How Does Patient-clinician Information Engagement Influence Self-reported Cancer-related Problems?: Findings from a Longitudinal Analysis

Background: Past research has linked patient-physician communication with improved emotional, physical, and social health. One component of communication, patient-clinician information engagement (PCIE), predicts improved short-term patient-reported outcomes, such as treatment satisfaction, through perceptions of feeling informed. However, to the authors' knowledge, the relation between PCIE and longer term cancer-related problems has not been examined previously. The authors examined the influence of PCIE on self-reported problems associated with cancer diagnosis and treatment based on a longitudinal survey among a randomly selected sample from the 2005 Pennsylvania Cancer Registry.

Methods: In total, 1293 respondents were surveyed who were diagnosed with colorectal, breast, or prostate cancers during 2006 and 2007. The baseline response rate was 64%, and the retention rate was 65%. The authors predicted an index of cancer-related problems at 1-year follow-up with the baseline cancer-related problem index and PCIE, controlling for demographic and clinical factors using regression analyses. The mean age of participants was 65 years, approximately 50% were women, and 86% were white.

Results: Having more cancer-related problems and PCIE at baseline significantly predicted more cancer-related problems at follow-up. In addition, baseline cancer-related problems and PCIE interacted significantly (P = .01): PCIE was associated with more cancer-related problems at follow-up among participants who reported more symptoms rather than fewer symptoms at baseline.

Conclusions: If respondents reported engaging more with their physicians at baseline, then they reported experiencing more cancer-related issues at follow-up; this pattern was stronger among those who reported more baseline problems. The current results indicated that increased discussion of cancer information with physicians may maintain the salience of these problems in cancer survivors' minds over time.