Association of solid tumor patients’ characteristics and cure expectations with their portal-reported health-related values.

Abstract

e24114 Background: Patient portals are an efficient, valid method of assessing patients’ health-related values (HRVs) to inform oncology teams’ care delivery. But patient-level factors influencing these HRVs (e.g., communication preferences, hopes, concerns, sources of strength) are unknown. Methods: A random sample of HRV portal questionnaire responses (200 of 852 solid tumor outpatients responding from 7/2023-7/2024 at a dedicated cancer center) coded for thematic content were analyzed descriptively (e.g., HRV code frequencies) alongside patient characteristics and questionnaire responses on cure expectations (patient Likert scale rating of the likelihood of cancer treatment to cure their cancer). Results: 200 patients were median age 66, 52% male, 75% White; 68% married/partnered, with median 16 months between first medical oncology visit and HRV questionnaire response, and intestinal [42%], pancreas [20%], and genitourinary cancers [12%]), 78% at advanced (metastatic) stage. Of treatment expectations reported by 150 patients (57% on active treatment; 57% expecting cure), no significant differences were found in HRV codes, in advanced or early-stage patients, based on cure expectations. Patients with advanced vs localized stage were more likely to report valuing communication with the medical team (27% v 11%, p = 0.03) and less likely a desire to live as a source of strength (3% v 16%, p = 0.009) or a hope to keep working (1% v 11%, p = 0.009). Unmarried vs married patients reported friends as sources of strength (30% v 17%, p = 0.04), preferences for independence (13% v 1%, p = 0.002) and negativity/pessimism (5% v 0%, p = 0.03) more often. While faith was more frequently reported as a source of strength in religious vs non-religious patients (38% v 13%, p = 0.01), non-religious patients more often reported strength from their own identity/autonomy (10% v 2%, p = 0.047) and concerns of burdening others (20% v 6%, p = 0.02). Patients with less (vs more) time from initial visit to HRV portal response were more likely to identify family, and friends, as sources of strength (73% v 57%, p = 0.03, 29% v 13%, p = 0.009, respectively) and less likely the medical team (15% v 30%, p = 0.02); they also reported concerns about dying (28% v 14%, p = 0.02) and hopes for a return to physical normalcy (15% v 4%, p = 0.02) more frequently and hope for a happy/positive emotional state (5% v 15%, p = 0.03) less frequently. Conclusions: Patient-level factors (e.g., marital status, stage, religion, time since initial oncology visit) are associated with HRVs elicited via patient portal questionnaire. Identifying such factors may help clinicians deliver care that is concordant with patients’ HRVs and define appropriate care goals. Ongoing research is evaluating large-scale implementation of portal-enabled elicitation of patients’ HRVs to normalize and systematize communication informing person-centered oncology care.