Abstract P6-05-51: Best Quality of Care from a Distance (BQual-D): Maintaining high quality care for hormone receptor positive (HR+) metastatic breast cancer (MBC) during the COVID pandemic, patient participation and satisfaction with the program
Authors: Kimmick Gretchen , Divakaran Smrithi , Moore Heather , Rose Cynthia , Gentry Pamela , Willis Michael , Dent Susan , Sammons Sarah L. , Force Jeremy , Westbrook Kelly , Anders Carey , Shelby Rebecca 
Published: March 2023

Abstract
Background During the COVID pandemic, we designed and implemented a program, called BQual-D, to maintain high quality care for patients with HR+, HER2 negative MBC who were taking oral anti-cancer therapy and needed to shelter at home. This program augmented available clinical resources with (1) trained nurse coaches to manage side effects, improve adherence, monitor for cancer progression and screen for psychological distress via telehealth, and (2) a care coordinator to arrange blood testing at local labs to facilitate timely medication dose adjustments. BQual-D served patients from August 2020 through April 2021. Here, we describe survey results assessing patient (pt) satisfaction with BQual-D. Methods Pt’s satisfaction surveys included questions rated on a Likert scale (1 “strongly disagree” to 5 “strongly agree”) with questions regarding the following: satisfaction with the quality of the nurse coaching calls; perception that the nurse coach listened to what they were trying to convey; whether or not their needs were met by the nurse coaching calls; whether they felt that they received adequate explanation regarding the nurse coaching calls; whether they would recommend the nurse coaching calls to a friend; perception of whether or not the nurse coach was negative or critical towards them; whether or not they would do it over (i.e., if they would return to the nurse coaching calls); whether or not they felt that the nurse coach was friendly or warm toward them; they were able to more effectively deal with care and symptoms; they felt free to express themselves; they were able to focus on what was of real concern to them; the nurse seemed to understand what they were thinking and feeling. Patients were also asked how much the calls helped with their care and symptoms. Descriptive statistics are reported (i.e., frequencies and means). Results 84 pts were screened and contacted for the BQual-D program. Of the 64 pts who responded, 52 (81.3%) were interested and enrolled in BQual-D; 12 (18.8%) declined. Among those who enrolled, 1 voluntarily withdrew, and 7 withdrew due to change in treatment. Participants had a mean age of 65 (range 36 – 88 yrs) and the following racial distribution - Caucasian/White (38, 73.1%), Black or African American (12, 23.1%), American Indian (1, 1.9%) and American Indian or Alaskan Native (1, 1.9%). Satisfaction surveys were received from 32 (50%) pts. Results of surveys regarding patient satisfaction with the nurse coach were generally positive. Pts agreed or strongly agreed that they were satisfied with the quality of the nurse coaching calls (94%), the nurse coach listened to what they were trying to convey (94%), their needs were met by the nurse coaching calls (91%), they understood the purpose of the call (90%), and they would recommend the nurse coaching calls to a friend (88%). The majority (74%) agreed or strongly agreed that they were able to more effectively deal with their care and symptoms after the nurse coach calls. When asked how much the calls helped their care and symptoms, 61% indicated that they made things a lot better, 19% indicated that they made things somewhat better, 16% indicated that they made no difference. One patient indicated that the calls made things somewhat worse. Conclusions During the COVID pandemic, when sheltering at home was encouraged, patient satisfaction with BQual-D, which provided additional health resources (nurse coaches, care coordinator) to support pts on oral therapy for HR+ MBC, was high. Resources needed to implement BQual-D should be explored as a way of providing additional support for pts to minimize the requirement for in-person visits. Funding: Supported by a grant from Pfizer.
Citation Format: Gretchen Kimmick, Smrithi Divakaran, Heather Moore, Cynthia Rose, Pamela Gentry, Michael Willis, Susan Dent, Sarah L. Sammons, Jeremy Force, Kelly Westbrook, Carey Anders, Rebecca Shelby. Best Quality of Care from a Distance (BQual-D): Maintaining high quality care for hormone receptor positive (HR+) metastatic breast cancer (MBC) during the COVID pandemic, patient participation and satisfaction with the program. [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-51.