Abstract PS9-22: Supportive care needs and patient experience of women with metastatic breast cancer in a safety-net system

Abstract

Abstract Background: Metastatic breast cancer (MBC) is an incurable, albeit treatable cancer affecting over 150,000 women in the US. Addressing supportive care needs has become increasingly important as women are living longer with MBC due to advances in treatment. However, most supportive care programs were developed for women with early stage breast cancer. The existing literature also offers limited understanding of the needs of patients receiving care in safety net settings, which are often under-resourced and treat medically underserved populations, who are more likely to be diagnosed with MBC. Methods: This study sought to understand the supportive care needs and experience of MBC patients receiving care in a safety net system. Semi-structured interviews were conducted with 11 patients (average age = 42.8 years, SD = 19.5) who were undergoing treatment for MBC. Questions centered on the diagnosis and treatment experience, patient-provider communication, and perceived barriers to care. Interviews were digitally audio-recorded, transcribed and coded using a Grounded Theory approach. Results: Patients noted that a lack of familiarity with medical terminology and insufficient medical knowledge made it difficult for them to evaluate treatment options, make treatment decisions, and communicate their supportive care needs. Half (n=5) did not feel their healthcare concerns were validated when expressed and some even went so far as to exaggerate reports of physical symptom severity in order to receive more timely and attentive care. Patients were dissatisfied with the timeliness of information delivery, scheduling delays, and long wait times. Some also felt that seeing different providers (e.g., residents, fellows) each time they came into the clinic interfered with the doctor-patient bond and continuity of care. Conclusion: This study identified patient, provider, and system-level factors affecting MBC patients’ experience of care in a safety-net system. Our findings indicate a strong need for support services including outreach to address health literacy issues, treatment decision making, and symptom management concerns. They also indicate a need for improved disease and treatment information exchange between patients and healthcare providers. Citation Format: Ashley Buchanan, Ola El-Mubasher, Astrid Sarfo, Hoda Badr. Supportive care needs and patient experience of women with metastatic breast cancer in a safety-net system [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-22.