Cancer Patients Rarely Request Unneeded Tests, Treatments: Study

Cancer Patients Rarely Request Unneeded Tests, Treatments: Study

Cancer Patients Rarely Request Unneeded Tests, Treatments: Study

Doctors' claims that this is fueling increasing health costs unwarranted, expert says

SOURCE: University of Pennsylvania, news release, Feb. 12, 2015

THURSDAY, Feb. 12, 2015 (HealthDay News) -- Despite some doctors' claims to the contrary, cancer patients rarely request unnecessary tests or treatments, a new study finds.

Researchers surveyed 34 oncologists, 11 oncology fellows and 15 nurse practitioners immediately after visits with cancer patients at three Philadelphia hospitals between October 2013 and June 2014.

Only 440 of the 5,050 visits (about 9 percent) included patient requests for tests or treatments, the investigators found. Of those, health care providers complied with 365 of the clinically appropriate requests. In addition, there were 50 demands for unnecessary tests or treatments, and health care providers complied with only seven of those demands.

About half of the patient requests were for medical imaging tests, nearly 14 percent were for laboratory tests and about 5 percent were for genetic tests or chemosensitivity tests, the University of Pennsylvania team found.

More than 15 percent of patient requests were for palliative care treatments, such as pain and sleep medicines. About 4 percent of patient requests were for chemotherapy, and less than 1 percent were for costly proton beam therapy, the study findings showed.

Patients most likely to demand or request tests or treatments included those who had poor relationships with their health care providers and those on active therapy, according to the study published Feb. 12 in the journal JAMA Oncology.

"We decided to look specifically at cancer patients' demands because oncology is a setting where there are life-and-death stakes for patients and the drugs and tests can get very expensive," senior study author Dr. Ezekiel Emanuel, chair of the department of medical ethics and health policy at the University of Pennsylvania School of Medicine in Philadelphia, said in a university news release.

"However, we found, contrary to expectations, that patient demands are low and cannot be a key driver of increasing health care costs," he added.

While many doctors claim that patient demands are contributing to rising health care costs, this study shows that few patients insist on unnecessary tests or treatments.

The findings show that doctors "have to stop blaming patients for being demanding. In reality, it is hardly happening," Dr. Anthony Back, of the Seattle Cancer Care Alliance, wrote in an accompanying editorial.

"The myth of the demanding patient is more about our own responses and how lackluster communication skills can contribute to difficult situations that stick in our throats and in our memories. And when we have calmed down enough to look up, we see that what is really happening between patients and physicians these days is something quite different," Back concluded.

More information

The U.S. National Cancer Institute has more about cancer.

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