Improving patient self-management in hepatocellular carcinoma using care sequence plans: A comparative survey study.

Abstract

e23327 Background: Care Sequence plans, a 4R Oncology model tool (Right Information and Right Care for the Right Person at the Right Time), have demonstrated benefits in care delivery and patient self-management. Prior studies have shown their usefulness in supporting patient engagement and understanding of care. This study evaluated the impact of Care Sequence plans on patient-reported self-management outcomes among people with hepatocellular carcinoma (HCC) at a Houston-based institution. Methods: Care Sequence plans were provided to people with HCC from May to October 2025 (Care Seq cohort). Patient surveys were administered to them and to a baseline cohort of patients with HCC who did not receive plans. Survey responses were compared across 15 patient-reported metrics. Fisher’s exact test was used. Results: Survey response rates were 78% (25/32) in the baseline cohort and 73% (16/22) in the Care Sequence cohort. Directional improvement observed in all 15 self-management metrics among patients who received Care Sequence plans. Five metrics demonstrated statistically significant improvement. The most significant improvement was in patient-reported knowledge of responsibility for different components of cancer care (100% vs 72%, p = 0.02). Other significant improvements were understanding provider instructions, participation in treatment decisions, clarity of the cancer care plan, and perception that providers had a detailed plan to manage care. Conclusions: Implementation of Care Sequence plans for patients with HCC was associated with consistent directional improvement across patient self-management domains, with statistically significant gains in care clarity and patient engagement. These findings support the value of Care Sequence plans as a scalable tool to enhance patient understanding, coordination, and self-management in complex cancer care. Metric Care Seq % Baseline % pvalue n=16 n=25 Told and remembered goal of care 81 64 0.2 I was confident in my ability to understand my doctor’s instructions 100 80 0.07~ It was easy for me to actively participate in decisions about my treatment 100 80 0.07~ My providers had a detailed plan to manage my cancer care 100 80 0.07~ I wanted to be in control of my cancer care 81 68 0.29 I knew who was responsible for different parts of my cancer care 100 72 0.02^ I knew my own responsibilities, like scheduling and going to appointments 100 84 0.12 My care providers spent enough time with me during my appointments 100 84 0.12 I wanted to know details about my cancer care plan 100 84 0.12 My cancer care plan for the next 3-6 months was clear to me 88 64 0.09~ I was able to manage and organize my care 88 80 0.43 I was able to explain my care plan to my family or friends 94 80 0.23 I knew how long different steps in my care will take 73 64 0.40 I knew what care steps should finish before other steps or care begins 88 67 0.13 I felt in control of my care 75 72 0.56 ^significant at < 0.05, ~ at < 0.1