Incorporating lay health workers (LHWs) into cancer care can improve patient satisfaction and reduce costs, according to a randomized trial published in JAMA Oncology.
Between August 13, 2013, and February 2, 2015, researchers enrolled 213 patients with stage 3 or 4 or recurrent cancer at the Veterans Affairs Palo Alto Health Care System in California. Patients were randomized to meet with an LHW (intervention cohort) or receive usual care (control group). Patients in the LHW cohort were assisted with establishing end-of-life care preferences.
Can an outpatient lay health worker intervention improve end-of-life care for patients with cancer? Researchers from @StanfordMed investigated this at @VAPaloAlto. Results in @JAMA_current. https://t.co/hNmXyu42iM #eol
— CHCF (@CHCFNews) July 28, 2018
Within 6 months of enrollment, patients in the intervention group had greater documentation of goals of care than the control group (92.4% vs. 17.5%.; P<0.001). Patients in the interview group also had larger increases in satisfaction with care, according to the Consumer Assessment of Health Care Providers and Systems “satisfaction with provider” item (P<0.001).
There was no difference in the number of patients who died within 15 months of enrollment between the cohorts (57.1% intervention vs. 55.6% control; P=0.68).
Integration of lay health worker in outpatient setting of VA hosp, trained to work w pts on end of life goals, led to highly significant increase in documentation of #endoflife goals, lower ER visits & admits, lower costs, & greater pt satisfaction. https://t.co/6dUw5t7t7H #HPM pic.twitter.com/fNnoQjydgA
— JAMA Oncology (@JAMAOnc) July 31, 2018
In the 30 days prior to death, patients in the intervention group had greater hospice use (76.7% vs. 48.3%; P=0.002), fewer emergency department visits (P<0.001), fewer hospitalizations (P<0.001), and lower costs (median = $1,048 vs. $23,482; P<0.001) than the control group.