Cancer Survivors with Sub-Optimal Patient-Centered Communication Prior to and During the Early COVID Pandemic

Abstract

Abstract Purpose Patient-Centered Communication (PCC) is an essential element of patient-centered cancer care. However, our knowledge of recent PCC performance among cancer survivors is limited. Therefore, this study aimed to assess the prevalence of optimal PCC and characterize the sociodemographic and clinical factors associated with optimal PCC in recent years, including during the initial SARS/COVID-19 (COVID) epidemic. Methods This study used nationally representative cross-survey data (Health Information National Trends Survey, 2017 to 2020) among cancer survivors (n = 2,579). We calculated the prevalence of optimal PCC of each domain (%) and the overall PCC prevalence (mean score) by time (pre-COVID, 2017-19 vs. COVID, 2020). Multivariable-adjusted weighted logistic regression models were developed to estimate the odds ratio (OR) and 95% confidence intervals (95% CI) of optimal PCC for each domain, as well as the overall outcome. Results The prevalence of optimal PCC decreased in most domains during COVID compared to pre-COVID up to 7.3% (managing uncertainty). Cancer survivors who reported psychological distress (ORs = 0.45–0.67 little interest or nervousness), did not have a usual source of care (ORs = 1.77–2.34), or were male (ORs = 1.40–1.78) were less likely to have optimal PCC in most domains as well as the overall PCC assessments. Conclusions We identified subgroups of vulnerable cancer survivors with sub-optimal PCC during COVID.