The impact of 4R oncology model on patient self management and satisfaction in lung versus breast cancer.

Abstract

e18703 Background: Proposed under NCI ASCO Teams project, the 4R Oncology model (Right Info/Care/Patient/Time) facilitates patient self management (PSM) and team based care delivery with a novel 4R Care Sequence plan (JOP 2016). 4R has been shown to improve PSM in breast cancer (JCOOP 2021), but its impact in other cancers is unknown. Also, the 4R effect on patient satisfaction – a care quality aspect important at patient and institutional levels - has not been evaluated. We examined and compared 4R impact on PSM and patient satisfaction in lung (LC) and breast (BC) cancers at 3 centers of a large health system Oct 2020 - Dec 2021. Methods: Surveys of patient cohorts: 4R cohort who received 4R plans and historical control who received care pre-4R. Cohorts included BC stages 0-3 and all LC stages. See Table for metrics. Results: Survey response rates: 53% (control), 42% (4R). All PSM and satisfaction metrics significantly improved in 4R vs. control groups for the combined cohort of both cancers (Table). LC and BC patients significantly benefited from 4R vs control in 2 PSM metrics (b, c). LC patients benefited more than BC patients in 1 PSM and 3 satisfaction metrics (a, g, i, j). For other metrics (d, e, f, h) benefits in LC occurred in the same direction and same magnitude as in BC, but were not significant, likely due to smaller group size. Among 4R patients, similar ratios of LC and BC patients deemed 4R useful (76%, 78%, p = .7) (data not shown). Conclusions: 4R improved self management and satisfaction among patients with lung or breast cancer. Notably, it helped lung cancer patients who are typically older and sicker than breast cancer patients to better understand their cancer and manage their care. It also helped lung cancer patients feel more respected and taken seriously, suggesting that 4R countered the stigma and guilt often experienced by these patients. Variable impact in some metrics between lung and breast cancers suggest different self management needs relevant to these metrics. Further model refinement should address these differences. [Table: see text]