scholarly journals 193. Impact of COVID-19 Pandemic on Pulmonary Tuberculosis Evaluations and Diagnosis at a Large Safety Net Hospital in Los Angeles, California

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S117-S118
Author(s):  
Aditya J Jones ◽  
Edward C Jones-Lopez ◽  
Susan Bulter-Wu ◽  
Melissa L Wilson ◽  
John Rodman ◽  
...  
Keyword(s):  
Los Angeles ◽  
Disease Severity ◽  
Chest Radiograph ◽  
Medical Records ◽  
Medical Center ◽  
Safety Net ◽  
Sputum Smear ◽  
Pulmonary Tb ◽  
Number Of Patients ◽  
Safety Net Hospital

Abstract Background There is significant global concern that the COVID-19 pandemic may negatively impact tuberculosis (TB) control. This is a descriptive analysis of TB evaluations and diagnosis during 2019 (pre COVID-19 period) and 2020 (COVID-19 period) at the largest safety net hospital in Los Angeles County (LAC+USC Medical Center). Methods The medical records of patients diagnosed with pulmonary TB from January 1, 2019 to December 31, 2020 were identified through laboratory and electronic medical records. We included all patients with ≥ 1 sputum positive result for Mycobacterium tuberculosis (MTB) culture and reviewed their Xpert MTB/RIF MTB PCR. Results Table 1 shows summary of results. During the COVID-19 period, the number of patients evaluated for pulmonary TB decreased by 64% compared to the previous year (Figure 1). The proportion of patients with culture-confirmed TB disease however, was nearly identical (P=0.913) (Table 1). Sputum acid-fast bacilli (AFB) smear positivity increased 52% to 64% during COVID-19 (P=0.324) and disease severity as measured by chest radiograph, was significantly higher during the COVID-19 period (P = 0.031) (Figure 2). Trend of sputum AFB smear and culture samples collected from January 1, 2019 to December 31, 2020. Summary of results of patients diagnosed with pulmonary TB from January 1, 2019 to December 31, 2020 at LAC+USC Medical Center. Results of two-sample test for proportions of 2019 vs 2020 for cavitary lesions, extent of disease, and sputum positive AFB smear microscopy. Conclusion These preliminary results suggest that when compared to the previous year, the number of pulmonary TB evaluations decreased by 64% during the COVID period. Whereas the proportion of patients diagnosed with TB disease was similar, TB patients during the COVID-19 period had more advanced disease at diagnosis, as measured by sputum smear AFB microscopy and disease severity on chest radiograph (P=0.031). These data suggest potentially consequential interruptions and delays in pulmonary TB diagnosis during the COVID-19 period. Disclosures Susan Bulter-Wu, PhD , Cepheid (Consultant)

scholarly journals Profil Penderita Penyakit Tuberkulosis Paru BTA Positif yang Ditemukan di BP4 Lubuk Alung periode Januari 2012 – Desember 2012

2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Eni Yulvia Susilayanti ◽  
Irvan Medison ◽  
Erkadius Erkadius
Keyword(s):  
Health Care ◽  
Pulmonary Tuberculosis ◽  
Medical Records ◽  
Medical Center ◽  
Pulmonary Diseases ◽  
Sputum Smear ◽  
Tuberculosis Patients ◽  
Pulmonary Tb ◽  
Suspected Tuberculosis ◽  
History Of

AbstrakTuberkulosis masih merupakan masalah kesehatan di Indonesia karena prevalensi yang masih tinggi,i terutama di negara berkembang. Karena penyebarannya yang tinggi, maka perlu diketahui bagaimana profil penderita penyakit ini agar penularannya bisa diminimalkan. Tujuan dari penelitian ini adalah untuk mengetahui profil penderita tuberculosis paru BTA positif yang berobat di Balai Pengobatan Penyakit Paru (BP4) Lubuk Alung periode 1 Januari 2012 – 31 Desember 2012. Penelitian ini bersifat deskriptif retrospektif. Instrumen yang digunakan adalah data dari rekam medik di Balai Pengobatan Penyakit Paru (BP4) Lubuk Alung sejak 1 Januari 2012 – 31 Desember 2012. Populasi yang ada seluruhnya dijadikan subjek penelitian. Kemudian dilakukan pencatatan dari beberapa variabel yang diteliti. Hasil penelitian ini menunjukkan bahwa dalam periode tersebut jumlah penderita yang berobat ke BP4 Lubuk Alung adalah 19.440 orang, sebanyak 3.224 orang diantaranya suspek. Penderita BTA (+) 1.109 orang. Jenis kelamin laki-laki (70,8%) lebih banyak dari perempuan. Usia terbanyak adalah 21-30 tahun (23,2%). Daerah asal terbanyak adalah Kab. Padang Pariaman (29,4%). Derajat kepositifan BTA sputum terbanyak berupa positif tiga (+3) adalah (44,2%). Tipe penderita terbanyak merupakan penderita kasus baru sebanyak (91,7%). Keluhan terbanyak yang dirasakan ketika berobat adalah batuk (99%). Sebanyak (13,4%) memiliki penyakit penyerta selain tuberkulosis. Riwayat penggunaan obat sebelumnya sebanyak (11,3%). Sebanyak (99%) dirujuk ke puskesmas dan unit pelayanan kesehatan terdekat. Berdasarkan pendataan profil penderita TB Paru BTA Positif bisa dilihat paling banyak adalah derajat (+3) dan dirujuk ke unit pelayanan terdekat.Kata kunci: profil, tuberkulosis paruAbstractTuberculosis is still a health problem in Indonesia because the prevalence is still high, especially in developing countries. Due to the speed of spread, it is necessary to know the profile of people who suffer from this disease, so the transmission can be minimized. The purpose of this study was to determine the profile of positive acid-fast-bacilli (BTA) in pulmonary tuberculosis patients who seek treatment at Medical Center for Pulmonary Diseases (BP4) Lubuk Alung during the period 1 January 2012-31 December 2012.This is a descriptive retrospective study by taking the data from medical records in BP4 Lubuk Alung. Using the enterety of the population. The results of this study indicate that in this period the number of people who went to BP4 Lubuk Alung were 19.440 people, 3.224 of them suspected tuberculosis. Patients with BTA (+) was 1.109 people. We found male 70.78%. Most are 21-30 years of age 23.2%. The area of origin mostly from Kab. Padang Pariaman 29.4%. The degree of sputum smear positivity mostly positive three (+3) was 44.2%. Type of most patients are people with new cases 91.7%. Most complaints was cough 99%. A total of 13.44% had concomitant diseases other than tuberculosis. History of previous anti tuberculosis drugs (OAT) we found in 11.3%. And 99% are referred to hospitals and health care units nearby. Based on the data collection, profile of positif pulmonary TB patients is (+3) and mostly referred to the nearest health center and service unit.Keywords:profile, pulmonary tuberculosis

ChemoPalRx: Development and implementation of a chemotherapy mobile provider order entry system in a safety net hospital.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18071-e18071
Author(s):  
Kin Wai (Tony) Hung ◽  
Natasha Banerjee
Keyword(s):  
Los Angeles ◽  
Mobile Application ◽  
Medical Center ◽  
Hospital Setting ◽  
Safety Net ◽  
Quality Improvement Initiative ◽  
Order Entry ◽  
Development Environment ◽  
Safety Net Hospital ◽  
Safety Parameters

e18071 Background: Computerized provider order entry (CPOE) systems have been shown to enhance the safety and efficiency of prescribing chemotherapy over the handwritten ordering process. However, many institutions lack the financial ability, technological capability, or operational flexibility to invest in and implement such a system. In particular, Olive View-UCLA Medical Center (OVMC), a Los Angeles County safety net hospital, is among these institutions with unique restrictions that preclude the use of chemotherapy CPOE and mandate handwritten orders. Methods: In an effort to bridge the gap for safe chemotherapy prescribing, we aimed to develop and implement an effective, scalable, and sustainable chemotherapy provider order entry solution that was operationally sensitive to institutions without a chemotherapy CPOE. The solution was designed as a mobile application using Xcode, the integrative development environment of Apple Inc., with the Swift programing language. Results: On September 5th, 2018, we launched a free, chemotherapy provider order entry solution on the worldwide Apple App Store – ChemoPalRx. Using ChemoPalRx, providers can search, customize, and print common chemotherapy regimens in prescription format. Along with a reference library of over 120 order set and 450 medications, ChemoPalRx is equipped with the functions to automate dosage calculation, suggest pre-medications and safety parameters, and trigger alerts for missing prescribing information. As a quality improvement initiative, we implemented ChemoPalRx at OVMC. Implementation stages include obtaining administrative buy-in, consulting with multidisciplinary staffs, investing $100 USD for a prescription printer, and encouraging providers to download ChemoPalRx on their own mobile devices. An ongoing prospective cohort study is being conducted to determine ChemoPalRx effectiveness in reducing errors compared to handwritten orders. Conclusions: ChemoPalRx is developed to enhance the safety and efficiency of chemotherapy prescribing. Implementation of this mobile application is feasible in the safety-net hospital setting and has the potential to transform oncology practices globally.

scholarly journals ChemoPalRx: Development and implementation of a chemotherapy mobile provider order entry system in a safety net hospital.

2019 ◽  
Vol 5 (suppl) ◽  
pp. 73-73
Author(s):  
Kin Wai (Tony) Hung ◽  
Natasha Banerjee
Keyword(s):  
Los Angeles ◽  
Mobile Application ◽  
Medical Center ◽  
Hospital Setting ◽  
Safety Net ◽  
Quality Improvement Initiative ◽  
Order Entry ◽  
Development Environment ◽  
Safety Net Hospital ◽  
Safety Parameters

73 Background: Computerized provider order entry (CPOE) systems have been shown to enhance the safety and efficiency of prescribing chemotherapy over the handwritten ordering process. However, many institutions lack the financial ability, technological capability, or operational flexibility to invest in and implement such a system. In particular, Olive View-UCLA Medical Center (OVMC), a Los Angeles County safety net hospital, is among these institutions with unique restrictions that preclude the use of chemotherapy CPOE and mandate handwritten orders. Methods: In an effort to bridge the gap for safe chemotherapy prescribing, we aimed to develop and implement an effective, scalable, and sustainable chemotherapy provider order entry solution that was operationally sensitive to institutions without a chemotherapy CPOE. The solution was designed as a mobile application using Xcode, the integrative development environment of Apple Inc., with the Swift programing language. Results: On September 5th, 2018, we launched a free, chemotherapy provider order entry solution on the worldwide Apple App Store – ChemoPalRx. Using ChemoPalRx, providers can search, customize, and print common chemotherapy regimens in prescription format. Along with a reference library of over 120 order set and 450 medications, ChemoPalRx is equipped with the functions to automate dosage calculation, suggest pre-medications and safety parameters, and trigger alerts for missing prescribing information. As a quality improvement initiative, we implemented ChemoPalRx at OVMC. Implementation stages include obtaining administrative buy-in, consulting with multidisciplinary staffs, investing $100 USD for a prescription printer, and encouraging providers to download ChemoPalRx on their own mobile devices. An ongoing prospective cohort study is being conducted to determine ChemoPalRx effectiveness in reducing errors compared to handwritten orders. Conclusions: ChemoPalRx is developed to enhance the safety and efficiency of chemotherapy prescribing. Implementation of this mobile application is feasible in the safety-net hospital setting and has the potential to transform oncology practices globally.

Reducing hospitalizations: Implementation of CADD pumps in infusion clinic at a Los Angeles safety net hospital.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18648-e18648
Author(s):  
Tiffanie Thy Do ◽  
James Jen-Chi Yeh
Keyword(s):  
Los Angeles ◽  
Medical Center ◽  
Cost Savings ◽  
Healthcare Setting ◽  
Safety Net ◽  
Inpatient Hospital ◽  
Outpatient Chemotherapy ◽  
Safety Net Hospital ◽  
Hospital Bed ◽  
Hospital Days

e18648 Background: Computerized ambulatory drug delivery (CADD) pumps introduced in the 1980s made it possible to move infusion delivery from the hospital to the home. At Harbor-UCLA Medical Center, hundreds of scheduled chemotherapy admissions occur annually. The procurement and implementation of CADD pumps was a collaborative effort with members of pharmacy, nursing, physicians and administration. The implementation of CADD pumps for home chemotherapy demonstrated a cost-savings by decreasing the number of inpatient hospital days required for scheduled chemotherapy admissions. Methods: The first outpatient chemotherapy infusion by CADD pump began on 12/5/2017. Records from 12/5/2017 through 12/4/2018 (365 days) were reviewed to assess the benefit of CADD pumps, defined by inpatient hospital days avoided. Eight chemotherapy regimens were administered through outpatient CADD pumps; the equivalent number of inpatient hospital days were estimated based on inpatient hospital records between 2015 and 2017. The average number of hospital days that would have occurred inpatient per chemotherapy regimen was multiplied by the number of outpatient CADD pump chemotherapy infusions to estimate the number of inpatient hospital days avoided. Based on information provided by our hospital’s finance department, including reimbursement for inpatient and similar outpatient care, each hospital day avoided was estimated to provide $1,695 in cost-savings. On average, a typical hospitalization for infusional 5-FU chemotherapy was three days in length. Results: Over one year, 35 patients received a total of 178 outpatient CADD infusions. The average number of CADD infusions per patient was five. We estimated that 642 hospital bed days were saved over a 1-year period following the implementation of outpatient CADD pumps. With the estimate that each hospital bed day saved was valued at $1,695, we concluded a savings of $1.1 million dollars at our hospital through the implementation of CADD pumps within the first year. Conclusions: The implementation of CADD pumps for home chemotherapy demonstrated cost-savings by decreasing the number of inpatient hospital days required for scheduled chemotherapy admissions. This shift provides a superior value for the patient with equivalent treatment outpatient, spending less time in the healthcare setting, and reduced health care costs. [Table: see text]

Abstract 090: Armenian Ethnicity: An Independent Risk Factor for Positive Exercise Treadmill Tests

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Ara H Rostomian ◽  
Daniel Sanchez ◽  
Jonathan Soverow
Keyword(s):  
Risk Factors ◽  
Los Angeles ◽  
Multivariate Logistic Regression Analysis ◽  
Safety Net ◽  
The United States ◽  
World Health ◽  
Limited Information ◽  
Safety Net Hospital ◽  
Exercise Treadmill ◽  
History Of

Background: Several studies have examined the risk of cardiovascular disease (CVD) among larger racial and ethnic groups such as Hispanics and African-Americans in the United States, but limited information is available on smaller subgroups such as Armenians. According to the World Health Organization, Armenia ranks eighth in CVD rates among all countries however it is unclear if Armenian immigrants living in the US have the same high rates of disease. This study examined whether being of Armenian descent increased the risk of having a positive exercise treadmill test (ETT) among patients treated at a safety net hospital in Los Angeles County. Methods: Data on patients who received an ETT from 2008-2011 were used to conduct a retrospective analysis of the relationship between Armenian ethnicity and ETT result as a surrogate measure for CVD. A multivariate logistic regression analysis was used to estimate the odds ratios (OR) for having a positive ETT among Armenians relative to non-Armenians, adjusting for the following pre-specified covariates: gender, age, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary artery disease (CAD), and patient history of CAD. Results: A total of 5,297 patients, ages 18 to 89, were included. Of these, 13% were Armenian and 46% were male, with an average age of 53 years. Armenians had higher odds of having a positive ETT than non-Armenians (Crude OR=1.30, p=0.037, CI:1.02,1.66). After adjusting for CV risk factors, Armenians were still significantly more likely to have a positive ETT than non-Armenians (OR=1.33, p=0.029, CI:1.03,1.71). CAD (OR 2.02, p<0.001, CI:1.38,2.96), and hyperlipidemia (OR=1.31, p=0.008, CI:1.07,1.60) were also significantly associated with a positive ETT. Conclusion: Armenians have a higher likelihood of having a positive ETT than non-Armenians. This relationship appears to be independent of traditional CV risk factors and suggests a role for cultural and/or genetic influences.

Calcium and magnesium infusions for prevention of oxaliplatin-induced peripheral neuropathy.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 387-387
Author(s):  
M. Bupathi ◽  
G. Mahmud ◽  
J. Kovar ◽  
E. Wang ◽  
T. E. O'Brien
Keyword(s):  
Peripheral Neuropathy ◽  
Cumulative Dose ◽  
Medical Center ◽  
Demographic Data ◽  
Performance Status ◽  
Safety Net ◽  
Control Group ◽  
Minority Population ◽  
Tumor Type ◽  
Safety Net Hospital

387 Background: Oxaliplatin plays an important role in chemotherapy regimens for colorectal and other GI malignancies. Debilitating peripheral neuropathy (PN) often develops with use of this drug. One study (Grothey A et al, ASCO 2009, abst #4025) has shown that pre- and post-oxaliplatin infusions with calcium (Ca) and magnesium (Mg) may reduce this toxicity. To confirm this in an unselected indigent minority population, a retrospective review was performed comparing development of PN in oxaliplatin exposed patients treated with or without Ca/Mg. Methods: Records of patients who received oxaliplatin from 1/2008 to 12/2009 at MetroHealth Medical Center, a large safety net hospital in Cleveland, OH, were reviewed. 47 patients received Ca/Mg + oxaliplatin and 46 oxaliplatin alone. Data collected included age, race, gender, insurance status, performance status, tumor type, stage, concomitant diseases (DM and EtOH), number of cycles and cumulative dose of oxaliplatin. PN was determined using the Common Terminology Criteria of Adverse Events (CTCAE) version 3.0. Patients were followed 6 months after completion of oxaliplatin. Results: Demographic data was similar between the two groups. Colorectal cancer compromised 77% of the treatment group and 85% of control group. Patients who received Ca/Mg had significantly less PN in all three grades (1-3) compared with the control group (grade 1 89.4% vs. 71.7%, grade II 10.6% vs. 19.6%, grade 3 0% vs. 8.7%, respectively). The cumulative dose of oxaliplatin did not differ between the two groups (Ca/Mg median 1,143 range 260-2,169; control median 1,425 range 137-2,635). The combined total grades 2 and 3 in both the treatment and control (10.6% vs. 28.3%, p = 0.038) favored use of Ca/Mg. Conclusions: This small, retrospective study confirms that Ca/Mg infusions reduce the incidence of clinically significant (grade 2/3) PN in pts receiving oxaliplatin. No significant financial relationships to disclose.

scholarly journals 3220 Can you read me now? Clinician variations in managing and responding to secure messages from patients

2019 ◽  
Vol 3 (s1) ◽  
pp. 59-59
Author(s):  
Joy Li-Yueh Lee ◽  
Michael Weiner ◽  
Marianne Matthias
Keyword(s):  
Primary Care ◽  
Medical Center ◽  
Safety Net ◽  
Patient Centeredness ◽  
Cognitive Approach ◽  
Electronic Communications ◽  
Secure Messaging ◽  
Safety Net Hospital ◽  
Primary Care Clinicians

OBJECTIVES/SPECIFIC AIMS: To identify areas of variation in primary care clinician responses to secure messaging and to assess the quality of secure messages by clinicians. METHODS/STUDY POPULATION: This mixed-methods study included twenty one primary care clinicians from a Midwestern safety net hospital and Veterans Affairs medical center. Participants were presented with five short clinical vignettes and corresponding secure messages from hypothetical patients and asked to compose responses. Participants were interviewed about their cognitive approach to the responses as well as perspectives on quality of care as related to electronic communications. RESULTS/ANTICIPATED RESULTS: Every participant recalled having patients who misused secure messaging for urgent issues, suggesting the need for more patient education and the possible adverse consequences of overlooked messages. The study also uncovered key differences in several areas, include clinician timeliness, message management, the circumstances in which they would use messaging, and the content of the messages (including patient-centeredness). While participants agreed that messages about clinical issues should not be resolved via secure messaging, there was a lack of consensus regarding emotionally charged messages and messages dealing with medication adjustments. Some participants spoke of the need for more guidance in knowing when best to use secure messaging. “Sometimes,” one physician said, “it feels like we’re just making up [rules for secure messaging].” Although clinician responses were uniformly respectful, the patient-centeredness varied in the use of jargon and social talk, as well as clarity for patients. DISCUSSION/SIGNIFICANCE OF IMPACT: This study revealed variations in provider approaches to secure messaging, and the content of responses. These variations reflect lack of consensus about how care is delivered via secure messaging, and reveal the need for clinician guidance. They also suggest possible negative patient consequences if secure messaging is used ineffectively. The extent to which variations are undesirable remains unknown. Future work will explore the consequences of such variations.

scholarly journals Predicting diabetes-related hospitalizations based on electronic health records

2018 ◽  
Vol 28 (12) ◽  
pp. 3667-3682 ◽  
Author(s):  
Theodora S Brisimi ◽  
Tingting Xu ◽  
Taiyao Wang ◽  
Wuyang Dai ◽  
Ioannis Ch Paschalidis
Keyword(s):  
New England ◽  
Medical Center ◽  
Computational Cost ◽  
Safety Net ◽  
New Method ◽  
Supervised Machine Learning ◽  
Support Vector ◽  
Large Set ◽  
Machine Learning Classification ◽  
Safety Net Hospital

Objective: To derive a predictive model to identify patients likely to be hospitalized during the following year due to complications attributed to Type II diabetes. Methods: A variety of supervised machine learning classification methods were tested and a new method that discovers hidden patient clusters in the positive class (hospitalized) was developed while, at the same time, sparse linear support vector machine classifiers were derived to separate positive samples from the negative ones (non-hospitalized). The convergence of the new method was established and theoretical guarantees were proved on how the classifiers it produces generalize to a test set not seen during training. Results: The methods were tested on a large set of patients from the Boston Medical Center – the largest safety net hospital in New England. It is found that our new joint clustering/classification method achieves an accuracy of 89% (measured in terms of area under the ROC Curve) and yields informative clusters which can help interpret the classification results, thus increasing the trust of physicians to the algorithmic output and providing some guidance towards preventive measures. While it is possible to increase accuracy to 92% with other methods, this comes with increased computational cost and lack of interpretability. The analysis shows that even a modest probability of preventive actions being effective (more than 19%) suffices to generate significant hospital care savings. Conclusions: Predictive models are proposed that can help avert hospitalizations, improve health outcomes and drastically reduce hospital expenditures. The scope for savings is significant as it has been estimated that in the USA alone, about $5.8 billion are spent each year on diabetes-related hospitalizations that could be prevented.

Initiating a Standard Venous Thromboembolism Prophylaxis Order Set Designed to Improve Patient Outcomes at Los Angeles County + University of Southern California

2016 ◽  
Vol 82 (10) ◽  
pp. 1000-1004 ◽  
Author(s):  
Daniel Gardner ◽  
Andrew Liman ◽  
Victoria Autelli ◽  
Casey O'Connell ◽  
Nicholas Testa ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Los Angeles ◽  
Patient Outcomes ◽  
Los Angeles County ◽  
Southern California ◽  
Safety Net ◽  
University Of Southern California ◽  
Vte Prophylaxis ◽  
Safety Net Hospital ◽  
Order Sets

Improving patient safety is vital for all hospitals due to increasing public reporting and pay-for-performance reimbursement. Venous thromboembolism (VTE) remains a leading cause of preventable mortality accounting for 5 per cent of inpatient deaths. The purpose of this study was to outline the process of implementing standard VTE prophylactic order sets in a 600-bed academic safety net hospital and assess the resulting change in patient outcomes. Outcomes were assessed by comparing the rate that eligible inpatients receive VTE prophylaxis and the rate of preventable VTE's compared with total VTE's. From 2011 to 2015, random samples of 60 Los Angeles County+University of Southern California inpatients were generated monthly to examine compliance rates by comparing ICD-9 diagnostic codes to ordered VTE prophylaxis. All inpatient VTE's are retrospectively analyzed. Baseline-ordered VTE prophylaxis was 37 per cent in 2010. The target of 85 per cent was exceeded by the second quarter of 2012 to 2013 when compliance reached 88 per cent, a 51 per cent increase from baseline ( P < 0.01). These results suggest VTE protocols are effective though standardization across service lines is often difficult. Despite these challenges, after implementing standard order sets, we saw compliance increase significantly. Ongoing analysis to determine whether VTE rates have significantly decreased is presently underway.

Interest and use of alternative/holistic therapies amongst cancer patients at a large urban safety-net hospital.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18289-e18289
Author(s):  
Bartlomiej Posnik ◽  
Romy Jose Thekkekara ◽  
Sushma Bharadwaj ◽  
Barbara Yim ◽  
Shweta Gupta
Keyword(s):  
Cancer Patients ◽  
Conventional Medicine ◽  
Safety Net ◽  
Cook County ◽  
Cook County Hospital ◽  
Alternative Treatments ◽  
Number Of Patients ◽  
Safety Net Hospital ◽  
Urban Safety ◽  
Holistic Therapies

e18289 Background: Patient interest in alternative/holistic therapies during cancer treatment is common in oncology. Studies have shown that 1 in 3 cancer patients in Europe turn to alternative therapies in combination with conventional medicine. Observational studies have shown some benefit of herbal medications in treating chemotherapy-associated complications; however, there remains skepticism in clinical practice. This study was undertaken to evaluate the interest and use of alternative treatments amongst cancer patients at a large urban safety-net hospital. Methods: An anonymous optional survey was offered in a random fashion to malignant hematology/oncology patients at Cook County Hospital in downtown Chicago. Results: One hundred seventy patients completed the survey comprised of 51% men, 78% being over age 50, and 67% with a high school or higher level of education. Responses included 35% African Americans, 34% Hispanics, and 25% Caucasians. At the time of the survey 16% of patients were currently using alternative treatments, while another 12% were planning to. Eighty-seven percent stated that they believed alternative treatments were very/somewhat beneficial, 77% expressed being very/somewhat interested in their use, and 77% stated they were very/somewhat likely to use such treatments. The treatments of interest included herbal supplements/oils in 40%, meditation/prayer in 29%, and cleanses/diets in 26%. Media and internet were the primary sources of information for 41% patients, while 36% heard about these treatments from family/friends. Although 51% of patients described having some safety concerns of such therapies, 77% had not discussed with their doctor. Conclusions: Our data showed that 28% of patients were either already taking or planning to take alternative/holistic therapies in conjunction with conventional medicine for their cancer care. Data also shows that an even larger number of patients are interested in such options and perceive them to be beneficial; however, there is a general reluctance to discuss it with the treating physician. The use of complementary therapies needs to be more openly discussed in order to better guide patients and assure safety.[Table: see text]

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