Patient-reported quality of supportive care among patients with colorectal cancer in the veterans affairs health care system

Michelle Van Ryn, Sean M. Phelan, Neeraj K. Arora, David Haggstrom, George L. Jackson, S. Yousuf Zafar, Joan M. Griffin, Leah L. Zullig, Dawn Provenzale, Mark W. Yeazel, Rahul M. Jindal, Steven B. Clauser

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: High-quality supportive care is an essential component of comprehensive cancer care. We implemented a patient-centered quality of cancer care survey to examine and identify predictors of quality of supportive care for bowel problems, pain, fatigue, depression, and other symptoms among 1,109 patients with colorectal cancer. Patients and Methods: Patients with new diagnosis of colorectal cancer at any Veterans Health Administration medical center nationwide in 2008 were ascertained through the Veterans Affairs Central Cancer Registry and sent questionnaires assessing a variety of aspects of patient-centered cancer care. We received questionnaires from 63% of eligible patients (N = 1,109). Descriptive analyses characterizing patient experiences with supportive care and binary logistic regression models were used to examine predictors of receipt of help wanted for each of the five symptom categories. Results: There were significant gaps in patient-centered quality of supportive care, beginning with symptom assessment. In multivariable modeling, the impact of clinical factors and patient race on odds of receiving wanted help varied by symptom. Coordination of care quality predicted receipt of wanted help for all symptoms, independent of patient demographic or clinical characteristics. Conclusion: This study revealed substantial gaps in patient-centered quality of care, difficult to characterize through quality measurement relying on medical record review alone. It established the feasibility of collecting patient-reported quality measures. Improving quality measurement of supportive care and implementing patient-reported outcomes in quality-measurement systems are high priorities for improving the processes and outcomes of care for patients with cancer.

Original languageEnglish
Pages (from-to)809-815
Number of pages7
JournalJournal of Clinical Oncology
Volume32
Issue number8
DOIs
StatePublished - Mar 10 2014

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Veterans Health
Quality of Health Care
Colorectal Neoplasms
Delivery of Health Care
Patient-Centered Care
Neoplasms
Logistic Models
United States Department of Veterans Affairs
Symptom Assessment
Veterans
Medical Records
Fatigue
Registries
Patient Care
Demography
Depression

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Patient-reported quality of supportive care among patients with colorectal cancer in the veterans affairs health care system. / Van Ryn, Michelle; Phelan, Sean M.; Arora, Neeraj K.; Haggstrom, David; Jackson, George L.; Zafar, S. Yousuf; Griffin, Joan M.; Zullig, Leah L.; Provenzale, Dawn; Yeazel, Mark W.; Jindal, Rahul M.; Clauser, Steven B.

In: Journal of Clinical Oncology, Vol. 32, No. 8, 10.03.2014, p. 809-815.

Research output: Contribution to journalArticle

Van Ryn, M, Phelan, SM, Arora, NK, Haggstrom, D, Jackson, GL, Zafar, SY, Griffin, JM, Zullig, LL, Provenzale, D, Yeazel, MW, Jindal, RM & Clauser, SB 2014, 'Patient-reported quality of supportive care among patients with colorectal cancer in the veterans affairs health care system', Journal of Clinical Oncology, vol. 32, no. 8, pp. 809-815. https://doi.org/10.1200/JCO.2013.49.4302
Van Ryn, Michelle ; Phelan, Sean M. ; Arora, Neeraj K. ; Haggstrom, David ; Jackson, George L. ; Zafar, S. Yousuf ; Griffin, Joan M. ; Zullig, Leah L. ; Provenzale, Dawn ; Yeazel, Mark W. ; Jindal, Rahul M. ; Clauser, Steven B. / Patient-reported quality of supportive care among patients with colorectal cancer in the veterans affairs health care system. In: Journal of Clinical Oncology. 2014 ; Vol. 32, No. 8. pp. 809-815.
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