Understanding the impact of taste changes in oncology care

2016 ◽  
Vol 24 (4) ◽  
pp. 1917-1931 ◽  
Author(s):  
Joel B. Epstein ◽  
Gregory Smutzer ◽  
Richard L. Doty
Keyword(s):  
Taste Changes ◽  
Oncology Care ◽  
The Impact

scholarly journals COVD-25. THE PARADOXICAL EFFECTS OF COVID-19 ON CANCER CARE IN THE NEURO-ONCOLOGY SETTING

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii26-ii26
Author(s):  
Nicole Cort ◽  
Alex Broom ◽  
Katherine Kenny ◽  
Alexander Page ◽  
Jennifer Durling ◽  
...  
Keyword(s):  
Cancer Care ◽  
Standard Of Care ◽  
Adult Brain ◽  
Evidence Based ◽  
Negative Consequences ◽  
Traditional Practice ◽  
Delivery Of Care ◽  
Paradoxical Effects ◽  
Oncology Care ◽  
The Impact

Abstract COVID-19 has caused ongoing interruptions to healthcare systems worldwide, shifting care to virtual platforms, and placing significant economic and logistical burdens on clinical practice. The pandemic has created uncertainty in delivering the standard of care, both in areas of cancer diagnosis and treatment, especially within neuro-oncology. Due to the pandemic, care and operational planning goals have shifted to infection prevention, modifying recommendations to decrease viral transmission and increasing telemedicine use, potentially creating a burden on implementing evidence-based medicine. These dynamics have since begun to redefine traditional practice and research regimens, impacting the comprehensive care that cancer patients can and should receive; and the enduring consequences for the delivery of healthcare. The impact of COVID-19 on oncology practice and trials might endure well beyond the short- to mid-term of the active pandemic. Therefore, these shifts must be accompanied by improved training and awareness, enhanced infrastructure, and evidence-based support to harness the positives and offset the potential negative consequences of the impacts of COVID-19 on cancer care. To address these paradoxical effects, we will conduct iterative, qualitative (face-to-face/video conference) interviews with neuro-oncology clinical and research professionals and adult brain tumor patients receiving care during the pandemic. We will capture unique aspects of oncology care: the lived, subjective, situated, and contingent accounts of patients and medical professionals, especially during a pandemic. We will also specifically compare the impact of telehealth during the pandemic on delivery of care to complex neuro-oncology patients. A summary of this in-depth, qualitative approach will result in a sophisticated understanding of neuro-oncology care on the frontline at a time of crisis, as experienced during a pandemic, to articulate best practices for future implementation.

Impact of cancer- and patient-level factors on provider risk in the Oncology Care Model.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18852-e18852
Author(s):  
Basit Iqbal Chaudhry ◽  
Andrew Yue ◽  
Shuchita Kaila ◽  
Kay Sadik ◽  
Lisa Tran ◽  
...  
Keyword(s):  
Domain Knowledge ◽  
Research Literature ◽  
Risk Exposure ◽  
Progression Rate ◽  
Cell Transplant ◽  
Care Model ◽  
Data Set ◽  
Patient Level ◽  
Oncology Care ◽  
The Impact

e18852 Background: Transferring financial risk from payers to providers to align incentives is central to value-based payment (VBP) reform, including Medicare’s Oncology Care Model (OCM). We simulated the impact of selected cancer- and patient-level factors on providers’ risk in OCM for multiple myeloma (MM), due to its clinical complexity. We hypothesize that risk exposure is sensitive to factors extrinsic to the OCM methodology, including clinical phenotype, disease state and progression rate. Methods: Simulation was used to address omitted variable bias in payer data. We developed 9 key clinical MM scenarios to examine provider risk, based on conceptual frameworks that included patient- and cancer-level factors. The model was parameterized using the Medicare limited data set, research literature and domain knowledge. Twenty factors were varied for each model, e.g. age, autologous stem cell transplant (ASCT). Results: Simulations results showed MM risk for providers depended highly on cancer and patient level factors (see table). For example, high-risk patients were on average $21.5K over target while undergoing ASCT (despite risk adjustment for ASCT) and $18-28K under target for follow on maintenance (maint.) episodes. Conclusions: Provider exposure to risk in OCM is highly sensitive to factors at the cancer and patient level. The distribution of clinical phenotypes, state of disease, and rate of disease progression can significantly impact risk exposure for providers in OCM. New methodologies that model risk in more clinically granular ways are needed to improve VBP in oncology. [Table: see text]

Abstract 718: The Impact of COVID-19 on breast oncology care practices during the pandemic in New York City: A single center retrospective study

2021 ◽  
Author(s):  
Danielle Seidman ◽  
Brittney S. Zimmerman ◽  
Lauren Margetich ◽  
Serena Tharakan ◽  
Natalie Berger ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Retrospective Study ◽  
York City ◽  
Single Center ◽  
Oncology Care ◽  
Care Practices ◽  
The Impact

Development of the oncology opportunity cost assessment tool.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13502-e13502
Author(s):  
Nathan Handley ◽  
Adam F Binder ◽  
Alexandra Gentsch ◽  
Rachel Granberg ◽  
Arianna Heyer ◽  
...  
Keyword(s):  
Focus Groups ◽  
Opportunity Cost ◽  
Assessment Tool ◽  
Cost Of Care ◽  
Cost Assessment ◽  
Opportunity Costs ◽  
Cognitive Interviews ◽  
Patient Level ◽  
Oncology Care ◽  
The Impact

e13502 Background: While awareness of direct patient-level costs of cancer care are growing, less is known about the patient-level opportunity cost of care. Opportunity costs of care may include time spent seeking care, lost wages, lost leisure time, and other indirect costs associated with seeking care. Despite acknowledgment of the importance of considering patient opportunity costs in care treatment decisions, assessment of opportunity costs experienced by individual patients or caregivers is not routinely performed by healthcare providers in general, or oncology providers in particular. The purpose of this work was to develop an instrument, the Oncology Opportunity Cost Assessment Tool (OOCAT), to evaluate patient opportunity cost of seeking oncology care. Methods: Survey development was an iterative process with multiple rounds of stakeholder engagement. First the research team developed a list of potential opportunity cost themes informed by their own experiences. Next, we met with an established patient advisory group within the cancer center to expand this list of themes. We then conducted focus groups with patients and caregivers to explore in further depth their logistical and financial considerations related to seeking care. Findings were used to further expand the list of opportunity cost themes, with this list reviewed in real time with the focus group participants to ensure perspectives were appropriately captured. We then generated a set of survey items to represent each of the themes listed. We generated two items to represent each unique theme. The first item of the instrument sought to quantify the opportunity cost of the theme (e.g. time spent parking); the second component ascertained the patient-perceived importance of the theme using a 7-point Likert scale. Upon drafting of the initial OOCAT, we performed cognitive interviews with a random sampling of patients in order to ensure content validity and clarity of instrument items. Results: We completed 4 virtual focus groups with a total of 23 participants (17 patients and 6 caregivers) followed by cognitive interviews with 13 patients. The resulting OOCAT consists of 17 items that examine time requirements, financial implications, and logistical and quality of life challenges for both patients and caregivers associated seeking oncology care. Conclusions: The OOCAT is a 17-item instrument designed to quantify patient-level opportunity costs of seeking oncology care. Further studies work is needed to validate the OOCAT survey and assess the impact of incorporating quantified assessment of opportunity cost into decision regarding when and where to seek oncology care.

Disruptions to U.S. medical oncology care during the COVID-19 Pandemic: CancerLinQ Discovery (CLQD) analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6547-6547
Author(s):  
Abdul-Rahman Jazieh ◽  
Mark Riffon ◽  
Jennifer C. King ◽  
Gabrielle Betty Rocque ◽  
Electra D. Paskett ◽  
...  
Keyword(s):  
Medical Oncology ◽  
Cohort Analysis ◽  
Healthcare Delivery ◽  
Absolute Number ◽  
Retrospective Cohort Analysis ◽  
Hispanic Patients ◽  
Oncology Care ◽  
Oncology Practice ◽  
The Impact

6547 Background: The COVID-19 pandemic disrupted all facets of healthcare delivery including cancer care. This study evaluates the disruptions to US medical oncology practice during the pandemic in terms of number and type of patients (pts) encounters to determine the impact on continuity of patient care. Methods: We conducted a retrospective cohort analysis using the CLQD electronic health record database, containing data from 2+ million pts from all 50 states. We assessed changes in the monthly proportions of visit encounter types (in-person outpatient [IPOP] and telehealth [TE]) for new and established patients (NP and EP) with an invasive malignancy, benign or in situ neoplasm, or benign hematology diagnosis having an encounter between 1/1/2018 and 9/30/2020. Results: 781,945 pts were studied. Median age on 1/1/2018 was 64 years (IQR: 53-73), 38% were female, and 58% had an invasive malignancy. From 12/2019 to 9/2020, total monthly encounters dropped from 157,964 to 90,662. Monthly IPOP visits for NP dropped from 11.2% to 7.9%, an absolute drop of 3.3% and a relative drop of 30%; TE for NP increased by 1.1% (Table). Monthly IPOP visits for EP, as a percentage of all visits, dropped from 94.4% to 86.6% from 12/2019 to 6/2020 but rebounded to 90.4% by 9/2020. Fraction of TE increased substantially during the pandemic period reaching a peak in 6/2020 (13.8% for EP and 1.6% for NP) and decreased in 9/2020 to 9.6% and 1.1% for EP and NP, respectively. Compared to non-Hispanic patients, Hispanic patients had a larger reduction in IPOP and more TE during the study period. Percentage of monthly encounters, by type, from baseline*. Conclusions: We observed a reduction in the absolute number and monthly percentage of IPOP encounters during the COVID-19 pandemic. For EP, increases in TE does not fully compensate for reductions in IPOP. The reduction in IPOP NP encounters is particularly concerning since it was not accompanied by a compensatory increase in TE. The reduction in NP is consistent with reported pandemic-associated reductions in cancer screening and suggest a notable delay in cancer diagnoses during the pandemic. Reduction in Hispanic IPOP encounters warrants further evaluation.[Table: see text]

scholarly journals Impact of Pharmacy Benefit Managers on Oncology Practices and Patients

2020 ◽  
Vol 16 (5) ◽  
pp. 276-284 ◽  
Author(s):  
Trevor J. Royce ◽  
Caroline Schenkel ◽  
Kelsey Kirkwood ◽  
Laura Levit ◽  
Kathryn Levit ◽  
...  
Keyword(s):  
Prescription Drug ◽  
Prescription Drugs ◽  
Business Practices ◽  
Pharmacy Benefit ◽  
Drug Benefits ◽  
Quality Cancer Care ◽  
Number Of Patients ◽  
Oncology Care ◽  
The Impact

Pharmacy benefit managers (PBMs) are thoroughly integrated into the drug supply chain as administrators of prescription drug benefits for private insurers, self-insuring business, and government health plans. As the role of PBMs has expanded, their opaque business practices and impact on drug prices have come under increasing scrutiny. PBMs are particularly influential in oncology care because prescription drugs play a major role in the treatment of most cancers and an increasing number of patients with cancer are treated with oral oncology agents managed by PBMs. There is concern that some PBM practices may threaten access to high-quality cancer care and may increase the financial and administrative burden on patients and practices. In this article, we review the role of PBMs in prescription drug coverage and reimbursement, discuss the impact of PBMs on oncology care, and present data from the 2018 ASCO Practice Survey assessing the knowledge and attitude of oncology practices toward PBMs.

scholarly journals Monitoring the heart during cancer therapy

2019 ◽  
Vol 21 (Supplement_M) ◽  
pp. M44-M49 ◽  
Author(s):  
Mohsen Habibian ◽  
Alexander R Lyon
Keyword(s):  
Myocardial Injury ◽  
Treatment Strategies ◽  
Cancer Therapies ◽  
Monitoring Strategies ◽  
Increased Risk ◽  
Oncology Care ◽  
Pre Treatment ◽  
The Impact ◽  
Protective Treatment ◽  
Clinical Strategy

Abstract A growing number of effective cancer therapies is associated with cardiovascular (CV) toxicities including myocardial injury or dysfunction, leading to reduced ventricular function, and increased risk of heart failure. As the timing of administration of cancer treatment is known, the potential for risk stratification pre-treatment, and appropriate surveillance and monitoring during treatment, and intervention with cardio-protective treatment strategies in patients exhibiting early evidence of CV toxicity is an appealing clinical strategy. The field of cardio-oncology has developed, and the application of monitoring strategies using CV biomarkers and CV imaging has been to focus of many studies and is now implemented in dedicated cardio-oncology services supporting oncology centres. In this article, we review the background and rationale for monitoring, the different options and their strengths, weaknesses and where they are helpful in specific cardiotoxic cancer therapies, and the impact in cardio-oncology care.

scholarly journals Preserving Milk Nutrition with Light Protection Packaging (P16-063-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Cheryl Stancik ◽  
Susan Duncan ◽  
Philipp Niedenzu
Keyword(s):  
Light Exposure ◽  
Nutrient Content ◽  
Protection Factor ◽  
Food Category ◽  
Visual Appearance ◽  
Taste Changes ◽  
Leading Indicator ◽  
Light Protection ◽  
Dairy Milk ◽  
The Impact

Abstract Objectives Light exposure of packaged foods during their distribution, retailing, and consumer use can degrade product nutrient content as well as visual appearance and taste. Changes to food nutrients caused by light may negatively alter their functionality, bioavailability, and efficacy. Proper package design consideration may protect nutrients and sensory quality and is important for delivering health value and positive eating experience. Dairy milk is a food category of interest due its vulnerability to nutrient degradation with light exposure. Our research aims to quantify the impacts of light on milk nutrients to elucidate the role of packaging for nutrient preservation of dairy milk. Methods A patented method was used to determine a Light Protection Factor (LPF) to quantify light protection performance of the study packaging materials. The method provides light exposure to the packaging under evaluation and monitors a light sensitive marker solution to then determine the LPF value. Aqueous riboflavin (RF) solution was chosen as the marker in our study as it is a leading indicator of milk nutrient and sensory decline. Results Each of four light protection packaging treatments was measured by use of the LPF methodology. The impact of light on the nutrient content of extended-shelf-life milk was observed over a month in a simulated retail storage environment (fluorescently lighted refrigerator case, 2186 lux, 3 C) as a function of these light protection packaging treatments. LPF light protective performances of packaging treatments were correlated to RF preservation of packaged milks through the study (R2 > 0.95). The highest LPF packaging treatment (LPF 64) preserved milk RF at 83% of its initial level through the study whereas the control packaging without light protection treatment (LPF 1) had only 23% RF remaining in the same study period. Conclusions LPF can be used to quantitatively design packages with improved light protection performance ensuring RF content of milk through product life. As RF decline is a leading indicator of decline of other light sensitive nutrients, this methodology has applicability to quantitatively predict preservation of other nutrients impacted by light such as Vitamins A and D. Funding Sources The Chemours Company FC, LLC.

Drug-related problems with targeted/immunotherapies at an oncology outpatient clinic

2019 ◽  
Vol 26 (3) ◽  
pp. 595-602
Author(s):  
Esra Kucuk ◽  
Aygin Bayraktar-Ekincioglu ◽  
Mustafa Erman ◽  
Saadettin Kilickap
Keyword(s):  
Adverse Drug Event ◽  
Clinical Pharmacist ◽  
Adverse Drug Events ◽  
Drug Event ◽  
Targeted Chemotherapy ◽  
Drug Related Problems ◽  
Patients With Cancer ◽  
Common Drug ◽  
Oncology Care ◽  
The Impact

Background Some studies in the literature describe drug-related problems in patients with cancer, although few studies focused on patients receiving targeted chemotherapy and/or immunotherapy. To identify the incidence of drug-related problems in patients receiving targeted chemotherapy and/or immunotherapy, and demonstrate the impact of a clinical pharmacist in an outpatient oncology care setting. Methods Prospective study was conducted in a hospital outpatient oncology clinic between October 2015 and March 2016. Patients greater than 18 years old receiving cetuximab, nivolumab, ipilimumab, or pembrolizumab were included in the study and monitored over a three-month period by a clinical pharmacist. Drug-related problems were analyzed using the Pharmaceutical Care Network Europe classification system. The main outcome measures were the frequency and causes of drug-related problems and the degree of resolution achieved through the involvement of a clinical pharmacist. Results A total of 54 patients (mean age: 57 ± 12 years) were included. There were 105 drug-related problems and 159 associated causes. Among the planned interventions (n = 149), 92 interventions were at the patient-level with 88 (96%) being accepted by the doctors. This resulted in 68 (65%) drug-related problems being completely resolved and 9 (8.6%) being partially resolved. The most common drug-related problem identified was “adverse drug event” (n = 38, 36%). Of the 105 drug-related problems, 63 (60%) related to targeted chemotherapy and/or immunotherapy with 34 (54%) classified as an “adverse drug event.” Conclusion Adverse drug events were the most common drug-related problems in patients with cancer. The involvement of a clinical pharmacist improved the identification of drug-related problems and helped optimize treatment outcomes in patients receiving targeted chemotherapy/immunotherapy.

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