Mount Sinai Researchers Find Value -- and Limitations -- of Patient Assistance Programs for Women with Breast Cancer
Nearly 80 percent of women who contacted a patient assistance program had some or all of their needs met, compared with only 35 percent of those who did not
Patient assistance programs can help breast cancer patients meet a variety of needs that can interfere with getting recommended adjuvant therapies such as radiation, chemotherapy, and hormonal treatments, according to a study published recently in the online edition of the Journal of Oncology Practice.
Most breast cancer patients who had information about patient assistance programs used them to learn more about adjuvant therapy, obtain psychosocial support, and overcome practical/financial obstacles to getting treatment, reported researchers from the Icahn School of Medicine at Mount Sinai.
Researchers found that, in most cases, patients who were referred to assistance programs did contact organizations running programs, such as Cancer Care Inc., SHARE, and the Mount Sinai Breast Health Resources Program.
"Doctors have been frustrated by data showing that perhaps as many as 20 percent of women with breast cancer – especially black and Hispanic women -- do not take advantage of lifesaving adjuvant therapies," said Nina Bickell, MD, MPH, Professor of Health Evidence and Policy and Professor of Medicine at Mount Sinai. "Some women lack critical information about the value of these treatments, while others need help dealing with the emotional aspects of breast cancer treatment or with practical matters such as transportation, insurance, or childcare before taking the next step. Fortunately, there are many high-quality patient assistance programs that can help women address these issues."
For the study, Dr. Bickell and her team recruited 374 women with early-stage breast cancer who had recently undergone breast surgery. The researchers conducted a brief assessment to identify women who needed information, psychosocial support, or help with practical issues that might affect access to treatment. Half of the women received a customized list of patient assistance programs, based on findings from the needs assessment, and an individualized action plan; the other half received a New York State Department of Health pamphlet about breast cancer that includes a list of local resources.
The vast majority of women in the study reported some type of need, regardless of the type of information they received. Nearly 80 percent of women who contacted a patient assistance program, had some or all of their needs met, compared with only 35 percent of those who did not connect with a program. The programs were particularly effective in meeting women’s needs for information about adjuvant treatments or counseling. However, very few women in either group reported that they had obtained sufficient help in overcoming practical obstacles to treatment.
Most women in the study went on to get the adjuvant therapy recommended by their doctor. Treatment rates were nearly identical in both groups of women, regardless of the type of information they received.
"We were delighted to discover that most of the women in our study who needed some type of assistance had a successful encounter with a patient assistance program and got the treatments they needed," said Dr. Bickell. "Nevertheless, national statistics suggest that women in the U.S. continue to face economic and logistical barriers to getting adjuvant therapy for breast cancer. To ensure that patient assistance programs have the greatest impact on reducing national disparities in care, private philanthropies, which represent the biggest source of funding for these valuable programs, will be challenged to increase development in this area.
About the Department of Health Evidence and Policy
The academic agenda of the Mount Sinai Department of Health Evidence and Policy focuses on patient-oriented and population-based research, and the policy mechanisms that affect the health of populations and the effectiveness, efficiency and equity of health care delivery systems. As an interdisciplinary department, our expertise includes clinical evaluative research, biostatistics, quality of care, patient safety, health equity and community-engaged research, social epidemiology, health services research, the analysis of technological innovation and health policy.
About the Center for Health Equity and Community Engaged Research
The Center for Health Equity and Community Engaged Research, housed within the Department of Health Evidence and Policy, aims to improve the health and health care of underserved populations by identifying causes of disparities in health and healthcare, developing and testing community-partnered, sustainable interventions and disseminating lessons learned to inform policy and systems change.
About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care.
The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the "Honor Roll" of best hospitals in America, ranked No. 15 nationally in the 2016-2017 "Best Hospitals" issue of U.S. News & World Report. The Mount Sinai Hospital is also ranked as one of the nation's top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai's Kravis Children's Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals."