A qualitative survey evaluating transportation barriers for patients undergoing radiation therapy.

162 Background: Adherence to radiation treatments (RT) requires significant care coordination at multiple levels, which may pose barriers to equitable care. There is a paucity of data regarding how patients get to and from RT and the transportation barriers they may face. Methods: An in-person 18-question survey designed with multidisciplinary input was administered over 2 weeks by 3 physicians to adult patients undergoing outpatient RT at an urban academic medical center. Analysis of Likert scale responses was done by Student’s t-test with p value <0.05 defined as statistically significant. Results: Of 100 respondents (94% response rate), the median age was 66 years (IQR 60-75), 76% were non-Hispanic White and 22% were Black. 95% of patients had an ECOG performance status of 0 or 1, while the most common sites treated were lung (22%), head and neck (22%), and pelvis (19%). To receive their treatment, 45% of patients reported having a friend or family member drive them, while 39% reported driving themselves, and 16% reported another means of transportation (e.g., rideshare service, public transportation, etc). 17% of patients reported not having a backup method of transportation; this was reported most frequently in patients using another means of transportation (56%) and those relying on friends or family driving them (16%). When asked to rate the likeliness of arranging another form of transportation from a scale of 1 (least likely) to 10 (most likely), patients who used another means of transportation had lower scores compared to those who drove themselves or had a friend or family member drive them (3.7 vs 5.6, p=0.04). The biggest challenges of getting to and from RT were reported to be heavy traffic (27%), issues with parking (18%), distance (16%), and cost (8%). A minority of patients (30%) reported ever being asked by their oncology healthcare team about their transportation to RT. Of the 67 patients who have had a friend or family member drive them to any of their RT, 42% reported that that person needed to take time off of work and 12% reported they needed to rearrange their work schedule to do so. Conclusions: Transportation-related challenges during RT are common and under-addressed. Patients who use another means of transportation besides self, friends, or family (e.g., rideshare service, public transportation, etc) have the most precarious access to treatment. Nearly 20% of patients noted parking as the biggest challenge in transportation to RT. Furthermore, significant economic burden may impact caregivers who provide transportation to patients (i.e., taking time off or rearranging work schedules). These findings indicate that transportation-related challenges of RT require more detailed attention in order to optimize patient quality-of-life.