Intervention to improve care delivery and patient self-management for people with primary liver cancer who have socioeconomic disadvantages.

Abstract

e16232 Background: The 4R Oncology Model (4R = Right information/care/patient/time) supports patient self-management (Trosman, JCOOP 2021) and guideline-based care delivery (Liu, JCOOP 2022). 4R Care Sequence plans provide a care checklist and a graphical depiction of care timing and sequence. Here we report the impact of the 4R Care Sequence plans on care delivery and patient self-management among patients with primary liver cancer with socioeconomic disadvantages. Methods: 4R plans were provided to patients with liver cancer Jan – Dec ’23 (4R cohort). Patient-reported data were collected via surveys. Analyses compared the 4R cohort (N = 42) to a control cohort of patients who received care pre-4R, Jan - Dec ’22 (N = 52). Statistical analysis used Fisher’s exact and t-tests. Results: Survey response rates: control cohort 61% (52/85), 4R cohort 58% (42/73). Comparing control to 4R cohort respectively, patients exhibited the following characteristics: male (63%, 67%), White (67%, 74%), Black (25%, 19%), an average age (64.1, 63.9), and the majority had annual income less than $30,000 (62%, 67%). 4R significantly improved care delivery and patient self-management in all metrics vs control (Table). Patient rating of provider satisfaction on a 10-point scale was lower in the control cohort compared to the 4R cohort (8.4, 9.8, p < 0.0001), data not shown. The significant improvement across metrics was observed regardless of age, race, sex. Among patients who made < $30k annually, referral rates to a dentist before treatment increased significantly between control and 4R cohorts (19%,79%, p < 0.0001). Among patients who made > $30k annually, dental referral rates did not change between the control and 4R cohorts (70%, 71%, p = 1.00). Income was not a factor for other metrics. Conclusions: The 4R intervention using Care Sequence plans for patients with primary liver cancer facilitated improvements in care delivery and patient self-management regardless of age, race, sex or income. Our results indicate that 4R benefits all patients, including those with socioeconomic disadvantages. [Table: see text]