ArticleCancer medicine2020
Association between patient-initiated emails and overall 2-year survival in cancer patients undergoing chemotherapy: Evidence from the real-world setting.
Article in Cancer medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Electronic Medical Record-Based Electronic Messaging Among Patients with Breast Cancer: A Systematic Review.Applied clinical informatics · 2023Pooled it
- Patient-Centered Digital Health Records and Their Effects on Health Outcomes: Systematic Review.Journal of medical Internet research · 2022Pooled it
- Graph augmented transformers improve chemotherapy toxicity symptom extraction from clinical notes.Nature communications · 2026Article
- Digital Health Portals for Individuals Living With or Beyond Cancer: Patient-Driven Scoping Review.JMIR cancer · 2025Article
- Advancing cancer care through digital access in the USA: a state-of-the-art review of patient portals in oncology.BMJ oncology · 2025Review
- Predicting Depression Risk in Patients With Cancer Using Multimodal Data: Algorithm Development Study.JMIR medical informatics · 2024Article
- Phone contacts and treatment discontinuation predict survival cancer patients in a subsidized drug access program.Journal of comparative effectiveness research · 2023Article
- Feasibility of a Digital Patient-Provider Communication Intervention to Support Shared Decision-Making in Chronic Health Care, InvolveMe: Pilot Study.JMIR formative research · 2022Article
- Limited English Proficiency and Disparities in Health Care Engagement Among Patients With Breast Cancer.JCO oncology practice · 2021Article
- Health management via telemedicine: Learning from the COVID-19 experience.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Assessing Patient Needs During Natural Disasters: Mixed Methods Analysis of Portal Messages Sent During Hurricane Harvey.Journal of medical Internet research · 2021Article
- Assessment of a Clinical Trial-Derived Survival Model in Patients With Metastatic Castration-Resistant Prostate Cancer.JAMA network open · 2021Article
- Association between patient-initiated emails and overall 2-year survival in cancer patients undergoing chemotherapy: Evidence from the real-world setting.Cancer medicine · 2020Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
purposePrior studies suggest email communication between patients and providers may improve patient engagement and health outcomes. The purpose of this study was to determine whether patient-initiated emails are associated with overall survival benefits among cancer patients undergoing chemotherapy. PATIENTS AND
methodsWe identified patient-initiated emails through the patient portal in electronic health records (EHR) among 9900 cancer patients receiving chemotherapy between 2013 and 2018. Email users were defined as patients who sent at least one email 12 months before to 2 months after chemotherapy started. A propensity score-matched cohort analysis was carried out to reduce bias due to confounding (age, primary cancer type, gender, insurance payor, ethnicity, race, stage, income, Charlson score, county of residence). The cohort included 3223 email users and 3223 non-email users. The primary outcome was overall 2-year survival stratified by email use. Secondary outcomes included number of face-to-face visits, prescriptions, and telephone calls. The healthcare teams' response to emails and other forms of communication was also investigated. Finally, a quality measure related to chemotherapy-related inpatient and emergency department visits was evaluated.
resultsOverall 2-year survival was higher in patients who were email users, with an adjusted hazard ratio of 0.80 (95 CI 0.72-0.90; p < 0.001). Email users had higher rates of healthcare utilization, including face-to-face visits (63 vs. 50; p < 0.001), drug prescriptions (28 vs. 21; p < 0.001), and phone calls (18 vs. 16; p < 0.001). Clinical quality outcome measure of inpatient use was better among email users (p = 0.015).
conclusionPatient-initiated emails are associated with a survival benefit among cancer patients receiving chemotherapy and may be a proxy for patient engagement. As value-based payment models emphasize incorporating the patients' voice into their care, email communications could serve as a novel source of patient-generated data.
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