The association between cancer care coordination and quality of life is stronger for breast cancer patients with lower health literacy: A Greater Plains Collaborative study

Bradley D. McDowell, Jennifer Klemp, Anne Blaes, Andrea Cohee, Amy Trentham-Dietz, Sailaja Kamaraju, Julie Otte, Sarah L. Mott, Elizabeth A. Chrischilles

Research output: Contribution to journalArticle

Abstract

Purpose: Health literacy (HL) and cancer care coordination (CCC) were examined for their relationship to quality of life (QOL) among breast cancer survivors. CCC was hypothesized to have a stronger relationship to QOL for women with lower HL. Methods: Women (N = 1138) who had completed treatment for Stage 0–III, ductal carcinoma breast cancer between January 2013 and May 2014 at one of eight large medical centers responded to a mailed questionnaire. Responses to questions about survivorship care planning and presence of professional care coordinator were combined to form an index of CCC. An index of HL was also derived. QOL was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B) scales. Results: 74.3% (N = 845) of patients reported having a health professional coordinate their care during treatment and 78.8% (N = 897) reported receiving survivorship care planning. CCC was classified as none, partial, or high for 7.1%, 32.7%, and 60.2% of the patients, respectively. Except for emotional well-being, the interaction between HL and CCC was significant for all QOL domains (p <.05); the effect of CCC on FACT-B scores was largest for people with lower HL. For the 39.8% of patients with less than high CCC, 111 (27.3%) had a level of HL associated with clinically meaningful lower QOL. Conclusions: The association between CCC and later QOL is strongest for people who have lower HL. Prioritizing care coordination for patients with lower health literacy may be an effective strategy in a setting of limited resources.

Original languageEnglish (US)
JournalSupportive Care in Cancer
DOIs
StatePublished - Jan 1 2019

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Health Literacy
Quality of Life
Breast Neoplasms
Neoplasms
Survival Rate
Ductal Carcinoma
Therapeutics
Health Status
Survivors
Patient Care
Health

Keywords

  • Breast cancer
  • Care coordination
  • Health literacy
  • Quality of life
  • Survivorship

ASJC Scopus subject areas

  • Oncology

Cite this

The association between cancer care coordination and quality of life is stronger for breast cancer patients with lower health literacy : A Greater Plains Collaborative study. / McDowell, Bradley D.; Klemp, Jennifer; Blaes, Anne; Cohee, Andrea; Trentham-Dietz, Amy; Kamaraju, Sailaja; Otte, Julie; Mott, Sarah L.; Chrischilles, Elizabeth A.

In: Supportive Care in Cancer, 01.01.2019.

Research output: Contribution to journalArticle

McDowell, Bradley D. ; Klemp, Jennifer ; Blaes, Anne ; Cohee, Andrea ; Trentham-Dietz, Amy ; Kamaraju, Sailaja ; Otte, Julie ; Mott, Sarah L. ; Chrischilles, Elizabeth A. / The association between cancer care coordination and quality of life is stronger for breast cancer patients with lower health literacy : A Greater Plains Collaborative study. In: Supportive Care in Cancer. 2019.
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abstract = "Purpose: Health literacy (HL) and cancer care coordination (CCC) were examined for their relationship to quality of life (QOL) among breast cancer survivors. CCC was hypothesized to have a stronger relationship to QOL for women with lower HL. Methods: Women (N = 1138) who had completed treatment for Stage 0–III, ductal carcinoma breast cancer between January 2013 and May 2014 at one of eight large medical centers responded to a mailed questionnaire. Responses to questions about survivorship care planning and presence of professional care coordinator were combined to form an index of CCC. An index of HL was also derived. QOL was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B) scales. Results: 74.3{\%} (N = 845) of patients reported having a health professional coordinate their care during treatment and 78.8{\%} (N = 897) reported receiving survivorship care planning. CCC was classified as none, partial, or high for 7.1{\%}, 32.7{\%}, and 60.2{\%} of the patients, respectively. Except for emotional well-being, the interaction between HL and CCC was significant for all QOL domains (p <.05); the effect of CCC on FACT-B scores was largest for people with lower HL. For the 39.8{\%} of patients with less than high CCC, 111 (27.3{\%}) had a level of HL associated with clinically meaningful lower QOL. Conclusions: The association between CCC and later QOL is strongest for people who have lower HL. Prioritizing care coordination for patients with lower health literacy may be an effective strategy in a setting of limited resources.",
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AU - Blaes, Anne

AU - Cohee, Andrea

AU - Trentham-Dietz, Amy

AU - Kamaraju, Sailaja

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N2 - Purpose: Health literacy (HL) and cancer care coordination (CCC) were examined for their relationship to quality of life (QOL) among breast cancer survivors. CCC was hypothesized to have a stronger relationship to QOL for women with lower HL. Methods: Women (N = 1138) who had completed treatment for Stage 0–III, ductal carcinoma breast cancer between January 2013 and May 2014 at one of eight large medical centers responded to a mailed questionnaire. Responses to questions about survivorship care planning and presence of professional care coordinator were combined to form an index of CCC. An index of HL was also derived. QOL was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B) scales. Results: 74.3% (N = 845) of patients reported having a health professional coordinate their care during treatment and 78.8% (N = 897) reported receiving survivorship care planning. CCC was classified as none, partial, or high for 7.1%, 32.7%, and 60.2% of the patients, respectively. Except for emotional well-being, the interaction between HL and CCC was significant for all QOL domains (p <.05); the effect of CCC on FACT-B scores was largest for people with lower HL. For the 39.8% of patients with less than high CCC, 111 (27.3%) had a level of HL associated with clinically meaningful lower QOL. Conclusions: The association between CCC and later QOL is strongest for people who have lower HL. Prioritizing care coordination for patients with lower health literacy may be an effective strategy in a setting of limited resources.

AB - Purpose: Health literacy (HL) and cancer care coordination (CCC) were examined for their relationship to quality of life (QOL) among breast cancer survivors. CCC was hypothesized to have a stronger relationship to QOL for women with lower HL. Methods: Women (N = 1138) who had completed treatment for Stage 0–III, ductal carcinoma breast cancer between January 2013 and May 2014 at one of eight large medical centers responded to a mailed questionnaire. Responses to questions about survivorship care planning and presence of professional care coordinator were combined to form an index of CCC. An index of HL was also derived. QOL was measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B) scales. Results: 74.3% (N = 845) of patients reported having a health professional coordinate their care during treatment and 78.8% (N = 897) reported receiving survivorship care planning. CCC was classified as none, partial, or high for 7.1%, 32.7%, and 60.2% of the patients, respectively. Except for emotional well-being, the interaction between HL and CCC was significant for all QOL domains (p <.05); the effect of CCC on FACT-B scores was largest for people with lower HL. For the 39.8% of patients with less than high CCC, 111 (27.3%) had a level of HL associated with clinically meaningful lower QOL. Conclusions: The association between CCC and later QOL is strongest for people who have lower HL. Prioritizing care coordination for patients with lower health literacy may be an effective strategy in a setting of limited resources.

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