A pilot study found that nurse practitioners (NPs) successfully improved access to oncology care among patients newly diagnosed with breast cancer, according to findings presented at the 2022 American Association of Nurse Practitioners (AANP) National Conference held June 21 to June 26, 2022, in Orlando, Florida.
“Waiting for an appointment with a specialty provider can be a very stressful and anxiety-producing experience for a patient newly diagnosed with cancer,” said lead author Ashley Johnson, MSN, FNP-C. “Diagnostic imaging and testing are often needed prior to scheduling a surgical procedure. Nurse practitioners are able to bridge this gap and offer earlier appointments, which may ease psychological distress and promote faster time to treatment.”
Prolonged wait time between diagnosis and first treatment also has been linked to worse outcomes, noted Johnson and coauthor Heather Jackson, PhD, FNP-BC, NEA-BC, FAANP.
The investigators implemented a pilot study among patients newly diagnosed with breast cancer at Vanderbilt University Medical Center between January and April 2021, a time when oncology surgeon availability for new patient appointments was limited at the institution’s breast cancer center. During the intervention period, patients were initially seen by surgical oncology NPs followed by surgical oncologists. The visit comprised an assessment, education, diagnostic testing, and specialty referrals using the National Cancer Institute conceptual framework for patient-centered communication.
Outcomes among patients treated under the pilot program (n=28) were compared with those among patients who received standard physician-based care (n=33) between September and December 2020.
Outcomes of NP Visits for Breast Cancer Surgical Consultation
The average time to initial visit with a physician was 9.7 days prior to the intervention compared with 6.9 days to NP visit and 21 days to physician visit during the intervention.
NP visits were also associated with more favorable patient responses about overall satisfaction, ability to get desired appointments, ease of scheduling appointments, overall care provider satisfaction, provider efforts to include the patient’s perspective in decisions, and provider discussion of treatments compared with physician visits (Table).
Table. Outcomes for Initial NP vs Physician Visit Following Breast Cancer Diagnosis
|Measure||NP Visit||Physician Visit|
|Average time to initial visit||6.9 days||9.7 days|
|Ability to get desired appointment||70%||53%|
|Ease of scheduling appointments||78%||66%|
|Provider discussion of treatments||92%||86%|
|Provider efforts to include patient perspective in decisions||92%||89%|
These data indicate that surgical oncology NPs provide timely access to oncology services and increase satisfaction among patients newly diagnosed with breast cancer, and may potentially decrease symptoms of perceived stress, depression, and anxiety during this difficult transition.
“Through patient-centered communication, NPs are able to address the unique physical and mental health needs of newly diagnosed cancer patients,” Johnson concluded.
|Visit Clinical Advisor’s meetings section for complete coverage of AANP 2022.|
Johnson A, Jackson H. Utilization of nurse practitioners to improve access to care for newly diagnosed breast cancer patients: a pilot study. Presented at: AANP 2022; June 21-26, 2022; Orlando, Fl.