Study: Navigators Help Breast Cancer Patients Get Recommended Care

Patient navigators can play an important role in helping poor and underserved women.

Patient navigators can play an important role in helping poor and underserved women overcome barriers to receiving recommended care for breast cancer, a recent study found.

Researchers performed a secondary analysis of women diagnosed with breast cancer who participated in the Patient Navigation Research Program (PNRP) to determine whether they received recommended anti-estrogen therapy, radiation, or chemotherapy. Compared to non-navigated patients, navigated patients were more likely to receive anti-estrogen therapy but no more likely than controls to receive radiation (data was insufficient to assess impact on chemotherapy). The findings were published online July 28 in the Journal of Clinical Oncology.

“These results suggest that patient navigation can be a promising solution/intervention,” the authors wrote, “particularly because the current literature suggests that minority women of low socioeconomic status are at risk of low adherence to anti-estrogen therapy.”

The study is based on data collected at 10 research centers between 2006-2011 on over 1,000 women with breast cancer participating in the PNRP, sponsored by the National Cancer Institute and the American Cancer Society.  Participants had a mean age of 56 years and were racially and ethnically diverse (38% black; 22% Hispanic; 36% white; and 4% other).

It is not clear why patient navigation was more effective in helping patients receive anti-estrogen therapy than radiation therapy, the authors said. However, they speculated that it may have been more difficult for navigators to deal with obstacles associated with receiving radiation treatment as opposed to obtaining prescriptions or educating patients to facilitate anti-estrogen therapy.

“Barriers addressed in radiation therapy may require a different set of actions compared with assistance in obtaining anti-estrogen therapy,” the authors wrote. “For example, assistance with transportation or managing work schedules could have played a more prominent role.”

More research is needed to confirm the study’s findings and address questions that it raises, such as how navigation improves receipt of recommended treatment and which populations and settings would most benefit from it, researchers said.

“Our lack of a consistent finding in favor of navigation for all three quality treatment metrics suggests that the benefits of navigation may depend on the type of barriers addressed (eg, financial, transportation) and personal interaction (education and/or understanding regarding illness, treatment, and so on),” the authors said. “Targeting resources to the right area (eg, timeliness, transportation, or logistical help) will identify which aspects of care are best suited for patient navigation to make a difference.”