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Ensuring patient-centered care in cancer

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https://www.readbyqxmd.com/read/28978214/strategies-to-manage-costs-in-idiopathic-pulmonary-fibrosis
#1
Gary M Owens
Idiopathic pulmonary fibrosis (IPF) is a diagnostically challenging disease. Clinicians are faced with the need to exclude alternative diagnoses, limited treatment and management guidelines, and few treatment options. Patients with IPF have significantly increased healthcare usage compared with similar patients without the disease. Medicare estimates for this disease are as high as $3 billion, not including cost of treatment. The disease, characterized by worsening dyspnea, declining lung function, nonspecific respiratory symptoms, and a varied clinical course randomly punctuated by episodes of acute exacerbations, is also accompanied by a host of comorbid conditions that contribute significantly to increased healthcare usage and cost...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28973701/fertility-preservation-in-breast-cancer
#2
REVIEW
Cristina O'Donoghue, Gwendolyn P Quinn, M Catherine Lee
As more young women survive breast cancer, fertility preservation (FP) is an important component of care. This review highlights the importance of early pretreatment referral, reviews the risks of infertility associated with breast cancer treatment, and defines existing and emerging techniques for FP. The techniques reviewed include ovarian suppression, embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation and transplantation. The barriers women face, such as not being appropriately referred and the costs of treatment, also are addressed...
October 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28948138/information-technology-enabled-team-based-patient-centered-care-the-example-of-depression-screening-and-management-in-cancer-care
#3
Gurvaneet S Randhawa, David K Ahern, Bradford W Hesse
The existing healthcare delivery systems across the world need to be redesigned to ensure high-quality care is delivered to all patients. This redesign needs to ensure care is knowledge-based, patient-centered and systems-minded. The rapid advances in the capabilities of information and communication technology and its recent rapid adoption in healthcare delivery have ensured this technology will play a vital role in the redesign of the healthcare delivery system. This commentary highlights promising new developments in health information technology (IT) that can support patient engagement and self-management as well as team-based, patient-centered care...
March 2017: Health Policy and Technology
https://www.readbyqxmd.com/read/28933226/nursing-adherence-to-ethical-codes-in-pediatric-oncology-wards
#4
Raziyeh Beykmirza, Lida Nikfarid, Foroozan Atashzadeh-Shoorideh, Maliheh Nasiri
BACKGROUND: The nature of children's cancer comes with lots of ethical issues. Nurses are encouraged to adhere to ethical codes in their practice. OBJECTIVES: This study aimed to compare the perspectives of nurses and mothers of children with cancer regarding the adherence of nurses to ethical codes. RESEARCH DESIGN: In this descriptive-comparative study, a researcher-made questionnaire was used to assess the amount of adherence to Iranian nurses' code of ethics in perspectives of pediatric oncology nurses and mothers...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28885676/cooperation-between-in-hospital-psychological-support-and-pastoral-care-providers-obstacles-and-opportunities-for-a-modern-approach
#5
Tullio Proserpio, Andrea Ferrari, Laura Veneroni, Carmine Arice, Maura Massimino, Carlo Alfredo Clerici
The meaning that patients with cancer attribute to life influences their expectations and their attitudes to the disease and its treatment. Over the centuries, religion has commonly been the answer encoded by the social setting when it came to matters of life and death. The present article analyzes the historical grounds for forms of cooperation between the scientific disciplines that focus on mental health and the approach of religion, centered on the Italian situation. Such cooperation was hard to imagine in the past, but the situation has changed considerably and cooperation is not only possible but extremely desirable...
September 7, 2017: Tumori
https://www.readbyqxmd.com/read/28867544/standardization-of-radiation-therapy-dose-for-locally-advanced-non-small-cell-lung-cancer-through-changes-to-a-lung-cancer-clinical-pathway-in-a-large-integrated-comprehensive-cancer-center-network
#6
Pooja Karukonda, Brian J Gebhardt, Zachary D Horne, Dwight E Heron, Sushil Beriwal
PURPOSE: The results of Radiation Therapy Oncology Group (RTOG) 0617, which randomized patients with stages IIIA/IIIB non-small cell lung cancer (NSCLC) to definitive chemoradiation therapy to 60 Gy versus 74 Gy, demonstrated a detrimental survival impact with high-dose radiation therapy. We evaluated the impact of changes to a provider-driven clinical pathway (CP) guiding management of NSCLC on practice throughout our cancer center network. METHODS AND MATERIALS: In 2001, we implemented a CP for management of stage IIIA/IIIB NSCLC with definitive chemoradiation therapy...
July 8, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28844825/patient-navigation-across-the-spectrum-of-women-s-health-care-in-the-united-states
#7
REVIEW
Kathryn M McKenney, Noelle G Martinez, Lynn M Yee
Patient navigation is a patient-centered intervention that uses trained personnel to identify patient-level barriers, including financial, cultural, logistical, and educational obstacles to health care and then mitigate these barriers to facilitate complete and timely access to health services. For example, to assist a woman with Medicaid who is seeking postpartum care, a patient navigator could help her schedule an appointment before her insurance benefits change, coordinate transportation and child care, give her informational pamphlets on contraception options, and accompany her to the appointment to ensure her questions are answered...
August 24, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28772096/prospective-identification-of-patients-at-risk-for-unwarranted-variation-in-treatment
#8
Amy S Kelley, Evan Bollens-Lund, Kenneth E Covinsky, Jonathan S Skinner, R Sean Morrison
BACKGROUND: Understanding factors associated with treatment intensity may help ensure higher value healthcare. OBJECTIVE: To investigate factors associated with Medicare costs among prospectively identified, seriously ill older adults and examine if baseline prognosis influences the impact of these factors. DESIGN/SUBJECTS: Prospective observation of Health and Retirement Study cohort with linked Medicare claims. MEASUREMENTS: We identified people with incident serious illness (a serious medical condition, for example, metastatic cancer or functional impairment); calculated subjects' one-year mortality risk; and then followed them for one year...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28768400/strategies-for-appropriate-patient-centered-care-to-decrease-the-nationwide-cost-of-cancers-in-korea
#9
Jong-Myon Bae
In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care...
July 2017: Journal of Preventive Medicine and Public Health, Yebang Ŭihakhoe Chi
https://www.readbyqxmd.com/read/28704594/critical-diagnoses-in-cytopathology-experience-at-a-large-medical-center
#10
Juan Xing, Lindsey Seigh, Sara E Monaco, N Paul Ohori, Samuel A Yousem, Rajnikant Amin, Liron Pantanowitz
BACKGROUND: Critical values have been well established and accepted in laboratory medicine, but to the authors' knowledge are less well accepted in anatomic pathology. Herein, the authors used a reporting process whereby reports with critical diagnoses were coded to ensure that the patient's clinical team was promptly notified electronically of this finding. The aim of the current study was to determine whether this coding mechanism was used appropriately for critical cytopathology diagnoses in the study health care system...
September 2017: Cancer
https://www.readbyqxmd.com/read/28645785/contraceptive-counseling-in-reproductive-aged-women-treated-for-breast-cancer-at-a-tertiary-care-institution-a-retrospective-analysis
#11
Sara L Johansen, Klaira Lerma, Kate A Shaw
OBJECTIVE: The objective was to assess the frequency of documented contraceptive and fertility preservation counseling for women treated for breast cancer. STUDY DESIGN: We conducted a chart analysis of female breast cancer patients (n=211) ages 18-45 years receiving chemotherapy treatment at Stanford Comprehensive Cancer Center from 2010 to 2014. Primary outcomes of contraceptive counseling and fertility preservation counseling documentation were assessed for frequency...
June 20, 2017: Contraception
https://www.readbyqxmd.com/read/28643745/adjuvant-hypofractionated-radiation-in-carcinoma-breast-photon-versus-electron-comparison-of-treatment-outcome
#12
G Prameela Chelakkot, Rahul Ravind, K Sruthi, Namrata Chigurupati, Sanketh Kotne, Raghavendra Holla, Ram Madhavan, M Dinesh
BACKGROUND: Breast cancer tissue is sensitive to hypofractionation. This is an analysis of patients treated with hypofractionated protocols since 2009, at our tertiary cancer center. METHODS: Details of breast cancer patients treated with adjuvant hypofractionated external beam radiation therapy (EBRT) from January 2009 to December 2014 were retrieved and analyzed. RESULTS: One thousand seven hundred and eighty patients received adjuvant EBRT during this period...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28641097/long-term-complications-after-hematopoietic-cell-transplantation
#13
REVIEW
Navneet S Majhail
The prevalence of autologous and allogeneic hematopoietic cell transplantation (HCT) survivors continues to increase. Among patients whose disease remains in remission for the first 2-5years after transplantation, it is estimated that approximately 80-90% will be alive over the subsequent 10years. However, the relative mortality rates of such patients continue to remain higher than those of their general population peers, with late complications contributing to significant long-term morbidity and mortality...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28595934/secular-trends-in-prostate-biopsy-criteria-and-outcomes-the-dartmouth-experience
#14
Lael Reinstatler, Cody Rissman, John D Seigne, Elias S Hyams
OBJECTIVE: To evaluate trends in prostate biopsy and cancer diagnosis at a center with conservative screening practices in the pre- and post-2012 era. More restrictive prostate-specific antigen (PSA) screening guidelines have led to lower rates of screening, biopsy, and diagnosis of prostate cancer. It is not clear, however, how regions with low baseline screening rates (the Lebanon, New Hampshire hospital referral region centered on Dartmouth-Hitchcock Medical Center had the lowest rate of screening among Medicare patients in 2012) have responded to these guidelines...
July 10, 2017: Urology
https://www.readbyqxmd.com/read/28561713/collaborating-with-advanced-practice-providers-impact-and-opportunity
#15
Heather M Hylton, G Lita Smith
Although significant progress has been made in cancer care, access to coordinated, high-quality care across the cancer care continuum remains a challenge for many patients. With significant workforce shortages in oncology anticipated, physician assistants (PAs) and nurse practitioners (NPs)-known collectively as advanced practice providers (APPs)-are considered to be a part of the solution to bridging the gap between the supply of and demand for oncology services. APPs are integral to the provision of team-based care in oncology, and optimizing the roles of all members of the patient's care team is vital to ensuring the teams are cost-effective and that each team member is performing at the functional level intended...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28535101/design-challenges-of-an-episode-based-payment-model-in-oncology-the-centers-for-medicare-medicaid-services-oncology-care-model
#16
Ronald M Kline, L Daniel Muldoon, Heidi K Schumacher, Larisa M Strawbridge, Andrew W York, Laura K Mortimer, Alison F Falb, Katherine J Cox, Carol Bazell, Ellen W Lukens, Mary C Kapp, Rahul Rajkumar, Amy Bassano, Patrick H Conway
The Centers for Medicare & Medicaid Services developed the Oncology Care Model as an episode-based payment model to encourage participating practitioners to provide higher-quality, better-coordinated care at a lower cost to the nearly three-quarter million fee-for-service Medicare beneficiaries with cancer who receive chemotherapy each year. Episode payment models can be complex. They combine into a single benchmark price all payments for services during an episode of illness, many of which may be delivered at different times by different providers in different locations...
July 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28514670/radiation-safety-in-children-with-congenital-and-acquired-heart-disease-a-scientific-position-statement-on-multimodality-dose-optimization-from-the-image-gently-alliance
#17
REVIEW
Kevin D Hill, Donald P Frush, B Kelly Han, Brian G Abbott, Aimee K Armstrong, Robert A DeKemp, Andrew C Glatz, S Bruce Greenberg, Alexander Sheldon Herbert, Henri Justino, Douglas Mah, Mahadevappa Mahesh, Cynthia K Rigsby, Timothy C Slesnick, Keith J Strauss, Sigal Trattner, Mohan N Viswanathan, Andrew J Einstein
There is a need for consensus recommendations for ionizing radiation dose optimization during multimodality medical imaging in children with congenital and acquired heart disease (CAHD). These children often have complex diseases and may be exposed to a relatively high cumulative burden of ionizing radiation from medical imaging procedures, including cardiac computed tomography, nuclear cardiology studies, and fluoroscopically guided diagnostic and interventional catheterization and electrophysiology procedures...
July 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28501117/institutional-variation-in-surgical-care-for-early-stage-breast-cancer-at-community-hospitals
#18
Christopher M Dodgion, Stuart R Lipsitz, Marquita R Decker, Yue-Yung Hu, Sudha R Pavuluri Quamme, Anita Karcz, Leonard D'Avolio, Caprice C Greenberg
BACKGROUND: There is significant institutional variation in the surgical care of breast cancer, and this may reflect access to services and resultant physician practice patterns. In previous studies, specialty care has been associated with variation in the operative treatment of breast cancer but has not been evaluated in a community setting. This study investigates these issues in a cohort of 59 community hospitals in the United States. MATERIALS AND METHODS: Data on patients receiving an operation for breast cancer (2006-2009) in a large, geographically diverse cohort of hospitals were obtained...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28469440/the-exercise-of-autonomy-by-older-cancer-patients-in-palliative-care-the-biotechnoscientific-and-biopolitical-paradigms-and-the-bioethics-of-protection
#19
REVIEW
Márcio Niemeyer-Guimarães, Fermin Roland Schramm
Toward the end of life, older cancer patients with terminal illness often prefer palliative over life-extending care and also prefer to die at home. However, care planning is not always consistent with patients' preferences. In this article, discussions will be centered on patients' autonomy of exercising control over their bodies within the current biotechnoscientific paradigm and in the context of population aging. More specifically, the biopolitical strategy of medicine in the context of hospital-centered health care control and of the frail condition of cancer patients in the intensive care unit will be considered in terms of the bioethics of protection...
2017: Palliative Care
https://www.readbyqxmd.com/read/28460082/reducing-cancer-burden-in-the-population-an-overview-of-epidemiologic-evidence-to-support-policies-systems-and-environmental-changes
#20
Elizabeth A Platz
"Reducing Cancer Burden in the Population: Epidemiologic Evidence to Support Policies, Systems, and Environmental Changes" is a compilation of 11 reviews addressing aspects of primary prevention of cancer (early life factors, vitamin D, and periodontal disease and the oral microbiome); primary and secondary prevention (in the transgender population); surveillance following secondary prevention (personalizing follow-up of patients diagnosed with an adenoma based on colorectal cancer risk); tertiary prevention (physical activity as an adjuvant to cancer treatment, measurement of patient-reported physical functioning in cancer treatment trials, and implementation of palliative care recommendations); and all 3 (changing epidemiology of oral cancers)...
January 1, 2017: Epidemiologic Reviews
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