Guides help cancer patients navigate health system, complete therapy

(Medical Xpress)—They're called patient navigators, but some might call them hurdle jumpers, task masters, or simply strong shoulders to lean on. People who first learn they might have cancer often need someone to guide them through the health system to ensure they receive tests and treatments from appropriate providers at the right time. Now, researchers have been able to confirm patient navigators play a valuable role in helping patients complete their treatment.

In a study published recently in Cancer Epidemiology Biomarkers and Prevention, researchers from The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC-James) found patients who were paired with a navigator proceeded to diagnostic testing and treatment faster than those who were not assigned a navigator.

"There are all sorts of barriers to receiving care in a timely manner," says Electra D. Paskett, associate director for population sciences at OSUCCC-James, who led the study. "Patients may not fully understand their diagnosis or insurance coverage. They may not know where to go or who to contact. These are just a few examples of issues that navigators can help the patient resolve."
 
The Ohio Patient Navigator Research Program examined the Ohio American Cancer Society model of patient navigation to determine its effectiveness at reducing the time to diagnostic resolution among patients with abnormal breast, cervical or colorectal cancer screening tests or symptoms. This was one of nine such studies testing various patient navigation models in the Patient Navigator Research Program.   
 
A total of 862 patients from 18 clinics in the Columbus area participated in the research. Half (9) of the clinics were randomized to provide a patient navigator to 485 study participants, while 377 participants at the remaining clinics were provided only written educational material focusing on their specific cancer test or abnormality.
 
Patient navigators interacted with participants by phone. They identified specific barriers to care and assisted the study participants by taking action tailored to the individual patient's needs. These actions included supportive listening, providing referrals, making appointments, facilitating communication with health care providers, helping to resolve child care or transportation problems, and providing health education. Case resolution was defined as the point at which the patient's abnormality was diagnosed as benign or cancerous.
 
After six months, the resolution rate was 36 percent higher among participants receiving navigation services than those patients not assigned a navigator. At 15 months the resolution rate was 65 percent higher than those not receiving navigation.
"This study shows that patient navigators help people get the appropriate care in a timely manner, which can go a long way toward reducing mortality from cancer," said Paskett, who is herself a breast cancer survivor.
 
Among the patients receiving navigation, 47 percent reported having no barriers to their care. Of those reporting barriers, the three most common were misperceptions about a test or treatment, communication concerns with health care providers, and difficulty scheduling appointments.
 
Unlike earlier and smaller studies of the effectiveness of patient navigation, this study examined a large and diverse group of participants in a mix of clinic types. Paskett says, in this study, the beneficial effect of patient navigation did not differ with regard to race, insurance coverage, education level or cancer type. However, there was some evidence that the benefits became evident earlier among patients with lower incomes.
 
"People from all walks of life benefit from having a navigator; someone who is a part of the clinical team and can help make sure the abnormalities are treated as soon as possible, when there is the best chance for a cure with the least medical intervention," said Paskett.
 
Patient navigators are often employed by hospitals to help patients negotiate the various complexities of the health care system. Alternatively, these services can also be provided by trained community health workers or trained volunteers.