scholarly journals Change in Pain Status and Subsequent Opioid and Marijuana Use Among Long-Term Adult Survivors of Childhood Cancer

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
I-Chan Huang ◽  
Nicole M Alberts ◽  
Merrion G Buckley ◽  
Zhenghong Li ◽  
Matthew J Ehrhardt ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Marijuana Use ◽  
Adult Survivors ◽  
Opioid Use ◽  
Status Change ◽  
Pain Status ◽  
Survivors Of Childhood Cancer ◽  
Over Time

Abstract We evaluated pain status change and associations with subsequent opioid/marijuana use among 1208 adult survivors of childhood cancer. Pain status and opioid/marijuana were self-reported at baseline and follow-up evaluation (mean interval = 4.2 years). Over time, 18.7% of survivors endorsed persistent/increasing significant pain; 4.8% and 9.0% reported having used opioids and marijuana at follow-up. Persistent/increased (vs none/decreased) pain, persistent/increased (vs none/decreased) anxiety, and lack of health insurance increased odds of subsequent opioid use by 7.69-fold (95% confidence interval [CI] = 3.71 to 15.95), 2.55-fold (95% CI = 1.04 to 6.24), and 2.50-fold (95% CI = 1.07 to 5.82), respectively. Persistent/increased (vs none/decreased) depression increased odds of subsequent marijuana use by 2.64-fold (95% CI = 1.10 to 6.33).

Programs for adult survivors of childhood cancer.

1998 ◽  
Vol 16 (8) ◽  
pp. 2864-2867 ◽  
Author(s):  
K C Oeffinger ◽  
D A Eshelman ◽  
G E Tomlinson ◽  
G R Buchanan
Keyword(s):  
Health Care ◽  
Childhood Cancer ◽  
Health Care Providers ◽  
Primary Care Physicians ◽  
Adult Survivors ◽  
Care Providers ◽  
Care Needs ◽  
Survivors Of Childhood Cancer

PURPOSE The potential for late effects of treatment necessitates long-term monitoring of adult survivors of childhood cancer. The purpose of this study was to determine how institutions follow up young adult survivors of pediatric malignancy. Specifically, we were interested in the types of health care providers who follow up these patients, how the follow-up is administered, and what barriers to follow-up have been encountered. METHODS A 16-item questionnaire was mailed to the 219 members of the Children's Cancer Group (CCG) and the Pediatric Oncology Group (POG). The survey consisted of four categories of questions that asked for information regarding the existence of a program to follow up young adults, the setting of the program, routine activities of the program, and commonly encountered barriers to care. RESULTS One hundred eighty-two members returned the survey (83% response rate). Fifty-three percent of the respondents have a long-term follow-up clinic at their institution. Whereas 44% have a mechanism for following up adult survivors, only 15% of the programs have established a formal database for adults. Nearly all the programs (93%) use a pediatric oncologist. Although an adult oncologist assists in 13% of the programs, primary care physicians are uncommonly (8%) involved. CONCLUSION Few programs focus on the long-term health care needs of adult survivors of childhood cancer. The majority of existing programs are in pediatric institutions, without significant input from adult-oriented, generalist health care providers.

Patient-generated online survivorship care plans for adult survivors of childhood cancer: Feasibility and patient preferences.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 54-54
Author(s):  
Dava Szalda ◽  
Marilyn M. Schapira ◽  
Lisa Schwartz ◽  
Esther Kim ◽  
Carolyn Vachani ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Pediatric Cancer ◽  
Online Survey ◽  
Adult Survivors ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
Survivors Of Childhood Cancer

54 Background: With improvements in pediatric cancer treatment, the number of childhood cancer survivors is growing rapidly. Survivorship care plans (SCPs) can provide survivors with necessary information and resources to engage in risk-based follow-up care. Online patient motivated SCPs are promising for adult survivors of childhood cancer with multiple care transitions and the need for self-management outside clinical encounters. Methods: An existing online SCP generator (OncoLife) was adapted to create Smart Adult Living After Childhood Cancer plans for survivors of pediatric Acute Lymphoblastic Lymphoma (ALL) and Hodgkin’s Lymphoma (HL) by incorporating Children’s Oncology Group Long Term Follow-Up Guidelines into existing information technology logic. Results: Adult survivors (n = 20) of pediatric ALL or HL, registered to be seen in radiation oncology or survivorship clinic at the University of Pennsylvania, created an online SCP and completed an online survey. Approximately 80% of patients contacted consented and completed SCP indicating high acceptability; two-thirds (66%) completed the survey. Participants were a median of 35.5 years of age and of 26.5 years since diagnosis. They were 50% female, majority Caucasian (90%), 70% ALL and 30% HL survivors. SCPs took an average of 9 minutes 46 seconds to complete. The majority (95%) of respondents found the SCP generator easy to use, would recommend it to others (85%), and were satisfied with the amount of information received (80%). Ninety percent stated they intended to discuss their SCP with a healthcare provider. Only a third (35%) of survivors stated they had previously received a formal SCP. Seventy percent (70%) stated a written or online plan was the best way to convey health information between visits. Preferences for use of online SCP included: 70% wanting a treatment summary to complete their SCP and 50% wanting personal information to be saved for later use. Conclusions: Online patient-motivated SCPs are a feasible and acceptable way to deliver information to adult survivors of pediatric cancer about long term health risks. Further research into optimal methods for creation, use and health benefits of SCPs is warranted.

Risk stratification to guide long-term follow up of teenage and young adult survivors of childhood cancer.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 10069-10069
Author(s):  
Susannah Jane Stanway ◽  
Rachael Windsor ◽  
Sarita Depani ◽  
Emma Potter ◽  
Komel Khabra ◽  
...  
Keyword(s):  
Young Adult ◽  
Risk Stratification ◽  
Childhood Cancer ◽  
Adult Survivors ◽  
Long Term Follow Up ◽  
Young Adult Survivors ◽  
Survivors Of Childhood Cancer

scholarly journals Supporting long-term follow-up of young adult survivors of childhood cancer: Correlates of healthcare self-efficacy

2016 ◽  
Vol 64 (2) ◽  
pp. 358-363 ◽  
Author(s):  
Kimberly A. Miller ◽  
Katherine Y. Wojcik ◽  
Cynthia N. Ramirez ◽  
Anamara Ritt-Olson ◽  
David R. Freyer ◽  
...  
Keyword(s):  
Young Adult ◽  
Childhood Cancer ◽  
Self Efficacy ◽  
Adult Survivors ◽  
Long Term Follow Up ◽  
Young Adult Survivors ◽  
Survivors Of Childhood Cancer

Longitudinal changes in health care utilization by adult survivors of childhood cancer in the Childhood Cancer Survivor Study (CCSS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6030-6030
Author(s):  
Jacqueline N. Casillas ◽  
Qi Liu ◽  
Melissa M. Hudson ◽  
Mark Greenberg ◽  
Mark W. Yeazel ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Childhood Cancer ◽  
Adult Survivors ◽  
Care Utilization ◽  
Level Of Care ◽  
Longitudinal Changes ◽  
Survivors Of Childhood Cancer ◽  
Over Time

6030 Background: The incidence of late effects increases as childhood cancer survivors age. Survivors require lifelong care focused on the risks arising from prior cancer therapy (survivor-focused care). Methods: We assessed longitudinal changes in health care utilization in adult survivors of childhood cancer participating in the CCSS. Utilization at baseline and most recent follow-up was classified into one of three mutually exclusive hierarchical categories: no health care, general medical care, or survivor-focused care. Relative risk (RR) and 95% confidence intervals (CI) were calculated for predictors of reduction in care over time from survivor-focused to general or no care. Multivariable models, adjusted for key treatment exposures, were created to assess the risk factors for reductions in level of care over time. Results: Among 8591 eligible survivors, mean age at last follow-up was 35.1 years (SD=7.8) with a mean of 11.6 years (SD=2.2) since baseline. Of 3993 (46%) survivors who reported survivor-focused care at baseline, 2383 (59.7%) reported a lower level of care at follow-up. Among 4598 (54%) not receiving survivor-focused care at baseline, 915 (20%) reported survivor-focused care at follow-up. Baseline predictors of a decreased level of care were no health insurance (RR=1.5, 95% CI 1.2-1.9), male sex (RR=1.4, 95% CI 1.2-1.6), being 10-19 years from diagnosis compared with 20+ years (RR=1.4, 95% CI 1.1-1.7). In contrast, factors associated with a maintenance in survivor-focused care were Canadian residency compared to U.S. residency with insurance (RR=0.7, 95% CI 0.6-0.9), unemployment (RR=0.8, 95% CI 0.7-0.9), physical limitations (RR=0.7, 95% CI 0.6-0.9), cancer-related pain (RR=0.7, 95% CI 0.5-0.8), poor emotional health (RR=0.7, 95% CI 0.5-0.9), having mild-moderate (RR=0.5, 95% CI 0.4-0.6) or severe-disabling chronic health condition (RR=0.6, 95% CI 0.5-0.7). Conclusions: Less than a third of adult survivors of childhood cancer report survivor-focused care. Rates decrease over time. Targeted interventions to maximize survivor-focused care in at-risk survivors should be tested so preventive and risk-reducing opportunities are not lost.

Adherence to Children’s Oncology Group (COG) long-term follow-up guidelines for echocardiogram screening in young adult survivors of childhood cancer.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e22513-e22513 ◽  
Author(s):  
Nicholas Andrew Madden ◽  
Claudia Deng ◽  
Taylor Fitch ◽  
Karen Elizabeth Effinger ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Young Adult ◽  
Childhood Cancer ◽  
Adult Survivors ◽  
Oncology Group ◽  
Long Term Follow Up ◽  
Young Adult Survivors ◽  
Survivors Of Childhood Cancer
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