Wong Emily C, Kaplan Celia P, Dreher Nickolas, Hwang Jimmy, Van't Veer Laura, Melisko Michelle E
All authors: University of California San Francisco, San Francisco, California.
JCO Clin Cancer Inform. 2018 Dec;2:1-13. doi: 10.1200/CCI.18.00018.
This study evaluated the use of an electronic Health Questionnaire System (HQS) within the University of California San Francisco Breast Care Center as a screening and triage tool to proactively recognize patients' supportive care needs during new patient consultations and identify demographic characteristics associated with referrals to three supportive care services.
A total of 428 patients with and without breast cancer between the ages of 18 and 84 years completed HQS intake forms before appointments at the University of California San Francisco Breast Care Center between November 2014 and May 2015 and agreed to participate in this study. Patient HQS responses triggered referrals to supportive care services, and a review of electronic health records was conducted to determine the outcomes of these referrals.
A total of 242 patients (56.5%) met criteria for at least one supportive care referral. Women with invasive breast cancer or ductal carcinoma in situ met criteria for supportive services more frequently than women without breast cancer diagnoses (76.9% v 23.8%; P < .001) and were most likely to receive referrals for genetic counseling (67.0%), psychological services (32.2%), and social services (12.1%). Multivariable logistic regression analysis showed that being married was associated with fewer referrals to social work (OR, 0.42; 95% CI, 0.21 to 0.81) and that those between 45 and 54 years of age were less likely to receive referrals to genetic counseling than those ≥ 55 years of age (OR, 0.41; 95% CI, 0.23 to 0.73). Among all referrals (n = 369), 26.8% resulted in completed appointments.
Using an automated intake form is an efficient way to identify and triage individuals in need of supportive care services and can provide insight into the populations with supportive care needs for targeted outreach.
本研究评估了加利福尼亚大学旧金山分校乳腺护理中心使用电子健康问卷系统（HQS）作为一种筛查和分诊工具，以便在新患者咨询期间主动识别患者的支持性护理需求，并确定与转介至三种支持性护理服务相关的人口统计学特征。
2014年11月至2015年5月期间，共有428名年龄在18至84岁之间的乳腺癌患者和非乳腺癌患者在加利福尼亚大学旧金山分校乳腺护理中心预约就诊前填写了HQS intake表格，并同意参与本研究。患者的HQS回答触发了转介至支持性护理服务的流程，并对电子健康记录进行了审查以确定这些转介的结果。
共有242名患者（56.5%）符合至少一项支持性护理转介标准。浸润性乳腺癌或导管原位癌女性比未患乳腺癌的女性更频繁地符合支持性服务标准（76.9%对23.8%；P <.001），并且最有可能接受遗传咨询（67.0%）、心理服务（32.2%）和社会服务（12.1%）的转介。多变量逻辑回归分析显示，已婚与转介至社会工作的次数较少相关（OR，0.42；95%CI，0.21至0.81），并且45至54岁的患者比≥55岁的患者接受遗传咨询转介的可能性更小（OR，0.41；95%CI，0.23至0.73）。在所有转介（n = 369）中，26.8%导致预约完成。
使用自动录入表格是识别和分诊需要支持性护理服务的个体的有效方法，并且可以深入了解有支持性护理需求的人群，以便进行有针对性的外展服务。
