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Ensuring patient-centered care in cancer

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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
#1
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...
May 23, 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
#2
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 multi-modality 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...
May 17, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28501117/institutional-variation-in-surgical-care-for-early-stage-breast-cancer-at-community-hospitals
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28456948/advance-care-planning-communication-oncology-patients-and-providers-voice-their-perspectives
#6
Jennifer L Bires, Elizabeth F Franklin, Helen M Nichols, John G Cagle
Advance care planning helps to ensure that patients' end-of-life preferences are understood and discussed with providers. It is an important component of patient-centered care, particularly when patients are facing life-limiting illness. It also has ethical implications for providers, yet evidence suggests that these conversations are not always occurring, particularly in underserved populations. The aim of this study was to understand the challenges and personal beliefs regarding ACP through interviews with patients undergoing active cancer treatment and their oncology providers...
April 29, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28421454/quality-indicators-in-endoscopic-ablation-for-barrett-s-esophagus
#7
REVIEW
Samuel Han, Sachin Wani
Barrett's esophagus (BE) is a well-established premalignant condition for esophageal adenocarcinoma (EAC); a cancer that is associated with a poor 5-year survival rate. Several strategies have been explored in the context of reducing the burden of EAC. Endoscopic eradication therapy (EET) is considered the standard of care for the management of patients with BE with dysplasia and early neoplasia; a practice that has been endorsed by all gastroenterology societal guidelines. The effectiveness of EET has been demonstrated in multiple studies and contemporary management includes a combination of endoscopic mucosal resection (EMR) of all visible lesions followed by eradication of the remaining BE using ablative techniques of which radiofrequency ablation (RFA) has the best evidence supporting effectiveness and safety...
April 18, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28390420/partnering-with-patients-in-translational-oncology-research-ethical-approach
#8
Marie-France Mamzer, Nathalie Duchange, Sylviane Darquy, Patrice Marvanne, Claude Rambaud, Giovanna Marsico, Catherine Cerisey, Florian Scotté, Anita Burgun, Cécile Badoual, Pierre Laurent-Puig, Christian Hervé
BACKGROUND: The research program CARPEM (cancer research and personalized medicine) brings together the expertise of researchers and hospital-based oncologists to develop translational research in the context of personalized or "precision" medicine for cancer. There is recognition that patient involvement can help to take into account their needs and priorities in the development of this emerging practice but there is currently no consensus about how this can be achieved. In this study, we developed an empirical ethical research action aiming to improve patient representatives' involvement in the development of the translational research program together with health professionals...
April 8, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28288595/mindful-yoga-for-women-with-metastatic-breast-cancer-design-of-a-randomized-controlled-trial
#9
RANDOMIZED CONTROLLED TRIAL
James W Carson, Kimberly M Carson, Maren K Olsen, Linda Sanders, Laura S Porter
BACKGROUND: Women with metastatic breast cancer (MBC) have average life expectancies of about 2 years, and report high levels of disease-related symptoms including pain, fatigue, sleep disturbance, psychological distress, and functional impairment. There is growing recognition of the limitations of medical approaches to managing such symptoms. Yoga is a mind-body discipline that has demonstrated a positive impact on psychological and functional health in early stage breast cancer patients and survivors, but has not been rigorously studied in advanced cancer samples...
March 13, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28284760/a-peer-review-process-as-part-of-the-implementation-of-clinical-pathways-in-radiation-oncology-does-it-improve-compliance
#10
Brian J Gebhardt, Dwight E Heron, Sushil Beriwal
PURPOSE: Clinical pathways are patient management plans that standardize evidence-based practices to ensure high-quality and cost-effective medical care. Implementation of a pathway is a collaborative process in our network, requiring the active involvement of physicians. This approach promotes acceptance of pathway recommendations, although a peer review process is necessary to ensure compliance and to capture and approve off-pathway selections. We investigated the peer review process and factors associated with time to completion of peer review...
January 19, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28177857/end-of-life-care-in-nunavik-quebec-inuit-experiences-current-realities-and-ways-forward
#11
Shawn Renee Hordyk, Mary Ellen Macdonald, Paul Brassard
BACKGROUND: Increasing longevity for Inuit living in Nunavik, northern Quebec, has resulted in heightened rates of cancers and chronic diseases necessitating complex treatments. Consequently, end-of-life (EOL) care, once the domain of Inuit families and communities, has come to include professionalized healthcare providers with varying degrees of awareness of factors to consider in providing care to Inuit populations. OBJECTIVE: To better understand the factors shaping EOL care in Nunavik to support the development of a sustainable model of care...
June 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28156561/a-qualitative-investigation-of-mindfulness-practice-to-support-advance-care-planning-acp
#12
Ann H Cottingham, Kathleen A Beck-Coon, Paul R Helft
15 Background: Despite ongoing attempts to increase ACP in the U.S, a national longitudinal study of patients with cancer found no significant change in participation in end-of-life (EOL) discussions or living will completion between 2000-2012. A key barrier to ACP includes emotional discomfort talking about EOL care preferences. Mindfulness practices facilitate emotional regulation through present-centered awareness and non-reactive coping. In this pilot, an intervention combining mindfulness training, mindful communication skill development, and information about ACP was hypothesized to increase ACP in patients with cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156459/changing-the-culture-for-psychosocial-care-does-it-need-changing
#13
Patricia A Parker, Daphine Lambert, Sujin Ann-Yi, Alan D Valentine, Frank V Fossella, Eduardo Bruera, Janet L Williams, Lorenzo Cohen
70 Background: National organizations recommend routine screening for psychosocial distress in cancer patients. American College of Surgeons (ACoS) Commission on Cancer mandates screening for accreditation with requirements for timing/method/tool for screening; assessment/referral; and documentation. METHODS: MD Anderson routinely screens patients for distress with policies and algorithms for the process. We sought to enhance this standard process by incorporating a dedicated psychosocial liaison in the clinic to ensure screening based on NCCN guidelines, follow-up with patients at the medical visit, and clear documentation and referral per ACoS standards...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152969/utilizing-an-a3-project-to-improve-assessment-of-oral-chemotherapy-adherence-across-a-five-site-enterprise
#14
Kathleen Dunn, Debra Kay Allen, Diane Denny, Maurie Markman
136 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of five hospitals that specialize in treating patients fighting complex or advanced-stage cancer. During the fall of 2013, two of the five centers began the pursuit of Quality Oncology Practice Initiative (QOPI) certification. A third site began QOPI certification the spring of 2014 and the remaining two sites followed suit the spring of 2015. This process brought attention to the patient population receiving oral chemotherapy and the importance of careful monitoring of those self-administering their cancer treatment regimens...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152902/the-standardization-of-skin-cancer-treatment-recommendations-through-the-analysis-of-clinical-pathways-data-and-an-evidence-based-physician-driven-committee-process
#15
Amanda Barry, Hans Benson, Zach Lorinc, Kathleen Lokay
147 Background: Clinical pathways (CP) have the potential to improve the quality and safety of care and lead to more predictable outcomes and costs through standardization. Via Oncology's CP program aims to standardize care at radiation centers across its nationwide network. Created through an evidence-based, physician-driven committee process, CP recommend the best treatment plan for specific patient populations based on a hierarchy of efficacy, toxicity, and cost. In the absence of definitive data, reaching a consensus on the best treatment recommendation is difficult, particularly for disease states such as melanoma, squamous cell carcinoma, and basal cell carcinoma for which a wide range of radiation doses and schedules are considered effective and regional and institutional preferences may vary...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152888/the-benefits-of-clinical-pathways-cp-for-radiation-oncology-in-a-large-cancer-care-network
#16
Sushil Beriwal, Hans Benson, Zach Lorinc, Amanda Barry, Kathleen Lokay
148 Background: UPMC CancerCenter and the University of Pittsburgh Cancer Institute (UPMC) created a radiation oncology CP program (now incorporated separately as Via Pathways) in 2003 to standardize care at 19 radiation sites. The program exists to ensure consistency and rapid adoption of best evidence-based care in a large, integrated NCI-designated comprehensive cancer center. METHODS: The web-based CP portal integrates with electronic medical records to provide point-of-care patient-specific decision support...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152857/the-radiation-oncology-emr-as-a-quality-and-outcomes-based-informatics-platform-a-multicenter-pilot-study
#17
Tammy Wotring, Andrew S Kennedy
168 Background: Radiation oncology specific oncology information systems (OIS) are highly specialized and capture large amounts of rich data related to patient care. There is great potential to expand the utility of these systems from data collection and point-of-care documentation to platforms for radiation oncology informatics. To this end, we have begun an effort to consolidate and standardize the OIS within a large network of radiation oncology clinics. We report initial findings from a multi-center OIS standardization pilot involving five clinics...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152773/bringing-person-centered-care-to-practice-with-cco-s-guideline-for-person-centred-care-in-adult-oncology-services
#18
Brett Nicholls, Hannah Shamji, Neil Johnson, Caroline Zwaal, Christian Stevens, Rhonel Biddy, Carly Griffin, Gail Laroque, Hans Messersmith, Simron Singh
65 Background: CCO ensures quality cancer care for 16 million residents in Ontario. CCO has identified person-centered care (PCC) as a top strategy in driving the quality agenda. CCO, in collaboration with the Program in Evidence-Based Care, developed a PCC Guideline to set the standard of care for people experiencing cancer in Ontario. A PCC video was developed as a tool for translating this knowledge to support healthcare providers to integrate Guideline recommendations into their practice. METHODS: A Guideline Working Group (GWG), including patients and health care providers, conducted a literature review and assessed the quality, relevance and utility of available evidence...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152730/addressing-patient-needs-through-compilation-of-self-reported-verbatim-comments
#19
Diane Denny, Sarah Hizon, Danielle Kendrick, Maurie Markman
111 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of five hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment that captures the patients' perceived symptom burden, from baseline and every 21 days thereafter. The SIT is comprised of questions utilizing the M.D. Anderson Symptom Inventory tool, with eight questions and a free text box added by CTCA. Patient comments are provided in approximately 5% of all assessments (representing 3,700 comments) since initiation of the SIT...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28116989/patient-reflections-on-decision-making-for-laryngeal-cancer-treatment
#20
Andrew G Shuman, Knoll Larkin, Dorothy Thomas, Frank L Palmer, Joseph J Fins, Shrujal S Baxi, Nancy Lee, Jatin P Shah, Angela Fagerlin, Snehal G Patel
Objective To describe the reflections of patients treated for laryngeal cancer with regard to treatment-related decision making. Study Design Cross-sectional survey-based pilot study. Setting Single-institution tertiary care cancer center. Subjects/Methods Adults with laryngeal carcinoma were eligible to participate (N = 57; 46% treated surgically, 54% nonsurgically). Validated surveys measuring decisional conflict and regret explored patients' reflections on their preferences and priorities regarding treatment-related decision making for laryngeal cancer and how patient-reported functional outcomes, professional referral patterns, and desired provider input influenced these reflections...
February 2017: Otolaryngology—Head and Neck Surgery
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