Abstract
We examined the effects of a communication intervention to engage family care partners on patient portal (MyChart) use, illness understanding, satisfaction with cancer care, and symptoms of anxiety in a single-blind randomized trial of patients in treatment for breast cancer. Patient-family dyads were recruited and randomly assigned a self-administered checklist to clarify the care partner role, establish a shared visit agenda, and facilitate MyChart access (n = 63) or usual care (n = 55). Interviews administered at baseline, 3, 9 (primary endpoint), and 12 months assessed anxiety (GAD-2), mean FAMCARE satisfaction, and complete illness understanding (4 of 4 items correct). Time-stamped electronic interactions measured MyChart use. By 9 months, more intervention than control care partners registered for MyChart (77.8 % vs 1.8%; p < 0.001) and logged into the patient’s account (61.2% vs 0% of those registered; p < 0.001), but few sent messages to clinicians (6.1% vs 0%; p = 0.247). More intervention than control patients viewed clinical notes (60.3% vs 32.7%; p = 0.003). No pre-post group differences in patient or care partner symptoms of anxiety, satisfaction, or complete illness understanding were found. Intervention patients whose care partners logged into MyChart were more likely to have complete illness understanding at 9 months (changed 70.0% to 80.0% vs 69.7% to 54.6%; p = 0.03); symptoms of anxiety were numerically lower (16.7% to 6.7% vs 15.2% to 15.2%; p = 0.24) and satisfaction numerically higher (15.8–16.2 vs 18.0–17.4; p = 0.25). A brief, scalable communication intervention led to greater care partner MyChart use and increased illness understanding among patients with more engaged care partners (NCT03283553).
Highlights
Those living with serious illness commonly value, desire, and rely on family[1,2]
A communication intervention to clarify the role of family care partners in face-to-face and electronic interactions led to meaningful increases in care partners’ access and use of the patient portal and twice as many patients viewing their oncology visit notes
Intervention patients whose care partners accessed MyChart using their own identity credentials during the observation period were more likely to have complete illness understanding than patients whose care partners were less actively engaged during the observation period
Summary
Those living with serious illness commonly value, desire, and rely on family[1,2]. the family is typically overlooked in cancer care[3]. To test this hypothesis, we conducted a single-blind randomized trial of patients in active treatment for breast cancer and their care partners to examine between-group differences in study outcomes at 9 months. This report of the final results describes effects on patient and care partner use of the patient portal and on measures of symptoms of anxiety, satisfaction with cancer care, and illness understanding at 9 months
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