A Randomized Controlled Trial of the Integrated Cancer Care Access Network on Cancer Treatment Completion and Quality of Life.

Francesca Gany, Irina Melnic, Yuelin Li, Jackie Finik, Minlun Wu, Julia Ramirez, Caroline Hwang, Jennifer Leng, Victoria Blinder
{"title":"A Randomized Controlled Trial of the Integrated Cancer Care Access Network on Cancer Treatment Completion and Quality of Life.","authors":"Francesca Gany, Irina Melnic, Yuelin Li, Jackie Finik, Minlun Wu, Julia Ramirez, Caroline Hwang, Jennifer Leng, Victoria Blinder","doi":"10.6004/jnccn.2025.7017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We prospectively examined the effect of a multilingual, multidisciplinary patient navigation and essential needs access program on oncology treatment completion and patient-reported outcomes among medically underserved patients with cancer. Medically underserved patients have limited socioeconomic/geographic access to medical care.</p><p><strong>Patients and methods: </strong>We conducted an unblinded, 2-arm randomized controlled trial among patients with stage I-III cancer at 2 New York City safety-net cancer clinics (2013-2016), where social work and appointment navigation support were generally available. Patients were randomized by permuted block to either the Integrated Cancer Care Access Network (ICCAN) intervention or the institution's usual and customary care (U&C). The primary outcome, treatment completion, was assessed at 12 months. Quality of life (EuroQol 5-Dimension [EQ-5D]), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), and stress (4-item Perceived Stress Scale [PSS-4]) scores were assessed at baseline and 12 months.</p><p><strong>Results: </strong>All 152 participants were assessed for the primary outcome (ICCAN, n=76; U&C, n=76). Most patients (57%) were foreign-born; 64% preferred English, and 36% preferred Spanish. Treatment completion was higher in the ICCAN arm compared with the U&C arm (92% vs 78%; P=.022). Both arms showed improvements in EQ-5D (effect sizes [ES]: U&C, 0.75; ICCAN, 1.47), PHQ-9 (U&C, 1.06; ICCAN, 1.33), and PSS-4 scores (U&C, 0.29; ICCAN, 1.13). Improvements in EQ-5D (P=.001), PHQ-9 (P=.046), and PSS-4 (P=.001) scores were significantly greater among patients in the ICCAN arm.</p><p><strong>Conclusions: </strong>Patients in the ICCAN arm had significantly better treatment completion and patient-reported outcomes than those receiving U&C. Future studies should explore service utilization and resource access to clarify the reasons for these differences. Comprehensive multidisciplinary patient navigation may improve outcomes for underserved patients with cancer.</p><p><strong>Clinicaltrials: </strong>gov identifier: NCT01742143.</p>","PeriodicalId":520697,"journal":{"name":"Journal of the National Comprehensive Cancer Network : JNCCN","volume":" ","pages":"1-8"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the National Comprehensive Cancer Network : JNCCN","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.6004/jnccn.2025.7017","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: We prospectively examined the effect of a multilingual, multidisciplinary patient navigation and essential needs access program on oncology treatment completion and patient-reported outcomes among medically underserved patients with cancer. Medically underserved patients have limited socioeconomic/geographic access to medical care.

Patients and methods: We conducted an unblinded, 2-arm randomized controlled trial among patients with stage I-III cancer at 2 New York City safety-net cancer clinics (2013-2016), where social work and appointment navigation support were generally available. Patients were randomized by permuted block to either the Integrated Cancer Care Access Network (ICCAN) intervention or the institution's usual and customary care (U&C). The primary outcome, treatment completion, was assessed at 12 months. Quality of life (EuroQol 5-Dimension [EQ-5D]), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), and stress (4-item Perceived Stress Scale [PSS-4]) scores were assessed at baseline and 12 months.

Results: All 152 participants were assessed for the primary outcome (ICCAN, n=76; U&C, n=76). Most patients (57%) were foreign-born; 64% preferred English, and 36% preferred Spanish. Treatment completion was higher in the ICCAN arm compared with the U&C arm (92% vs 78%; P=.022). Both arms showed improvements in EQ-5D (effect sizes [ES]: U&C, 0.75; ICCAN, 1.47), PHQ-9 (U&C, 1.06; ICCAN, 1.33), and PSS-4 scores (U&C, 0.29; ICCAN, 1.13). Improvements in EQ-5D (P=.001), PHQ-9 (P=.046), and PSS-4 (P=.001) scores were significantly greater among patients in the ICCAN arm.

Conclusions: Patients in the ICCAN arm had significantly better treatment completion and patient-reported outcomes than those receiving U&C. Future studies should explore service utilization and resource access to clarify the reasons for these differences. Comprehensive multidisciplinary patient navigation may improve outcomes for underserved patients with cancer.

Clinicaltrials: gov identifier: NCT01742143.

癌症治疗完成和生活质量的综合癌症护理获取网络的随机对照试验。
背景:我们前瞻性地研究了多语言、多学科的患者导航和基本需求获取计划对肿瘤治疗完成和患者报告的治疗结果在医疗服务不足的癌症患者中的影响。医疗服务不足的患者获得医疗服务的社会经济/地理条件有限。患者和方法:我们在2个纽约市安全网癌症诊所(2013-2016年)的I-III期癌症患者中进行了一项非盲、双组随机对照试验,这些诊所通常提供社会工作和预约导航支持。患者按排列区随机分配到综合癌症护理访问网络(ICCAN)干预或机构的常规和习惯护理(U&C)。12个月时评估主要结局——治疗完成情况。在基线和12个月时评估生活质量(EuroQol 5-Dimension [EQ-5D])、抑郁症状(患者健康问卷-9 [PHQ-9])和压力(4项感知压力量表[PSS-4])得分。结果:所有152名参与者都进行了主要结局评估(ICCAN, n=76;你,n = 76)。大多数患者(57%)是外国出生的;64%的人喜欢英语,36%的人喜欢西班牙语。ICCAN组的治疗完成率高于U&C组(92% vs 78%;P = .022)。两组的EQ-5D均有改善(效应量[ES]: U&C, 0.75;Iccan, 1.47), phq-9 (u&c, 1.06;ICCAN, 1.33)和PSS-4评分(U&C, 0.29;ICCAN, 1.13)。ICCAN组患者EQ-5D (P=.001)、PHQ-9 (P=.046)和PSS-4 (P=.001)评分的改善显著大于ICCAN组。结论:ICCAN组患者的治疗完成率和患者报告的结果明显优于U&C组。未来的研究应探讨服务利用和资源获取,以澄清这些差异的原因。综合多学科患者导航可以改善服务不足的癌症患者的预后。临床试验:gov标识符:NCT01742143。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信