scholarly journals A review of the evidence base for utilizing Child-Pugh criteria for guiding dosing of anticancer drugs in patients with cancer and liver impairment

ESMO Open ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 100162
Author(s):  
C. Palmieri ◽  
I.R. Macpherson
Keyword(s):  
Anticancer Drugs ◽  
Evidence Base ◽  
Liver Impairment ◽  
Patients With Cancer

scholarly journals Management of Distress in Patients with Cancer—Are We Doing the Right Thing?

2020 ◽  
Vol 54 (12) ◽  
pp. 978-984
Author(s):  
Joost Dekker ◽  
Kristi D Graves ◽  
Terry A Badger ◽  
Michael A Diefenbach
Keyword(s):  
Emotional Support ◽  
Hybrid Approach ◽  
Psychosocial Care ◽  
Evidence Base ◽  
Case Finding ◽  
Lessons Learned ◽  
Distress Screening ◽  
Underlying Assumption ◽  
Patients With Cancer ◽  
The Right

Abstract Background Screening for distress and referral for the provision of psychosocial care is currently the preferred approach to the management of distress in patients with cancer. To date, this approach has shown a limited effect on the reduction of distress. Recent commentaries have argued that the implementation of distress screening should be improved. On the other hand, the underlying assumption that a referral for psychosocial care is required for distressed patients can be questioned. This has led to the development of an alternative approach, called emotional support and case finding. Purpose In the context of finding innovative solutions to tomorrow’s health challenges, we explore ways to optimize distress management in patients with cancer. Methods and Results We discuss three different approaches: (i) optimization of screening and referral, (ii) provision of emotional support and case finding, and (iii) a hybrid approach with multiple assessments, using mobile technology. Conclusions We suggest continued research on the screening and referral approach, to broaden the evidence-base on improving emotional support and case finding, and to evaluate the utility of multiple assessments of distress with new interactive mobile tools. Lessons learned from these efforts can be applied to other disease areas, such as cardiovascular disease or diabetes.

scholarly journals Number of Unused Medications at the Time of Last Admission: A Prospective Observational Study in a Single Palliative Care Unit

2018 ◽  
Vol 35 (12) ◽  
pp. 1498-1504
Author(s):  
Takahito Omae ◽  
Nobuyuki Yotani ◽  
Akihiro Sakashita ◽  
Yoshiyuki Kizawa
Keyword(s):  
Palliative Care ◽  
Observational Study ◽  
Anticancer Drugs ◽  
Prospective Observational Study ◽  
Low Cost ◽  
Palliative Care Unit ◽  
Opioid Use ◽  
Patients With Cancer ◽  
Unused Medications ◽  
The Cost

Background: Unused medications (UM) are an important issue, with the waste associated with UM a burden to the health-care system. The aims of this study were to clarify the amount and costs of UM in patients with advanced cancer at the time of their last admission to a palliative care unit and to explore the factors contributing to the cost of UM and how patients dealt with UM. Methods: A prospective observational study was conducted in single palliative care unit. Unused medications were classified into 6 categories and the number and cost of UM by category calculated per patient. Patients were classified into 2 cost groups (high and low) based on the total cost of UM, and the number and cost of UM by category were compared between these 2 groups. Results: Of 194 consecutive hospitalized patients, data were analyzed for 90. The mean number and cost of UM per patient was 440 and US$301, respectively. Opioids accounted for 47% of the cost of UM. Comparing costs by UM category, the proportion of opioids (51% vs 21%; P < .0001) and oral anticancer drugs (14% vs 3%; P = .02) was higher in the high- than in the low-cost group. Conclusion: Based on the results of the present study, the estimated annual waste cost of UM for patients with cancer who died in Japan was approximately US$110 million. Interventions to educate patients regarding UM and to eliminate barriers to opioid use may help reduce the cost of UM, particularly opioids and anticancer drugs.

Medical-Legal Partnership: Lessons from Five Diverse MLPs in New Haven, Connecticut

2018 ◽  
Vol 46 (3) ◽  
pp. 602-609 ◽  
Author(s):  
Emily A. Benfer ◽  
Abbe R. Gluck ◽  
Katherine L. Kraschel
Keyword(s):  
Palliative Care ◽  
Best Practices ◽  
Social Determinants ◽  
Research Agenda ◽  
Evidence Base ◽  
Law School ◽  
New Haven ◽  
Formerly Incarcerated ◽  
Patients With Cancer ◽  
The Social

This article examines five different Medical-Legal Partnerships (MLPs) associated with Yale Law School in New Haven, Connecticut to illustrate how MLP addresses the social determinants of poor health. These MLPs address varied and distinct health and legal needs of unique patient populations, including: 1) children; 2) immigrants; 3) formerly incarcerated individuals; 4) patients with cancer in palliative care; and 5) veterans. The article charts a research agenda to create the evidence base for quality and evaluation metrics, capacity building, sustainability, and best practices; it also focuses specifically on a research agenda that identifies the value of the lawyers in MLP. Such a focus on the “L” has been lacking and is overdue.

scholarly journals The role of implementation science in improving distress assessment and management in oncology: a commentary on “Screening for psychosocial distress among patients with cancer: implications for clinical practice, healthcare policy, and dissemination to enhance cancer survivorship”

2019 ◽  
Vol 9 (2) ◽  
pp. 292-295 ◽  
Author(s):  
Paul B Jacobsen ◽  
Wynne E Norton
Keyword(s):  
Implementation Science ◽  
Psychosocial Care ◽  
Clinical Effectiveness ◽  
Psychosocial Interventions ◽  
Evidence Base ◽  
Future Research ◽  
Distress Screening ◽  
Screening Programs ◽  
Patients With Cancer ◽  
Pragmatic Clinical Trials

Abstract Despite considerable evidence that psychosocial interventions can effectively relieve distress in patients with cancer, many individuals who could benefit from these interventions do not receive them. A proposed solution to this problem is the establishment of programs in oncology settings that routinely screen for distress and refer patients for appropriate psychosocial care. This commentary addresses a review by Ehlers et al. that describes policies and procedures related to distress screening, summarizes prior research on this topic, and identifies key areas for future research. Among their major conclusions is the need for research to fill the gap in knowledge about how best to implement new distress screening programs as well as optimize the use and efficiency of existing programs. This commentary focuses on how the types of study methods, designs, and outcomes that are commonplace in implementation science to facilitate the integration of research into practice can be applied to distress screening programs. Priorities identified include designing and conducting pragmatic clinical trials, evaluating multilevel interventions, and using hybrid designs to simultaneously evaluate clinical effectiveness and barriers and facilitators of implementation. Use of these approaches holds considerable potential for developing an evidence base that can promote more widespread adoption of effective distress screening programs and inform further development of standards and policies related to the psychosocial care of patients with cancer.

scholarly journals International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

2014 ◽  
Vol 32 (24) ◽  
pp. 2595-2603 ◽  
Author(s):  
Hans Wildiers ◽  
Pieter Heeren ◽  
Martine Puts ◽  
Eva Topinkova ◽  
Maryska L.G. Janssen-Heijnen ◽  
...  
Keyword(s):  
Geriatric Assessment ◽  
International Society ◽  
Older Patients ◽  
Clinical Care ◽  
Geriatric Oncology ◽  
Evidence Base ◽  
Patients With Cancer ◽  
Consensus Statements ◽  
Oncology Treatment ◽  
Oncology Practice

Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment–related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care. Results GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another. Conclusion There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base.

Do Available Questionnaires Measure the Communication Factors That Patients and Families Consider Important at End of Life?

2008 ◽  
Vol 26 (23) ◽  
pp. 3874-3878 ◽  
Author(s):  
Eva Grunfeld ◽  
Amy Folkes ◽  
Robin Urquhart
Keyword(s):  
Literature Review ◽  
Supportive Care ◽  
End Of Life ◽  
Interpersonal Communication ◽  
Cancer Care ◽  
Evidence Base ◽  
Interprofessional Communication ◽  
Patients With Cancer ◽  
Care Services

Patients with advanced cancer report wanting better communication. Our previous research identified five specific communication domains important to end-of-life (EOL) cancer care: communicating information, interpersonal communication, communicating available supportive care services, communicating a transition in the objectives of care, and interprofessional communication. A literature review was conducted to identify patient-, family member–, or heath professional–reported questionnaires to measure these specific communication domains. On the basis of specific criteria, including validity and evidence base, 10 questionnaires were identified that have the potential to measure and monitor the quality of communication during EOL cancer care. No single questionnaire measured all five domains. There is a need to further develop questionnaires that have the capacity to specifically measure those communication domains that are important to patients with cancer and their families at EOL.

scholarly journals “Taylor-Made Qi Gong Approach”, A Pilot Study Controlled for Patient in Integrative Oncology Therapy: Evaluation of Time Result and/or Efficacy of “Taylor-Made Qi Gong Approach” (TMQG) than “Not Taylor-Made One (NTMQG)” on Patients with Cancer Undergoing Chemotherapy or in Follow Up – A Preliminary Perspective

2020 ◽  
pp. 1-3
Author(s):  
Massimo Bonucci ◽  
Massimo Bonucci ◽  
S. Puri
Keyword(s):  
Side Effects ◽  
Evidence Base ◽  
Integrative Oncology ◽  
Qi Gong ◽  
Health Maintenance ◽  
Patients With Cancer ◽  
Common Cancer ◽  
Correct Sequence

Qi Gong, like an ancient form of health maintenance of Traditional China Medicine, is applied to effectively give an integrative support on patients with cancer. The diagnosis and treatment of cancer are associated with significant changes in quality of life (QOL) and side effects. The effects of Qi Gong in treating common cancer-related side effects, including nausea, pain, fatigue, anxiety, inflammation, depressive symptoms and improving overall QOL are confirmed in literature [1-5]. Qi Gong includes many techniques (e.g. self-massages, movements, meditations, breath controlling and mindfulness) and managing physical body, breath and mind (consciousness). Most include more forms, “Family-styles” and only very few are able to combine significantly “body-breath-mind”. Furthermore, only for 2 or 3 are available an Evidence Base Medicine-track records. Actually, the efficacy of Qi Gong is currently achievable in long/med time and depends on: i) time-training, especially homely, ii) correct sequence and iii) steadiness.

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