Survey of Health Care Providers on Social Determinants of Health and Treatment Decision-Making for Patients With HR+/HER2− Metastatic Breast Cancer

Abstract Introduction Social determinants of health (SDOH) are a range of nonmedical factors that contribute to outcome disparities among certain groups of patients; however, little is known about how SDOH affect treatment decision-making for patients with cancer, particularly those with metastatic...

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Main Authors: Monique Gary, Editha Krueger, Molly Kisiel, Kimberly Demirhan, Alexandra Guarin Barajas, Joanne C. Ryan
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-04-01
Series:Oncology and Therapy
Subjects:
Online Access:https://doi.org/10.1007/s40487-025-00337-3
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author Monique Gary
Editha Krueger
Molly Kisiel
Kimberly Demirhan
Alexandra Guarin Barajas
Joanne C. Ryan
author_facet Monique Gary
Editha Krueger
Molly Kisiel
Kimberly Demirhan
Alexandra Guarin Barajas
Joanne C. Ryan
author_sort Monique Gary
collection DOAJ
description Abstract Introduction Social determinants of health (SDOH) are a range of nonmedical factors that contribute to outcome disparities among certain groups of patients; however, little is known about how SDOH affect treatment decision-making for patients with cancer, particularly those with metastatic breast cancer (mBC). This study sought to gain insights from physicians and advanced practice providers on the impact of SDOH on practice- and patient-level cancer care decision-making with a nationwide online survey. Methods The Social Determinants of Health in Metastatic Breast Cancer Survey was developed by the Association of Cancer Care Centers (ACCC) in partnership with Pfizer Inc, and in consultation with SDOH specialists. The 23-question survey captured experiences with SDOH-informed treatment decision-making for patients with cancer via multiple choice, Likert-scale, and free-response questions. ACCC-member physicians and advanced practice providers in the USA completed the survey between 23 January and 8 February 2024. Results Respondents (n = 145), a majority of whom were medical oncologists (60%), represented clinics from diverse geographic regions of the USA; approximately 65% of respondents’ clinics served patient populations with ≥ 10% Black, Indigenous, or People of Color. Common comprehensive cancer care services were provided by at least 59% of clinics, and SDOH factors were assessed by approximately 75% of clinics at diagnosis. Navigation services were available for patients with mBC at approximately 75% of respondents’ clinics. Financial considerations (51%) and the presence of a caregiver (35%) were the most frequently cited SDOH-related factors that impacted mBC treatment decision-making. Conclusion The surveyed ACCC-member care providers displayed a high degree of awareness regarding SDOH impacts on their practice and patients, but resource limitations were identified as barriers to comprehensive, SDOH-informed cancer care. Harnessing existing resources from local and national advocacy groups, especially navigator training programs, is an actionable, real-world solution for improving mBC care for patients facing SDOH barriers.
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spelling doaj-art-e2c0ffa261f442e6bb434a66cfaf53a52025-08-20T02:31:03ZengAdis, Springer HealthcareOncology and Therapy2366-10702366-10892025-04-0113242944610.1007/s40487-025-00337-3Survey of Health Care Providers on Social Determinants of Health and Treatment Decision-Making for Patients With HR+/HER2− Metastatic Breast CancerMonique Gary0Editha Krueger1Molly Kisiel2Kimberly Demirhan3Alexandra Guarin Barajas4Joanne C. Ryan5Cancer Program, Grand View HealthDignity Health-Cancer Institute, St. Joseph’s Hospital and Medical CenterAssociation of Cancer Care CentersAssociation of Cancer Care CentersPfizer IncPfizer IncAbstract Introduction Social determinants of health (SDOH) are a range of nonmedical factors that contribute to outcome disparities among certain groups of patients; however, little is known about how SDOH affect treatment decision-making for patients with cancer, particularly those with metastatic breast cancer (mBC). This study sought to gain insights from physicians and advanced practice providers on the impact of SDOH on practice- and patient-level cancer care decision-making with a nationwide online survey. Methods The Social Determinants of Health in Metastatic Breast Cancer Survey was developed by the Association of Cancer Care Centers (ACCC) in partnership with Pfizer Inc, and in consultation with SDOH specialists. The 23-question survey captured experiences with SDOH-informed treatment decision-making for patients with cancer via multiple choice, Likert-scale, and free-response questions. ACCC-member physicians and advanced practice providers in the USA completed the survey between 23 January and 8 February 2024. Results Respondents (n = 145), a majority of whom were medical oncologists (60%), represented clinics from diverse geographic regions of the USA; approximately 65% of respondents’ clinics served patient populations with ≥ 10% Black, Indigenous, or People of Color. Common comprehensive cancer care services were provided by at least 59% of clinics, and SDOH factors were assessed by approximately 75% of clinics at diagnosis. Navigation services were available for patients with mBC at approximately 75% of respondents’ clinics. Financial considerations (51%) and the presence of a caregiver (35%) were the most frequently cited SDOH-related factors that impacted mBC treatment decision-making. Conclusion The surveyed ACCC-member care providers displayed a high degree of awareness regarding SDOH impacts on their practice and patients, but resource limitations were identified as barriers to comprehensive, SDOH-informed cancer care. Harnessing existing resources from local and national advocacy groups, especially navigator training programs, is an actionable, real-world solution for improving mBC care for patients facing SDOH barriers.https://doi.org/10.1007/s40487-025-00337-3Advanced breast cancerCDK4/6 inhibitorHR+/HER2−OncologySocial determinants of healthTreatment decision-making
spellingShingle Monique Gary
Editha Krueger
Molly Kisiel
Kimberly Demirhan
Alexandra Guarin Barajas
Joanne C. Ryan
Survey of Health Care Providers on Social Determinants of Health and Treatment Decision-Making for Patients With HR+/HER2− Metastatic Breast Cancer
Oncology and Therapy
Advanced breast cancer
CDK4/6 inhibitor
HR+/HER2−
Oncology
Social determinants of health
Treatment decision-making
title Survey of Health Care Providers on Social Determinants of Health and Treatment Decision-Making for Patients With HR+/HER2− Metastatic Breast Cancer
title_full Survey of Health Care Providers on Social Determinants of Health and Treatment Decision-Making for Patients With HR+/HER2− Metastatic Breast Cancer
title_fullStr Survey of Health Care Providers on Social Determinants of Health and Treatment Decision-Making for Patients With HR+/HER2− Metastatic Breast Cancer
title_full_unstemmed Survey of Health Care Providers on Social Determinants of Health and Treatment Decision-Making for Patients With HR+/HER2− Metastatic Breast Cancer
title_short Survey of Health Care Providers on Social Determinants of Health and Treatment Decision-Making for Patients With HR+/HER2− Metastatic Breast Cancer
title_sort survey of health care providers on social determinants of health and treatment decision making for patients with hr her2 metastatic breast cancer
topic Advanced breast cancer
CDK4/6 inhibitor
HR+/HER2−
Oncology
Social determinants of health
Treatment decision-making
url https://doi.org/10.1007/s40487-025-00337-3
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