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Comparison of beliefs of lung cancer providers and minority patients.

6077 Background: Providers have a critical role in addressing lung cancer disparities in care. Mismatch in attitudes and beliefs between patient and providers can be a barrier to appropriate patient-provider communication and may contribute to disparities in care. In this study, we evaluated beliefs and attitudes about lung cancer and its treatment among patients with lung cancer and their providers.


METHODS
We administered a questionnaire to lung cancer patients and their physicians at 5 medical centers in New York City. The questionnaire asked about physicians' and patients' views with respect to treatment beliefs and preferences of minority and non-minority lung cancer patients.


RESULTS
Our cohort included 155 physicians (49% male; 53% White, 4% Black, 14% Hispanic) and 323 patients (46% male; 55% White, 21% Black, 19% Hispanic). Providers reported minority patients had greater views of fatalism (4% White, 28% Hispanic, 31% Black), which was consistent with minority patients who had even greater fatalistic beliefs (37% White, 69% Hispanic, 78% Black; p <0.0001). Providers reported that Hispanic and black patients are less likely to accept surgery when compared to white patients (19%, 28%, and 5%, respectively). However, minority patients were just as likely as whites to accept surgery (80% Hispanic, 77% Black, 82% White; p <0.0001). Similarly, providers considered that minorities were more likely to prefer their family making treatment decisions and discussing prognosis (65% Hispanic, 38% Black). However, the majority of minority patients wanted to be included in these discussions (96% Hispanic, 98% Black; p<0.007). Finally, providers reported that minorities are less receptive to a DNR directive or palliative care referral. While minority patients reported being less likely to want a DNR order, minority patients were just as likely as white patients to want to a palliative care referral.


CONCLUSIONS
There are significant differences among providers and patients regarding minority preferences and beliefs about lung cancer care. Understanding the influence and relative importance of these factors is an important step towards developing interventions to improve outcomes of minority patients with lung cancer.