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How communication between cancer patients and their specialists affect the quality and cost of cancer care

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Abstract

Purpose

Communication in cancer care is multidimensional and may affect patient treatment decision-making and quality of life. This study examined cancer patients’ perceptions of the communication with their cancer specialists and explored its impact on the care they received and the financial burden they experienced.

Methods

Semi-structured telephone interviews were conducted with 20 rural and 20 outer metropolitan Western Australians diagnosed with breast, lung, prostate or colorectal cancer. Thematic analysis using a phenomenological approach was undertaken to derive key themes regarding the communication experiences of the participants.

Results

Four main themes emerged: information context, communication about treatment options and treatment providers, communication about costs of treatment and impact of communication on continuity of care. The quality of the communication experienced by participants was variable and in many cases sub-optimal. This affected their ability to undertake well-informed decisions regarding treatment and providers and led to substantial out-of-pocket expenses for several participants. Whilst participants differed in their information needs and expectations, most participants trusted clinicians’ treatment recommendations.

Conclusions

Our results raise concerns about the quality of communication cancer patients receive during treatment and the repercussions for their treatment decisions and out-of-pocket expenses. Clear treatment and cost communication could empower patients in choosing treatment and providers. However, these findings suggest patients must remain vigilant during consultations and discuss available treatment pathways and their financial dimension to avoid costly treatments or missing out on available financial aid.

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Acknowledgements

The authors thank Ruth McConigley, Angela Ives, Sandy McKiernan and Violet Platt who were involved in the planning and conceptualisation of the study; Catalina Lizama who assisted with data collection; and Rachel Singer who transcribed the interviews. The authors wish to thank the staff at the Western Australian Cancer Registry for their support with the study.

Funding

This research was funded by the Cancer Council of Western Australia and Western Australian Government Department of Health through the WA Cancer and Palliative Care Network.

Author information

Authors and Affiliations

  1. UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia

    Neli Slavova-Azmanova, Jade C. Newton, Harry Hohnen, Claire E. Johnson & Christobel Saunders

  2. Monash Nursing and Midwifery, Monash University, Melbourne, Australia

    Claire E. Johnson

  3. Eastern Health, Melbourne, Australia

    Claire E. Johnson

Authors
  1. Neli Slavova-Azmanova
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  2. Jade C. Newton
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  3. Harry Hohnen
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  4. Claire E. Johnson
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  5. Christobel Saunders
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Contributions

CJ and CS designed the study; JN and HH conducted data collection; JN, HH, and NSA conducted the qualitative analysis; JN, NSA, HH, CJ, and CS contributed to the analysis and interpretation of the data; NSA and JN wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Neli Slavova-Azmanova.

Ethics declarations

The authors declare that they have no competing interests. Study participants provided written informed consent. The study was undertaken in accordance with relevant ethical standards and guidelines and was approved by the WA Country Health Service Ethics Committee (#2014:10) and the Department of Health WA Human Research Ethics Committee (#2014/26). The authors have full control of the primary data and are able to provide access upon request if deemed appropriate by all investigators.

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Slavova-Azmanova, N., Newton, J.C., Hohnen, H. et al. How communication between cancer patients and their specialists affect the quality and cost of cancer care. Support Care Cancer 27, 4575–4585 (2019). https://doi.org/10.1007/s00520-019-04761-w

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