Association of patient-provider communication domains with lung cancer treatment

Jenny J. Lin, Jessica Lake, Melanie M. Wall, Andrew R. Berman, John Salazar-Schicchi, Charles Powell, Steven M. Keller, Ethan A. Halm, Howard Leventhal, Juan P. Wisnivesky

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

BACKGROUND: Patient-physician communication is critical for helping patients understand and complete the complex steps needed to diagnose stage and treat lung cancer. We assessed which domains of patient-physician communication about lung cancer and its treatment are associated with receipt of disease-directed, stage-appropriate treatment. METHODS: Patients with recently diagnosed lung cancer were recruited from four medical centers in New York City from 2008 to 2011. Participants were surveyed about discussions with physicians regarding treatment, symptoms, and needs. Multiple regression analysis and structural equation modeling were used to assess which communication factors were associated with disease treatment. RESULTS: Of the 352 participants, 191 (54%) received disease-directed, stage-appropriate treatment. Unadjusted associations between communication items and treatment found that participants who felt that their physicians explained the risks and disadvantages of lung cancer treatment (p < 0.01), discussed their chances of cure (p = 0.02), discussed goals of treatment (p < 0.01), or who were warm and friendly (p = 0.04) were more likely to undergo treatment. Three communication domains were identified: treatment information, physician support, and patient symptoms/needs. After adjusting for known determinants of lung cancer treatment, increased treatment information was associated with higher probability of cancer-directed treatment (p = 0.003). Other communication domains (physician support or patient symptoms/needs) were not independent predictors of treatment (p > 0.05 for both comparisons). CONCLUSION: These data suggest that treatment information is particularly important for increasing the probability of cancer-directed therapy among lung cancer patients. Clinicians should ensure that they clearly discuss treatment goals and options with patients while maintaining empathy, supporting patient needs, and addressing symptoms.

Original languageEnglish (US)
Pages (from-to)1249-1254
Number of pages6
JournalJournal of Thoracic Oncology
Volume9
Issue number9
DOIs
StatePublished - 2014

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Lung Neoplasms
Communication
Physicians
Therapeutics
Regression Analysis

Keywords

  • Lung cancer
  • Patient-provider communication
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Lin, J. J., Lake, J., Wall, M. M., Berman, A. R., Salazar-Schicchi, J., Powell, C., ... Wisnivesky, J. P. (2014). Association of patient-provider communication domains with lung cancer treatment. Journal of Thoracic Oncology, 9(9), 1249-1254. https://doi.org/10.1097/JTO.0000000000000281

Association of patient-provider communication domains with lung cancer treatment. / Lin, Jenny J.; Lake, Jessica; Wall, Melanie M.; Berman, Andrew R.; Salazar-Schicchi, John; Powell, Charles; Keller, Steven M.; Halm, Ethan A.; Leventhal, Howard; Wisnivesky, Juan P.

In: Journal of Thoracic Oncology, Vol. 9, No. 9, 2014, p. 1249-1254.

Research output: Contribution to journalArticle

Lin, JJ, Lake, J, Wall, MM, Berman, AR, Salazar-Schicchi, J, Powell, C, Keller, SM, Halm, EA, Leventhal, H & Wisnivesky, JP 2014, 'Association of patient-provider communication domains with lung cancer treatment', Journal of Thoracic Oncology, vol. 9, no. 9, pp. 1249-1254. https://doi.org/10.1097/JTO.0000000000000281
Lin, Jenny J. ; Lake, Jessica ; Wall, Melanie M. ; Berman, Andrew R. ; Salazar-Schicchi, John ; Powell, Charles ; Keller, Steven M. ; Halm, Ethan A. ; Leventhal, Howard ; Wisnivesky, Juan P. / Association of patient-provider communication domains with lung cancer treatment. In: Journal of Thoracic Oncology. 2014 ; Vol. 9, No. 9. pp. 1249-1254.
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N2 - BACKGROUND: Patient-physician communication is critical for helping patients understand and complete the complex steps needed to diagnose stage and treat lung cancer. We assessed which domains of patient-physician communication about lung cancer and its treatment are associated with receipt of disease-directed, stage-appropriate treatment. METHODS: Patients with recently diagnosed lung cancer were recruited from four medical centers in New York City from 2008 to 2011. Participants were surveyed about discussions with physicians regarding treatment, symptoms, and needs. Multiple regression analysis and structural equation modeling were used to assess which communication factors were associated with disease treatment. RESULTS: Of the 352 participants, 191 (54%) received disease-directed, stage-appropriate treatment. Unadjusted associations between communication items and treatment found that participants who felt that their physicians explained the risks and disadvantages of lung cancer treatment (p < 0.01), discussed their chances of cure (p = 0.02), discussed goals of treatment (p < 0.01), or who were warm and friendly (p = 0.04) were more likely to undergo treatment. Three communication domains were identified: treatment information, physician support, and patient symptoms/needs. After adjusting for known determinants of lung cancer treatment, increased treatment information was associated with higher probability of cancer-directed treatment (p = 0.003). Other communication domains (physician support or patient symptoms/needs) were not independent predictors of treatment (p > 0.05 for both comparisons). CONCLUSION: These data suggest that treatment information is particularly important for increasing the probability of cancer-directed therapy among lung cancer patients. Clinicians should ensure that they clearly discuss treatment goals and options with patients while maintaining empathy, supporting patient needs, and addressing symptoms.

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