scholarly journals A Proactive Telephone-Delivered Risk Communication Intervention for Smokers Participating in Lung Cancer Screening: A Pilot Feasibility Trial

2017 ◽  
Vol 13 (3) ◽  
pp. 137-144 ◽  
Author(s):  
Steven B. Zeliadt ◽  
Preston A. Greene ◽  
Paul Krebs ◽  
Deborah E. Klein ◽  
Laura C. Feemster ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Usual Care ◽  
Usual Care Group ◽  
Intervention Group ◽  
Lung Cancer Screening ◽  
Feasibility Trial ◽  
Care Group ◽  
Telephone Counselling ◽  
Tobacco Treatment

Introduction: Many barriers exist to integrating smoking cessation into delivery of lung cancer screening including limited provider time and patient misconceptions.Aims: To demonstrate that proactive outreach from a telephone counsellor outside of the patient's usual care team is feasible and acceptable to patients.Methods: Smokers undergoing lung cancer screening were approached for a telephone counselling study. Patients agreeing to participate in the intervention (n = 27) received two telephone counselling sessions. A 30-day follow-up evaluation was conducted, which also included screening participants receiving usual care (n = 56).Results/Findings: Most (89%) intervention participants reported being satisfied with the proactive calls, and 81% reported the sessions were helpful. Use of behavioural cessation support programs in the intervention group was four times higher (44%) compared to the usual care group (11%); Relative Risk (RR) = 4.1; 95% CI: 1.7 to 9.9), and seven-day abstinence in the intervention group was double (19%) compared to the usual care group (7%); RR = 2.6; 95% CI: 0.8 to 8.9).Conclusions: This practical telephone-based approach, which included risk messages clarifying continued risks of smoking in the context of screening results, suggests such messaging can boost utilisation of evidence-based tobacco treatment, self-efficacy, and potentially increase the likelihood of successful quitting.

scholarly journals Randomized Electronic Promotion of Lung Cancer Screening: A Pilot

2017 ◽  
pp. 1-6
Author(s):  
Abbie L. Begnaud ◽  
Anne M. Joseph ◽  
Bruce R. Lindgren
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Usual Care ◽  
Task Force ◽  
Intervention Group ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
Care Group ◽  
University Of Minnesota ◽  
Former Smokers

Purpose Screening for lung cancer with low-dose computed tomography is endorsed by the US Preventive Services Task Force, but many eligible patients have yet to be offered screening. Major barriers to the implementation of screening are physician and system related—the requirement for a detailed smoking history, including pack-years, to determine eligibility. We conducted this pilot to determine the feasibility of lung cancer screening (LCS) promotion that would offer screening to eligible persons and patient completion of smoking history to estimate the size of the population of former smokers who may be eligible for LCS in a single health care system. Patients and Methods Two hundred participants were randomly selected from former smokers who were seen at the University of Minnesota Health in the past 2 years and assigned to control (usual care) and electronic promotion, stratified by age. Electronic messages to promote LCS were sent to an intervention group, including a link to complete a detailed smoking history in the electronic health record. Results Of 99 participants, 66 (67%) in the intervention group read the message, 24 (36%) of 66 responded, and 19 (79%) of 24 respondents completed the smoking history. Ten intervention participants and 13 usual care participants were eligible for screening on the basis of pack-year history. Four eligible participants underwent screening in the intervention group compared with one participant in the usual care group. Conclusion Electronic promotion may help identify patients who are eligible for LCS but will not reliably reach all patients because of low response rates. In this sample of former smokers, the majority are ineligible for LCS on the basis of pack-year history. Electronic methods can improve documentation of smoking history.

Interdisciplinary palliative care for patients with lung cancer.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 130-130
Author(s):  
Betty R. Ferrell ◽  
Virginia Sun ◽  
Arti Hurria ◽  
Mihaela C. Cristea ◽  
Dan Raz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Psychological Distress ◽  
Supportive Care ◽  
Usual Care ◽  
Usual Care Group ◽  
Intervention Group ◽  
Well Being ◽  
Care Group ◽  
Ambulatory Care Setting

130 Background: Palliative care, including symptom management and attention to quality of life (QOL) concerns, should be addressed throughout the trajectory of a serious illness such as lung cancer. This study tested the effectiveness on an interdisciplinary palliative care intervention for patients with stage I-IV non-small cell lung cancer (NSCLC). Methods: Patients undergoing treatments for NSCLC were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. Patients in the intervention group were presented at interdisciplinary care meetings and appropriate supportive care referrals were made. They also received four educational sessions. In both groups, QOL, symptoms, and psychological distress were assessed at baseline and 12 weeks using surveys which included the FACT-L, FACIT-Sp-12, LCS, and the Distress Thermometer. Results: A total of 491 patients were included in the primary analysis. Patients who received the intervention had significantly better scores for QOL (109.1 vs. 101.4; p < .001), symptoms (25.8 vs. 23.9; p < .001), spiritual well-being (38.1 vs. 36.2; p < .001), and lower psychological distress (2.2 vs. 3.3; p < .001) at 12 weeks, after controlling for baseline scores, compared to patients in the usual care group. Patients in the intervention group also had significantly higher numbers of completed advance care directives (44% vs. 9%; p < .001), and overall supportive care referrals (61% vs. 28%; p < .001). Conclusions: Interdisciplinary palliative care in the ambulatory care setting resulted in significant improvements in QOL, symptoms, and distress for NSCLC patients.

Tobacco Treatment Specialist Training for Lung Cancer Screening Providers

2021 ◽  
Author(s):  
Kelly L. Roughgarden ◽  
Benjamin A. Toll ◽  
Nichole T. Tanner ◽  
Cassie C. Frazier ◽  
Gerard A. Silvestri ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
Specialist Training ◽  
Tobacco Treatment ◽  
Treatment Specialist

Effect of Artificial Intelligence on Nutritional Status of children post cardiac surgery; A Randomized Controlled Trial (Preprint)

2022 ◽  
Author(s):  
Maryam Zahid ◽  
Ume Sughra
Keyword(s):  
Nutritional Status ◽  
Usual Care ◽  
Usual Care Group ◽  
Mobile Application ◽  
Controlled Trial ◽  
Intervention Group ◽  
Care Group ◽  
Randomized Controlled ◽  
Nutritional Status Of Children ◽  
Post Cardiac Surgery

BACKGROUND Malnutrition is the most common problem in congenital heart diseases patients. Health based mobile applications play an important role in planning and tracking of diet for better nutritional status OBJECTIVE To assess the effect of artificial intelligence on nutritional status of children post cardiac surgery in comparison to usual care group. To assess usefulness of diet related mobile application in comparison to usual care group. METHODS This is a two arm randomized controlled trial that was conducted at a Tertiary Care Hospital, Rawalpindi. The study duration was 6 months from February 2021 till July 2021. Sample size was calculated to be 88. Intervention group was given a diet related mobile application and usual care group was handed a pamphlet with diet instructions on discharge. RESULTS Mean weight of all participants was 15 ± 5.7 kg at the time of discharge whereas at the end of 8th week mean weight of the participants in usual care group was 16.5 ± 7.2 kg and intervention group was 17.1 ± 5 kg. Average calories consumed by usual care group was 972 ± 252 kcal and 1000.75 ± 210 kcal by intervention group after 8 weeks of discharge. Average proteins consumed by the usual care group was 34.3 ± 12.5 grams and 39± 6.4 grams by intervention group after 8 weeks of discharge. At the end of intervention preferred diet planning tool for 79% of the participants was mobile application. At 8th week 93% of the participants considered the visual cues useful, 80% think that the mobile application language was understandable, 79% of the participants think nutritional goal setting is a useful feature in mobile application and 55% of the participants think the recipes in the application were useful. CONCLUSIONS The study showed strength for the future of scalable modern technology for self-nutrition monitoring. There was slight increase in the weight and nutritional intake of both groups as interventions period was limited. CLINICALTRIAL Study was registered on clinicaltrial.gov website with trial identity number NCT04782635.

scholarly journals Acceptability and Feasibility of an Isometric Resistance Exercise Program for Abdominal Cancer Surgery: An Embedded Qualitative Study

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482095085
Author(s):  
Ferhana Hashem ◽  
David Stephensen ◽  
Amanda Bates ◽  
Tracy Pellatt-Higgins ◽  
Ralph (Nobby) Peter Hobbs ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Resistance Exercise ◽  
Usual Care ◽  
Intervention Group ◽  
Exercise Program ◽  
Cancer Surgery ◽  
Feasibility Trial ◽  
Moderate Intensity ◽  
Care Group ◽  
Exercise Interventions

Although it is recognized in the early stages of cancer recovery that changes in lifestyle including increases in physical activity improves physical function, there are no clear findings whether low versus moderate intensity activity or home or gym exercise offer optimal benefit. Isometric-resistance exercises can be carried out with very little equipment and space and can be performed while patients are bed-bound in hospital or at home. This embedded qualitative study, based in an English hospital trust providing specialist cancer care, was undertaken as a component of a feasibility trial to evaluate the acceptability and feasibility of an isometric-resistance exercise program and explore the suitability of functional assessments by drawing from the experiences of abdominal cancer patients following surgery. Telephone interviews were undertaken with 7 participants in the intervention group, and 8 interviews with the usual care group (n = 15). The gender composition consisted of 11 females and 4 males. Participants’ ages ranged from 27 to 84 (M = 60.07, SD = 15.40). Interviews were conducted between August 2017 and May 2018, with audio files digitally recorded and data coded using thematic framework analysis. Our results show that blinding to intervention or usual care was a challenge, participants felt the intervention was safe and suitable aided by the assistance of a research nurse, yet, found the self-completion questionnaire tools hard to complete. Our study provides an insight of trial processes, participants’ adherence and completion of exercise interventions, and informs the design and conduct of larger RCTs based on the experiences of abdominal cancer surgery patients.

scholarly journals Impact of pharmacist-led care on glycaemic control of patients with uncontrolled type 2 diabetes: a randomised controlled trial in Nigeria

2021 ◽  
Vol 19 (3) ◽  
pp. 2402
Author(s):  
Emmanuel A. David ◽  
Rebecca O. Soremekun ◽  
Isaac O. Abah ◽  
Roseline I. Aderemi-Williams
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Usual Care ◽  
Usual Care Group ◽  
Intervention Group ◽  
Glycated Haemoglobin ◽  
Care Group ◽  
Laboratory Parameters ◽  
Randomised Controlled

Background: Diabetes mellitus is a chronic, degenerative disease, requiring a multi-dimensional, multi-professional care by healthcare providers and substantial self-care by the patients, to achieve treatment goals. Objective: To evaluate the impact of pharmacist-led care on glycaemic control in patients with uncontrolled Type 2 Diabetes Methods: In a parallel group, single-blind randomised controlled study; type 2 diabetic patients, with greater than 7% glycated haemoglobin (A1C) were randomised into intervention and usual care groups and followed for six months. Glycated haemoglobin analyzer, lipid analyzer and blood pressure monitor/apparatus were used to measure patients’ laboratory parameters at baseline and six months. Intervention group patients received pharmacist-structured care, made up of patient education and phone calls, in addition to usual care. In an intention to treat analysis, Mann-Whitney U test was used to compare median change at six months in the primary (A1C) and secondary outcome measures. Effect size was computed and proportion of patients that reached target laboratory parameters were compared in both arms. Results: All enrolled participants (108) completed the study, 54 in each arm. Mean age was 51 (SD 11.75) and majority were females (68.5%). Participants in the intervention group had significant reduction in A1C of -0.75%, compared with an increase of 0.15% in the usual care group (p<0.001; eta-square= 0.144). The proportion of those that achieved target A1C of <7% at 6 months in the intervention and usual care group was 42.6% vs 20.8% (p=0.02). Furthermore, intervention patients were about 3 times more likely to have better glucose control; A1C<7% (aOR 2.72, 95%CI: 1.14-6.46) compared to usual care group, adjusted for sex, age, and duration of diabetes. Conclusions: Pharmacist-led care significantly improved glycaemic control in patients with uncontrolled T2DM.

scholarly journals Effect of targeted fluid minimization and diuretic therapy on hospital- acquired heart failure and adverse outcomes in patients with no preexisting cardiac dysfunction

2021 ◽  
Author(s):  
Kwannate Intarawongchot ◽  
Sutep Gonlachanvit ◽  
Sarinya Puwanant
Keyword(s):  
Hospital Mortality ◽  
Usual Care ◽  
Cardiac Dysfunction ◽  
Usual Care Group ◽  
Intervention Group ◽  
Care Group ◽  
Mechanical Ventilator ◽  
Icu Admission ◽  
Intervention Protocol ◽  
Hospital Acquired

Abstract Background This study aimed to investigate: 1) the incidence of hospital-acquired heart failure (HF) in patients with no preexisting cardiac disorder, and 2) whether the use of an intervention protocol comprised of targeted fluid minimization and diuretic therapy can reduce the incidence of hospital-acquired HF and adverse outcomes.Methods We conducted a single-center, open-labeled, prospective cohort study enrolling patients with no preexisting cardiac dysfunction who were admitted to the medical wards and had a positive intravenous fluid balance > 4 L within 3 days. We assigned patients in a 1:1 ratio to the intervention protocol (intervention group) or usual care. The primary outcome was hospital-acquired HF. The secondary outcomes included in-hospital mortality, intensive critical unit (ICU) admission, mechanical ventilator usage, or prolonged hospital stay > 30 days.Results A total of 98 patients (mean age 66; 52% male) were enrolled (intervention group, 49; usual care group, 49). The incidence of hospital-acquired HF among all patients was 21%. Patients with hospital-acquired had higher rates of in-hospital mortality (48% vs.13%; p = 0.001), ICU admission (33% vs.10%; p = 0.010) and mechanical ventilator usage (62% vs. 35%; p = 0.027). Prolonged hospital stay > 30 days rates were similar in patients with and without hospital-acquired HF. Hospital-acquired HF was not found statistically different between groups (intervention group 18% vs. usual care group 25%; p = 0.460). Patients in the intervention group did have lower rates of subsequent ICU admission (8%vs.23%; p = 0.049) and hospitalizattion > 30 days. (8%vs.27%; p = 0.018) compared with the usual care group. In-hospital mortality and mechanical ventilator usage were not different between groups.Conclusions The incidence of hospital-acquired HF in patients with no preexisting cardiac dysfunction who had a positive cumulative fluid balance of > 4 L within 3 days was not uncommon, about one in five patients. Hospital-acquired HF can lead to increased in-hospital mortality and co-morbidities. Targeted fluid minimization and diuretics did show a reduced rate of ICU admission and prolonged hospitalization. However, no statistical difference in rates of hospital-acquired HF and in-hospital mortality compared to the control group were found.

scholarly journals Factors Associated With Obtaining Lung Cancer Screening Among Persons Who Smoke

2021 ◽  
Vol 6 (2) ◽  
pp. 238146832110678
Author(s):  
Kristin G. Maki ◽  
Kaiping Liao ◽  
Lisa M. Lowenstein ◽  
M. Angeles Lopez-Olivo ◽  
Robert J. Volk
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Intervention Group ◽  
Secondary Analysis ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
Anticipated Regret ◽  
Factors Associated ◽  
Patient Decision ◽  
Low Dose Computed Tomography

Background. Screening with low-dose computed tomography scans can reduce lung cancer deaths but uptake remains low. This study examines psychosocial factors associated with obtaining lung cancer screening (LCS) among individuals. Methods. This is a secondary analysis of a randomized clinical trial conducted with 13 state quitlines’ clients. Participants who met age and smoking history criteria were enrolled and followed-up for 6 months. Only participants randomized to the intervention group (a patient decision aid) were included in this analysis. A logistic regression was performed to identify determinants of obtaining LCS 6 months after the intervention. Results. There were 204 participants included in this study. Regarding individual attitudes, high and moderate levels of concern about overdiagnosis were associated with a decreased likelihood of obtaining LCS compared with lower levels of concern (high levels of concern, odds ratio [OR] 0.17, 95% confidence interval [CI] 0.04–0.65; moderate levels of concern, OR 0.15, 95% CI 0.05–0.53). In contrast, higher levels of anticipated regret about not obtaining LCS and later being diagnosed with lung cancer were associated with an increased likelihood of being screened compared with lower levels of anticipated regret (OR 5.59, 95% CI 1.72–18.10). Other potential harms related to LCS were not significant. Limitations. Follow-up may not have been long enough for all individuals who wished to be screened to complete the scan. Additionally, participants may have been more health motivated due to recruitment via tobacco quitlines. Conclusions. Anticipated regret about not obtaining screening is associated with screening behavior, whereas concern about overdiagnosis is associated with decreased likelihood of LCS. Implications. Decision support research may benefit from further examining anticipated regret in screening decisions. Additional training and information may be helpful to address concerns regarding overdiagnosis.

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