Abstract A9: Perceptions of information provided by oncologists in clinical interactions with black and white patients/companions

Abstract

Abstract Purpose: Most patients want and need information about their cancer and their preferred source is a health care provider. Previous studies show the quality of communication between oncologists and black patients is often of lower quality than with white patients. The purpose of this study was to assess differences in perceptions by black and white patients and their companions about information provided during initial oncology interactions. Methods: Data collection occurred in the multidisciplinary outpatient clinic of a comprehensive cancer center serving a majority black population in Detroit. The research was part of a larger study on oncologist-patient-companion communication. Patients were eligible if this was their first visit and they had a companion with them. Patients, oncologists, and companions independently completed questionnaires assessing their perceptions of whether each of 6 topics had been discussed (diagnosis, prognosis, metastasis, treatment, side effects, next steps), and if so, what the oncologist said about the topic. In addition, participants were asked how well the patient understood each of the topics discussed. Patients were also asked how much they agreed with the oncologists’ diagnosis. Results: The sample included 61 oncology patients (18% black, 82% white), their companions, and eight oncologists (all non-black). Black patients were underrepresented because they were much less likely to bring a companion. No black-white differences were found in how often patients and companions agreed with their oncologists as to whether the topics were discussed or what the oncologist said about the topics. For both blacks and whites, the greatest agreement with the oncologist was about diagnosis and the least was about side effects. Although no black-white differences occurred in agreement about whether or not side effects were discussed, pairs that agreed reported that side effects were not discussed in 38% of interactions with blacks and not discussed in only 3% of interactions with whites (p =.002). Companions reported a similar pattern of black-white disparities regarding side effects. No differences were found in oncologist reports of how well black v. white patients understood each topic, but black patients reported significantly less understanding of the discussion of diagnosis than did White patients (p=.001). Further, blacks reported less agreement than whites with their oncologists’ opinions of the seriousness of the cancer (p=.05) and how much it had spread (p < .001). Conclusion: We found few black-white differences in patient and companion agreement with oncologists regarding perceptions of what was discussed during the interactions. However, findings suggest oncologists discuss side effects less frequently with blacks than with whites. Also, blacks report less understanding and more disagreement with oncologists than white patients. A limitation was the underrepresentation of blacks because they frequently did not have a companion present; future studies should compare the quality of information exchange between oncologists and black patients with and without companions. This study suggests interventions are needed to improve the quality of information exchange for black patients in cancer clinical interactions. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A9.