Comparative effectiveness of a patient centered pathology report for bladder cancer care.

Publication Type:

Journal Article

Source:

The Journal of urology (2016)

Abstract:

INTRODUCTION: Patients have unprecedented access to their medical records. However, many documents, such as pathology reports, may be beyond the health literacy of most patients. We compared the effectiveness of bladder biopsy patient-centered pathology reports (PCPR) with standard reports.

METHODS: Local bladder cancer experts provided consensus on the important elements of a bladder biopsy pathology report for informing prognosis and counseling. Patient focus groups identified patient-centered formats and language to convey these elements and constructed a pilot PCPR. 40 patients undergoing bladder biopsy were block randomized to receive the standard report with or without the PCPR. We assessed patient self-efficacy, provider communication, provider empathy, and also tested bladder cancer knowledge at pathology disclosure and one month later. We compared study groups with descriptive statistics.

RESULTS: Experts identified stage, grade, and histology as the most important elements of a bladder biopsy pathology report. Patients prioritized three themes: narrative format, tumor stage illustration, and risk stratification for recurrence. 39 patients completed initial and follow-up assessments. PCPR patients had an improved ability to identify their cancer stage (initial percent unable to describe stage being 58% vs. 20%, p=0.02; vs. follow-up 47% vs. 15%, p=0.03) and trended toward improved identification of cancer grade. Provider communication trended toward improved communication for PCPR. Ratings of patient self-efficacy did not differ by report.

CONCLUSIONS: PCPR are associated with greater patient knowledge about their bladder cancer diagnosis and may aid patient-provider communication. This pilot may serve as a model for the development of PCPR for other cancers.