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Abstract Purpose Prior 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 methods We 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. Results Overall 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 |
