Patients with advanced cancer who met with community health workers between their regular cancer care appointments were less likely to require acute care and more likely to participate in advance care planning and receive mental health, palliative, and hospice care, according to study findings published in JAMA Oncology.
Researchers randomized 128 patients with newly diagnosed advanced-stage or recurrent solid and hematologic cancers from August 8, 2017–November 30, 2021, 1:1 to receive usual care (control group) or usual care plus a six-month community health worker–led intervention (intervention group). During phone or in-person visits, community health workers conducted symptom assessments and advance care planning discussions.
“A significant part of it was nonverbal,” a nurse community health worker who participated in the study said. “You’re developing a trust relationship so that the patient is willing to share and be forthright. Sometimes just keeping their emotional state stable can help, because when people get frightened and worried, they run to the emergency department.”
They found that intervention participants had 62% lower risk of acute care use at six months than control participants, and none of the intervention participants required acute care in the month before death. At 12 months, intervention participants were 1.7 times less likely to seek acute care, 8 times more likely to have advance care plans, 4 times more likely to obtain palliative care, and nearly 2 times more likely to receive hospice and mental and emotional care.
“This study provides more evidence that health care clinics and systems can integrate CHWs to improve the way that they deliver health care for people with cancer,” the researchers said. “This helps patients spend less time in the emergency department or hospital and have better experiences.”