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Online communication helps treatment decisions following breast cancer diagnosis
Women who engaged with social medial following their breast cancer diagnosis reported more deliberation and satisfaction with their treatment decisions, according to survey results.
“Our findings highlight an unmet need in patients for decisional support when they are going through breast cancer treatment,” Lauren P. Wallner, PhD, MPH, assistant professor of general medicine at University of Michigan Medical School, said in a press release. “But at this point, leveraging social media and online communication in clinical practice is not going to reach all patients. There are barriers that need to be considered.”
Lauren P. Wallner
Wallner and colleagues identified 3,631 women aged 20 to 79 years with newly diagnosed stage I to stage III breast cancer using SEER registries of Los Angeles County and Georgia. Women were surveyed a mean of 6 months following their diagnosis about their treatment experiences as part of the iCanCare study.
The analysis included data from 2,460 women (mean age, 61.9 years; 59.3% white; 16.3% black; 13.6% Latina; 8.3% Asian) who had complete information regarding online communication and their appraisal of decision-making.
Researchers categorized women’s use of online communication based on their reports as never or rare, some use or frequent use. Means of communication included texting, email, social media or web-based support groups to discuss their cancer diagnosis, treatment or care.
Patients appraised their decision-making process using a five-item decision stratification scale that indicated high vs. lower satisfaction, as well as a newly developed four-item measure of deliberation derived from a measure of public deliberation, categorized as more vs. less deliberation.
Overall, 41.2% of the cohort reported some or frequent use of online communication, the most common of which was email or texting (34.7%), followed by social media (12.3%) and online support groups (11.9%).
“Women reported separate reasons for using each of these modalities,” Wallner said in a press release. “Email and texting were primarily to let people know they had been diagnosed. They tended to use social media sites and web-based support groups to interact about treatment options and physician recommendations. [They] also reported using all of these outlets to deal with the negative emotions and stress ... They’re using these communications to cope.”
Among women aged younger than 50 years, those with more education reported some or frequent online communication use more often (P < .001).
Online communication also varied across races. A higher proportion of some or frequent use occurred among white (45.6%) and Asian (42.7%) women than among black women (34.7%) and Latina women (32.9%).
“The presence of variation across age, race and education reinforces that barriers exist to incorporating these modalities broadly across patients with cancer,” Wallner and colleagues wrote.
Compared with women who reported never using online communication, those who were frequent users more positively appraised their decision-making. Women who reported frequent online communication were more likely to report decision satisfaction (OR = 1.45; 95% CI, 1.06-1.98) and having made a more deliberative decision (OR = 1.67; 95% CI, 1.34-2.1) compared with those who reported never using online communication.
“For some women, social media may be a helpful resource. But, there are still questions to answer before we can rely on it as a routine part of patient care,” Wallner said in a press release. “We don't know a lot about the type of information women are finding online. What are they sharing and what is the quality of that information? We need to understand that before we can really harness the potential of social media to better support patients through their cancer treatment and care.” – by Nick Andrews
Disclosure: Wallner reports prior grant funding from GlaxoSmithKline. The other researchers report no relevant financial disclosures.