The effects of curative‐intent cancer therapy on employment, work ability, and work limitations

6611 Background: Validated survey tools have been used to measure the quality of life (QOL) of patients treated for cancer, however, there are newer studies that have shown both an improvement in QOL, and improvement in overall survival using these tools. We integrated the Functional Assessment of Cancer Therapy – General Population (FACT-GP v.4) to direct the deployment of resources and interventions to improve the care of patients who have completed potentially curative therapy for cancer. Methods: This is an observational study of patients who received cancer therapy with curative intent in the last 18 months. The FACT-GP was administered by an RN via telephone. Patients contacted received and reviewed a Survivorship Care Plan (SCP) as defined by the American College of Surgeons Committee on Cancer. Patients who had a total score less than 60 on FACT-GP and/or had a score less than 12 on the Emotional Well-Being subscale (EWB) were considered high-risk and were referred to the Survivorship MDC for in-person evaluation. Results: From 10/1/2018 to 12/31/2018, 114 patients were referred to the cancer survivorship program. Of these, 64 (56%) patients had FACT-GP administered and were evaluated. 45 of these (70%) only completed the FACT-GP and received an SCP. 21 patients had a total score less than 60 and/or an EWB sub-score less than 12 and were identified as high-risk. 15 (72%) patients were seen in MDC, 4 (19%) patients were seen in conjunction with a scheduled appointment by the MDC team, 2 (9%) patients refused further evaluation. 66.7% of patients in the survivorship program were referred to Oncology Behavioral Health compared to 18.2% of all oncology patients. Survivorship patients in the cohort had a baseline utilization of the emergency department (ED) of 4.1% (10 of 241) from 1/1/2018 to 9/30/2018 and 0 (0 of 64) after the initiation of the intervention from 10/1/2018 to 12/31/2018. Conclusions: Integrating a validated QOL tool (FACT-GP) as a therapeutic intervention is feasible and may both identify needs and direct services for cancer survivors while possibly decreasing ED utilization. Clinical trial information: NCT03835052.

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Initial experience with an innovative pilot program evaluating a multidisciplinary approach to supportive care planning in a survivorship clinic setting.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.31_suppl.242 ◽

2014 ◽

Vol 32 (31_suppl) ◽

pp. 242-242

Author(s):

Lisa M. Radice ◽

Jeffrey Eagan ◽

Kathleen Y. Michie ◽

Marianne Pearson ◽

Joshua H. Petit

Keyword(s):

Cancer Therapy ◽

Supportive Care ◽

Rehabilitation Services ◽

Pilot Program ◽

Care Planning ◽

Optimal Care ◽

Curative Intent ◽

Patient Reported ◽

Survivorship Care Planning ◽

Specific Care

242 Background: The supportive care and rehabilitative needs of cancer patients are highly varied and complex, and optimal care planning often requires the provision and coordination of multiple modalities. To address these needs, an innovative model for multi-disciplinary evaluation and management within a survivorship clinic was piloted. Methods: Between November 2013 and May 2014, 50 patients who had completed cancer therapy with curative intent were seen in a multi-disciplinary survivorship clinic (MDSC) sequentially by an advanced practice practitioner (nurse practitioner or physician assistant), oncology social worker, and oncology rehabilitation therapist. Data regarding specific care planning resulting from this encounter, compliance with recommended therapies, and patient-reported satisfaction were collected. These data were compared against the remaining cohort of patients (N = 402) who completed curative intent cancer therapy in our cancer program during the same period. Results: Rate of referral for rehabilitation services (83.3% vs 13.9%, p < 0.01) and compliance with recommended therapy visits (85.7% vs 44.6%, p < 0.01) were significantly increased among patients seen within the MDSC pilot when compared with similar patients who were not seen in this setting. The number of referred therapy modalities was also increased among patients seen in the MDSC pilot, median 2 (range 1-3 modalities) vs 1 (range 1-2 modalities), respectively. Of patients who completed an assessment following the multi-disciplinary visit, 86% scored their overall experience as excellent which was the highest possible score. Conclusions: Patients seen within an innovative pilot program of multi-disciplinary survivorship care planning appreciated increased rates of referral for rehabilitation services, were referred for a greater number of therapy modalities, and were more compliant with recommended interventions than similar patients who were not seen in this setting. This patient cohort also reported high rates of satisfaction with the pilot program.

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Effects of curative-intent lung cancer therapy on functional exercise capacity and patient-reported outcomes

Supportive Care in Cancer ◽

10.1007/s00520-020-05294-3 ◽

2020 ◽

Vol 28 (10) ◽

pp. 4707-4720

Author(s):

Duc Ha ◽

Andrew L. Ries ◽

Scott M. Lippman ◽

Mark M. Fuster

Keyword(s):

Lung Cancer ◽

Cancer Therapy ◽

Exercise Capacity ◽

Patient Reported Outcomes ◽

Curative Intent ◽

Patient Reported ◽

Functional Exercise ◽

Lung Cancer Therapy ◽

Functional Exercise Capacity

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Work ability and percentage of hours worked related to limitations in patients with upper extremity musculoskeletal disorders: a cross-sectional cohort study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03387-y ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

A. van Schaaijk ◽

K. Nieuwenhuijsen ◽

M. H. W. Frings-Dresen

Keyword(s):

Cohort Study ◽

Work Ability ◽

Working Hours ◽

Work Hours ◽

Daily Activities ◽

Health Issues ◽

Cross Sectional ◽

Hours Worked ◽

Work Limitations ◽

Upper Extremity Musculoskeletal Disorders

Abstract Background The aim of this study was to assess the relationship between self-reported work ability and hours worked at the current time in Upper Extremity Musculoskeletal Disorders (UEMSD) patients. To further investigate this relationship, the association of work ability and working hours with several limitations in daily and working life were explored. Methods In this cross-sectional cohort study, a questionnaire was sent out to members of the UEMSD patient organisation, containing self-reported work ability, questions on working hours and limitations in work due to UEMSD. Limitations were measured with the Disabilities of Arm Shoulder and Hand questionnaire, ShortForm-36 subscales, and common hand grasps or grips. Work ability was measured with the work ability score, while worked hours were operationalised as the percentage of hours worked compared to fulltime. The correlation between worked hours and work ability was tested with the Pearson correlation coefficient. Variance in work ability and the hours worked were explained by limitations and assessed with two linear regression analyses. Results Based on data of 794 respondents a moderate correlation was found between work ability and worked hours r = 0.46; 95% CI [0.40, 0.53]. Models including limitations explained 52 and 21% of total variance in work ability and worked hours, respectively. Variance in both can be explained by the degree of difficulties performing daily activities at work, limitations in daily activities as a consequence of health issues and the ability to perform a precision grip. Additionally, work ability can be explained by limitations at work and other daily activities due to physical health issues, while the percentage of hours can additionally be explained by the ability to grasp a large object with one hand, the ability to use a keyboard, and the subject’s gender. Conclusions The number of worked hours does not fully match the work ability. Although they share three predictors, work ability and worked hours seem to be based on different aspects. Compared to work hours, work ability is more strongly related to limitations in daily activities and work. Taking self-reported work ability into account can improve the fit between work limitations and work hours.

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Phase III Randomized Controlled Trial of eRAPID: eHealth Intervention During Chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.20.02015 ◽

2021 ◽

pp. JCO.20.02015

Author(s):

Kate Absolom ◽

Lorraine Warrington ◽

Eleanor Hudson ◽

Jenny Hewison ◽

Carolyn Morris ◽

...

Keyword(s):

Quality Of Life ◽

Cancer Therapy ◽

Functional Assessment ◽

Self Efficacy ◽

Patient Population ◽

Symptom Control ◽

Well Being ◽

Symptom Reporting ◽

Curative Intent

PURPOSE Electronic patient self-Reporting of Adverse-events: Patient Information and aDvice (eRAPID) is an online eHealth system for patients to self-report symptoms during cancer treatment. It provides automated severity-dependent patient advice guiding self-management or medical contact and displays the reports in electronic patient records. This trial evaluated the impact of eRAPID on symptom control, healthcare use, patient self-efficacy, and quality of life (QOL) in a patient population treated predominantly with curative intent. METHODS Patients with colorectal, breast, or gynecological cancers commencing chemotherapy were randomly assigned to usual care (UC) or the addition of eRAPID (weekly online symptom reporting for 18 weeks). Primary outcome was symptom control (Functional Assessment of Cancer Therapy-General, Physical Well-Being subscale [FACT-PWB]) assessed at 6, 12, and 18 weeks. Secondary outcomes were processes of care (admissions or chemotherapy delivery), patient self-efficacy, and global quality of life (Functional Assessment of Cancer Therapy–General, EQ5D-VAS, and EORTC QLQ-C30 summary score). Multivariable mixed-effects repeated-measures models were used for analyses. Trial registration: ISRCTN88520246. RESULTS Participants were 508 consenting patients (73.6% of 690 eligible) and 55 health professionals. eRAPID compared to UC showed improved physical well-being at 6 ( P = .028) and 12 ( P = .039) weeks and no difference at 18 weeks (primary end point) ( P = .69). Fewer eRAPID patients (47%) had clinically meaningful physical well-being deterioration than UC (56%) at 12 weeks. Subgroup analysis found benefit in the nonmetastatic group at 6 weeks ( P = .0426), but not in metastatic disease. There were no differences for admissions or chemotherapy delivery. At 18 weeks, patients using eRAPID reported better self-efficacy ( P = .007) and better health on EQ5D-VAS ( P = .009). Average patient compliance with weekly symptom reporting was 64.7%. Patient adherence was associated with clinician's data use and improved FACT-PWB at 12 weeks. CONCLUSION Real-time monitoring with electronic patient-reported outcomes improved physical well-being (6 and 12 weeks) and self-efficacy (18 weeks) in a patient population predominantly treated with curative intent, without increasing hospital workload.

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Multifunctional metal–organic framework heterostructures for enhanced cancer therapy

Chemical Society Reviews ◽

10.1039/d0cs00178c ◽

2021 ◽

Author(s):

Jintong Liu ◽

Jing Huang ◽

Lei Zhang ◽

Jianping Lei

Keyword(s):

Cancer Therapy ◽

General Principle ◽

Biomedical Applications ◽

Metal Organic Framework ◽

Metal Organic ◽

Functional Modulation ◽

Organic Framework

We review the general principle of the design and functional modulation of nanoscaled MOF heterostructures, and biomedical applications in enhanced therapy.

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