A web-based interactive tool to improve breast cancer patient centredness

Abstract

The uniqueness of a patient as determined by the integration of clinical data and psychological aspects should be the aspired aim of a personalized medicine approach. Nevertheless, given the time constraints usually imposed by the clinical setting, it is not easy for physicians to collect information about the patient's unique mental dimensions and needs related to her illness. Such information may be useful in tailoring patient-physician communication, improving the patient's understanding of provided information, her involvement in the treatment process, and in general her empowerment during and after the therapeutic journey. The primary objective of this study is to evaluate the effect of an interactive empowerment tool (IEm) on enhancing the breast cancer patient-physician experience, in terms of increasing empowerment, i.e. by providing physicians with a personalised patient's profile, accompanied by specific recommendations to advise them how to interact with each individual patient on the basis of her personal profile. The study will be implemented as a two-arm randomised controlled trial with 100 adult breast cancer patients who fill in the ALGA-BC questionnaire, a computerised validated instrument to evaluate the patient's physical and psychological characteristics following a breast cancer diagnosis. The IEm tool will collect and analyse the patient's answers in real time and send them, together with specific recommendations to the physician's computer immediately before physician's first encounter with the patient. Patients will be randomised to either the intervention group using the IEm tool or to a control group who will only fill in the questionnaire without taking advantage of the tool (physicians will not receive the patient's profile). The proposed approach is supposed to improve the patient-physician communication leading to increased patient participation in the therapeutic process as a consequence leading to improvement in patient empowerment and personalisation of care.

Keywords: breast cancer; patient empowerment; patient–physician communication; personalised medicine; web-based tool.

Figure 1.. A screenshot from the ALGA-BC questionnaire. The figure shows one of the questions included in the ALGA-BC questionnaire as seen by the patient.

Figure 2.. A screenshot from the profiler application. Accessing the profiler, the physician can see the ‘Health Chart’, that is a graphic representation of the patient’s scores in the different areas; the ‘Analysis Table’, that indicates the patient’s scores and the range of comparison values (quartiles calculated in the comparison population); and the ‘Clinical Recommendations’, a brief explanation of the factor(s) in which the patient obtained an abnormal score and a practical recommendation to manage it.