

J Clin Oncol 42, 2024 (suppl 3; abstr 465)

DOI

10.1200/JCO.2024.42.3_suppl.465

Abstract #

465

Poster Bd #

B10

Abstract Disclosures

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