Master chemotherapy planning and clinicians rostering in a hospital outpatient cancer centre

Purpose To retrospectively determine the rate of death occurring within 14 and 30 days of systemic anticancer therapy (SACT), compare this against a previous audit and benchmark results against other cancer centres. Secondly, to determine if the introduction of immune checkpoint inhibitors (ICI), not available at the time of the initial audit, impacted mortality rates. Method All adult solid tumour and haematology patients receiving SACT at an Australian Regional Cancer Centre (RCC) between January 2016 and July 2020 were included. Results Over a 55-month period, 1709 patients received SACT. Patients dying within 14 and 30 days of SACT were 3.3% and 7.0% respectively and is slightly higher than our previous study which was 1.89% and 5.6%. Mean time to death was 15.5 days. Males accounted for 63.9% of patients and the mean age was 66.8 years. 46.2% of the 119 patients dying in the 30 days post SACT started a new line of treatment during that time. Of 98 patients receiving ICI, 22.5% died within 30 days of commencement. Disease progression was the most common cause of death (79%). The most common place of death was the RCC (38.7%). Conclusion The rate of death observed in our re-audit compares favourably with our previous audit and is still at the lower end of that seen in published studies in Australia and internationally. Cases of patients dying within 30 days of SACT should be regularly reviewed to maintain awareness of this benchmark of quality assurance and provide a feedback process for clinicians.

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Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd013665.pub2 ◽

2021 ◽

Cited By ~ 3

Author(s):

Thomas Struyf ◽

Jonathan J Deeks ◽

Jacqueline Dinnes ◽

Yemisi Takwoingi ◽

Clare Davenport ◽

...

Keyword(s):

Primary Care ◽

Signs And Symptoms ◽

Hospital Outpatient ◽

Outpatient Settings

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Older adults report cancellation or avoidance of medical care during the COVID-19 pandemic: results from the Longitudinal Aging Study Amsterdam

European Geriatric Medicine ◽

10.1007/s41999-021-00514-3 ◽

2021 ◽

Author(s):

Noah A. Schuster ◽

Sascha de Breij ◽

Laura A. Schaap ◽

Natasja M. van Schoor ◽

Mike J. L. Peters ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Medical Care ◽

Help Seeking ◽

Community Dwelling ◽

Multiple Chronic Conditions ◽

Hospital Outpatient ◽

Longitudinal Aging Study Amsterdam ◽

Aging Study ◽

Longitudinal Aging Study

Abstract Purpose Delay of routine medical care during the COVID-19 pandemic may have serious consequences for the health and functioning of older adults. The aim of this study was to investigate whether older adults reported cancellation or avoidance of medical care during the first months of the COVID-19 pandemic, and to explore associations with health and socio-demographic characteristics. Methods Cross-sectional data of 880 older adults aged ≥ 62 years (mean age 73.4 years, 50.3% female) were used from the COVID-19 questionnaire of the Longitudinal Aging Study Amsterdam, a cohort study among community-dwelling older adults in the Netherlands. Cancellation and avoidance of care were assessed by self-report, and covered questions on cancellation of primary care (general practitioner), cancellation of hospital outpatient care, and postponed help-seeking. Respondent characteristics included age, sex, educational level, loneliness, depression, anxiety, frailty, multimorbidity and information on quarantine. Results 35% of the sample reported cancellations due to the COVID-19 situation, either initiated by the respondent (12%) or by healthcare professionals (29%). Postponed help-seeking was reported by 8% of the sample. Multimorbidity was associated with healthcare-initiated cancellations (primary care OR = 1.92, 95% CI = 1.09–3.50; hospital OR = 1.86, 95% CI = 1.28–2.74) and respondent-initiated hospital outpatient cancellations (OR = 2.02, 95% CI = 1.04–4.12). Depressive symptoms were associated with postponed help-seeking (OR = 1.15, 95% CI = 1.06–1.24). Conclusion About one third of the study sample reported cancellation or avoidance of medical care during the first months of the pandemic, and this was more common among those with multiple chronic conditions. How this impacts outcomes in the long term should be investigated in future research.

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The evolution of parents’ beliefs about childhood cancer during diagnostic communication: a qualitative study in Guatemala

BMJ Global Health ◽

10.1136/bmjgh-2020-004653 ◽

2021 ◽

Vol 6 (5) ◽

pp. e004653

Author(s):

Dylan Graetz ◽

Silvia Rivas ◽

Lucia Fuentes ◽

Ana Cáceres-Serrano ◽

Gia Ferrara ◽

...

Keyword(s):

Cancer Education ◽

Medical Model ◽

Communication Process ◽

Sources Of Information ◽

Cancer Communication ◽

Structured Interviews ◽

Children With Cancer ◽

Cancer Centre ◽

Treatment Abandonment ◽

Cancer Beliefs

IntroductionFatalistic cancer beliefs may contribute to delayed diagnosis and poor outcomes, including treatment abandonment, for children with cancer. This study explored Guatemalan parents’ cancer beliefs during initial paediatric cancer communication, and the sociocultural and contextual factors that influence these beliefs.MethodsTwenty families of children with cancer were included in this study. We audio-recorded psychosocial conversations with psychologists and diagnostic conversations with oncologists, then conducted semi-structured interviews with parents to explore the evolution of their cancer beliefs. Audio-recordings were transcribed and translated from Spanish into English, with additional review in both languages by bilingual team members. All 60 transcripts were thematically analysed using a priori and novel codes.ResultsGuatemalan parents’ beliefs evolve as they learn about cancer through various sources. Sources of information external to the cancer centre, including prior experiences with cancer, media exposure, community discussion and clinical encounters, contribute to pre-existing beliefs. Many parents’ pre-existing cancer beliefs are fatalistic; some are influenced by Mayan spirituality. Sources internal to the cancer centre include psychologists and oncologists, other providers, other patients and families. Psychologists acknowledge pre-existing beliefs and deliver cancer education using verbal explanations and hand-drawings. Oncologists provide diagnostic information and outline treatment plans. Both support hope by providing a path toward cure. Parents’ lived experience is a culmination of sources and simultaneously independent. Ultimately most parents arrive at an understanding of cancer that is consistent with an allopathic medical model and offers optimism about outcomes.ConclusionAn interdisciplinary communication process that includes cancer education, is attentive to pre-existing beliefs, and supports hope may encourage acceptance of the allopathic medical model and need for treatment. Providers in settings of all resource levels may be able to use these techniques to support cross-cultural cancer communication, reduce treatment abandonment and improve therapy adherence.

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