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Ensuring patient-centered care in cancer

Kristine E Konopka
In the past 5 years, there has arguably been a shift in the pathologic diagnosis of lung cancer, especially adenocarcinoma, moving toward a more patient-centered approach to reporting that works to incorporate information that may be clinically meaningful to prognosis and impactful to clinical management strategy. As the demand for specialty team care surges, the need for effective communication between specialties continues to increase, particularly to ensure that we are all speaking the same language with regard to diagnostic certainty and the implementation of new terminology...
October 2016: Seminars in Respiratory and Critical Care Medicine
L Hughes, J Hamm, C McGahan, C Baliski
BACKGROUND: Breast-conserving surgery (BCS) is the preferred surgical approach for the majority of patients with early-stage breast cancer. There are frequent issues regarding pathologic margin status, requiring margin re-excision, and, in the literature, there is significant variability in re-excision rates, suggesting this is a potential quality-of-care issue. Understanding the patient-, disease-, and physician-related factors influencing reoperation rates is of importance in an effort to minimize this occurrence...
October 7, 2016: Annals of Surgical Oncology
Katherine Treiman, Lauren McCormack, Murrey Olmsted, Nancy Roach, Bryce B Reeve, Christa E Martens, Rebecca R Moultrie, Hanna Sanoff
BACKGROUND: Patient-centered communication (PCC) is an essential component of patient-centered care and contributes to patient satisfaction, health-related quality of life, and other important patient outcomes. OBJECTIVE: The aim of this study was to develop and test survey questions to assess patients' experiences with PCC in cancer care. METHODS: We used a conceptual model developed by the National Cancer Institute as our framework. The survey questions align with the six core functions of PCC defined in the model: Exchanging Information, Managing Uncertainty, Enabling Patient Self-Management, Fostering Healing Relationships, Making Decisions, and Responding to Emotions...
September 23, 2016: Patient
Cristiane Decat Bergerot, Errol J Philip, Tammy A Schuler, Karen Lynn Clark, Matthew Loscalzo, Marco Murilo Buso, João Nunes de Matos Neto, Jorge Vaz Pinto Neto, Alexandre Nonino, Tereza Cristina Cavalcanti Ferreira de Araujo
OBJECTIVE: International guidelines recommend routine screening for distress as part of care practices. Accordingly, a Brazilian cancer center developed and implemented a distress screening program (DS) in 2007, which was enhanced in 2009 through the inclusion of a psychosocial care meeting group (DS + PCM) regarding patients' psychosocial needs. The current paper will provide an overview of the development and pilot implementation of this program and initial analyses to assess patient outcomes and report initial results to extend international research on this key aspect of cancer care...
August 28, 2016: Psycho-oncology
Limin Gao, Jivin Joseph, Marcelle Santoro-Levy, Alan S Multz, Vladimir K Gotlieb
BACKGROUND: With the advances in cancer treatments, mortality rates in the United States have been consistently falling but they are accompanied by substantial increases in the cost of cancer care. Patient and prescription assistance programs (PPAPs) are offered by pharmaceutical manufacturers to provide free medications to medically indigent patients. To assist the Cancer Care Center (CCC) at Nassau University Medical Center (NUMC) with drug costs for chemotherapies, the pharmacy department uses a patient assistance program (PAP) to obtain medications from the drug companies at no cost...
July 2016: Hospital Pharmacy
Szu-Ching Shen, Yao-Ching Hung, Pei-Tseng Kung, Wen-Hui Yang, Yueh-Hsin Wang, Wen-Chen Tsai
Cervical cancer ranks as the fourth leading cause of cancer death in women worldwide. In Taiwan, although the universal health insurance system has achieved 99.9% coverage and ensured easy access to medical care, some cervical cancer patients continue to delay initiation of definitive treatment after diagnosis. This study focused on cervical cancer patients who delayed treatment for at least 4 months, and examined the characteristics, related factors, and survival in these patients.Data on patients with a new confirmed diagnosis of cervical cancer by the International Federation of Gynecology and Obstetrics (FIGO) staging system between 2005 and 2010 were obtained from the National Health Insurance Research Database and the Taiwan Cancer Registry...
August 2016: Medicine (Baltimore)
Tina W F Yen, Jianing Li, Rodney A Sparapani, Purushuttom W Laud, Ann B Nattinger
BACKGROUND: Several surgeon characteristics are associated with the use of sentinel lymph node biopsy (SLNB) for breast cancer. No studies have systematically examined the relative contribution of both surgeon and hospital factors on receipt of SLNB. OBJECTIVE: To evaluate the relationship between surgeon and hospital characteristics, including a novel claims-based classification of hospital commitment to cancer care (HC), and receipt of SLNB for breast cancer, a marker of quality care...
August 2016: Medicine (Baltimore)
Sandeep Singh, Sorabh Badaya
Carcinoma cervix remains a leading cause of cancer mortality among women in countries lacking any screening program. The existing screening policy and approach via conventional cytology centered mainly in Tertiary Care Center, is totally unaffordable to Indian women, especially in the remote areas. This suggests the need of depolarizing the resources via generating the near real time modalities which could be used at the door step of the needy ones. For any screening modality to be effective it should be adequately sensitive, specific, reproducible, cheap, simple, affordable, and the most important is should be real time to ensure wide coverage and curtail loss to follow-up...
April 2016: Journal of Cancer Research and Therapeutics
S M Peitzmeier, K Khullar, J Potter
PURPOSE: Papanicolaou (Pap) testing has dramatically decreased cervical cancer incidence in the USA, but only 83 % of women screen according to guidelines. Our study aimed to examine the real-world effectiveness of various outreach methods in engaging patients who are overdue for cervical cancer screening. METHODS: In total, 1,100 patients at an urban federally qualified health center overdue for Pap testing were randomized to receive usual care (control), letter outreach, email outreach, telephone outreach, or multimodal (letter/email/telephone) outreach over a period of 3 months...
September 2016: Cancer Causes & Control: CCC
Ragni Sommerbakk, Dagny Faksvåg Haugen, Aksel Tjora, Stein Kaasa, Marianne Jensen Hjermstad
BACKGROUND: Implementation of quality improvements in palliative care (PC) is challenging, and detailed knowledge about factors that may facilitate or hinder implementation is essential for success. One part of the EU-funded IMPACT project (IMplementation of quality indicators in PAlliative Care sTudy) aiming to increase the knowledge base, was to conduct national studies in PC services. This study aims to identify factors perceived as barriers or facilitators for improving PC in cancer and dementia settings in Norway...
2016: BMC Palliative Care
Ekhlas Al-Gamal, Tony Long
AIMS AND OBJECTIVES: The aims of this study were to identify the links between self-esteem, fatigue and health-related quality of life for children and young people during and following treatment for cancer. BACKGROUND: Measures to minimize adverse outcomes for survivors of childhood cancer have been developed, but the crucial periods of returning to school and transition to adult life and adult services are not addressed so well. Screening of quality of life, fatigue, and self-esteem in childhood cancer patients during and after treatment is important for optimizing the nursing response and improving outcomes for children...
July 5, 2016: Journal of Clinical Nursing
Cornelius A Thiels, Kristine T Hanson, Kathleen J Yost, Martin D Zielinski, Elizabeth B Habermann, Robert R Cima
OBJECTIVE: We aimed to evaluate variations in patient experience measures across different surgical specialties and to assess the impact of further case-mix adjustment. BACKGROUND: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a publicly reported survey of patients' hospital experiences that directly influence Medicare reimbursement. METHODS: All adult surgical inpatients meeting criteria for HCAHPS sampling from 2013 to 2014 at a single academic center were identified...
October 2016: Annals of Surgery
Alyssa Troeschel, Tenbroeck Smith, Kathleen Castro, Katherine Treiman, Joseph Lipscomb, Ryan M McCabe, Steven Clauser, Eliot L Friedman, Patricia D Hegedus, Kenneth Portier
PURPOSE: Patient experiences with symptom care need to be assessed and documented to ensure successful management of cancer-related symptoms. This paper details one method for creating symptom management quality improvement (SMQI) reports, including case-mix adjustment of patient-reported measures. Qualitative data regarding the acceptability of these reports at participating cancer centers (CCs) are also provided. METHODS: Data were collected from 2226 patients treated at 16 CCs via mailed/Web questionnaires...
June 23, 2016: Quality of Life Research
K Zibrik, J Laskin, C Ho
Nurse navigation is a developing facet of oncology care. The concept of patient navigation was originally created in 1990 at the Harlem Hospital Center in New York City as a strategy to assist vulnerable and socially disadvantaged populations with timely access to breast cancer care. Since the mid-1990s, navigation programs have expanded to include many patient populations that require specialized management and prompt access to diagnostic and clinical resources. Advanced non-small-cell lung cancer is ideally suited for navigation to facilitate efficient assessment in this fragile patient population and to ensure timely results of molecular tests for first-line therapy with appropriately targeted agents...
June 2016: Current Oncology
Karin Purshouse, Robert A Watson, David N Church, Charlotte Richardson, Gemma Crane, Zoe Traill, Mark Sullivan, Ian Roberts, Lisa Browning, Gareth Turner, Vishnu Parameshwaran, Joseph Johnson, Meenali Chitnis, Andrew Protheroe, Clare Verrill
PURPOSE: Testicular cancers are an uncommon and highly curable group of tumors that are typically managed by specialist multidisciplinary teams (MDTs). Although recent guidelines have emphasized the importance of tumor prognostic factors in predicting recurrence and personalizing therapy in early-stage disease, the role of central pathology review in determining these factors is unclear. PATIENTS AND METHODS: We compared the referral histopathology reports with those obtained after expert central review for all cases reviewed by the UK Thames Valley Cancer Network testicular tumor MDT from August 2004 to September 2012...
May 27, 2016: Clinical Genitourinary Cancer
Kathleen L Ruchalski, Kathleen Brown
Since the release of the US Preventive Services Task Force and Centers for Medicare and Medicaid Services recommendations for lung cancer screening, low-dose chest computed tomography screening has moved from the research arena to clinical practice. Lung cancer screening programs must reach beyond image acquisition and interpretation and engage in a multidisciplinary effort of clinical shared decision-making, standardization of imaging and nodule management, smoking cessation, and patient follow-up. Standardization of radiologic reports and nodule management will systematize patient care, provide quality assurance, further reduce harm, and contain health care costs...
July 2016: Journal of Thoracic Imaging
Centers For Disease Control And Prevention Public Health Service U S Department Of Health And Human Services
Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs. The Centers for Disease Control and Prevention (CDC) developed and published the Guideline for Prescribing Opioids for Chronic Pain to provide recommendations for the prescribing of opioid pain medication for patients 18 and older in primary care settings. Recommendations focus on the use of opioids in treating chronic pain (pain lasting longer than 3 months or past the time of normal tissue healing) outside of active cancer treatment, palliative care, and end-of-life care...
June 2016: Journal of Pain & Palliative Care Pharmacotherapy
Megan M Boniface, Sachin B Wani, Tracey E Schefter, Phillip J Koo, Cheryl Meguid, Stephen Leong, Jeffrey B Kaplan, Lisa J Wingrove, Martin D McCarter
The management of esophageal and gastric cancer is complex and involves multiple specialists in an effort to optimize patient outcomes. Utilizing a multidisciplinary team approach starting from the initial staging evaluation ensures that all members are in agreement with the plan of care. Treatment selection for esophageal and gastric cancer often involves a combination of chemotherapy, radiation, surgery, and palliative interventions (endoscopic and surgical), and direct communication between specialists in these fields is needed to ensure appropriate clinical decision making...
2016: Cancer Management and Research
Tiny van Merode, Silvia Bours, Ben van Steenkiste, Theo Sijbers, Gerard van der Hoek, Cor Vos, Gerard M J Bos, Trudy van der Weijden
BACKGROUND: To ensure true patient-centered care, the urgency of patient participation in research is increasingly recognized. This study takes this one step further and reports on patient participation in describing patients' needs for improving quality of care in the context of research priorities - a challenging partnership with patients in research as we yet lack experience in the Netherlands. OBJECTIVES: 1) To illustrate the process of describing patients' needs in the context of research priorities for patients with blood cancer (multiple myeloma or Waldenstrom's disease) with the purpose to improve the quality of health care...
2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Mark W Clemens, Roberto N Miranda, Charles E Butler
Breast implant-associated anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma arising around breast implants. Public awareness has increased following a safety communication warning of the association of breast implant-associated ALCL by the U.S. Food and Drug Administration in 2011. Difficulty with determining an accurate assessment of risk, including diagnosis, or standardized treatment regimen has led surgeons to commonly omit preoperative discussion of this rare and frequently misunderstood cancer...
April 2016: Plastic and Reconstructive Surgery
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