427P - The role of patient navigation (PN) in delivering goal-concordant care to advanced breast cancer (ABC) patients

Background

ABC patients encounter numerous challenges that can impede their access to comprehensive care and the realization of their educational and treatment goals. PN effectively addresses barriers and improves personalized goal-concordant care. MD Anderson (MDA) Breast Center has a comprehensive PN program that integrates a multidisciplinary team to support over 1,800 active ABC patients, ensuring timely access to specialized care.We examined the outcomes of ABC patients in a navigation cohort, who received APRN-led PN services, with those in a non-navigation cohort.

Methods

In this gathered data from the electronic health record from June 2020 to June 2023, we examined ABC patients who received navigation (at least one visit n=393) versus those who did not (n=5061) during this time. Emergency care visits, Advanced Care Planning (ACP) based on follow-up time, Barriers to Care and Goals of Care were collected on structure intake forms adapted from other institutions as part of an ABC APRN led Navigation clinic at every visit referred by treating clinician or self and analyzed using descriptive statistics.

Results

In the navigation cohort, the median number of MDA emergency visits per year was 5, for 74 (18.8%) patients, compared to the median of 7 visits per year for 479 (9.5%) in the non-navigation group. Additionally, a higher proportion of navigation patients had power of attorney documentation (29.52%) and living wills (23.41%) compared to non-navigation patients (13.21% and 9.76%, respectively). Among patients who received navigation, they commonly faced challenges such as knowledge deficit (93%), coordination of care (89%), and financial concerns (23%). Their life goals often included prioritizing family time (41%) and maintaining quality of life (36%). In terms of treatment, they sought symptom management (25%) and coordinated care (9%).

Conclusions

Patients enrolled in the PN program had high supportive care needs leading to emergency visits and significant knowledge and coordination needs. The ABC program was associated with increased ACP towards promoting goal concordant care. Future models should focus on PN, not only improving access to care but also facilitates addressing specific barriers and aligning treatment plans.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

D. Hui: Financial Interests, Personal, Other, Consultant: Eton Pharmaceuticals; Financial Interests, Personal, Other, Senior Associate Editor: Journal of Pain and Symptom Management; Non-Financial Interests, Member of Board of Directors: MASCC. D. Tripathy: Financial Interests, Personal, Advisory Board, Serving on Steering Committee for TrialsEducational Lectures: Novartis; Financial Interests, Personal, Advisory Board, Steering Committee for and ongoing trial: Pfizer; Financial Interests, Personal, Advisory Board, Advisory council for design and interpretation of trials: GSK; Financial Interests, Personal, Invited Speaker, Educational Lectures: AstraZeneca; Financial Interests, Personal, Advisory Board, To discuss and interpret clinical trial data: Immunomedics; Financial Interests, Personal, Advisory Board, Advice on clinical trial design: OncoPep; Financial Interests, Personal, Invited Speaker, Lecture on gene profiling: Exact Sciences; Financial Interests, Personal, Advisory Board, Consulting: Sermonix; Financial Interests, Personal, Advisory Board, Consultant: Personalis, Puma Biotechnology, Roche, AMBRX, BeiGene; Financial Interests, Personal, Advisory Board, Consultant and service on Data Monitoring Committee: Gilead; Financial Interests, Personal, Advisory Board, Steering Committee Member: Jazz Pharmaceuticals; Financial Interests, Institutional, Research Grant, Funding for laboratory experiments on the inhibition of CXCR4 in breast cancer cells: Polyphor; Financial Interests, Institutional, Coordinating PI, Global PI on one trial and local PI on another trial: Novartis; Financial Interests, Institutional, Local PI, Payment to institution for clinical trial expenses: AMBRX. All other authors have declared no conflicts of interest.