scholarly journals Changing from telephone to videoconference for pre-treatment pharmacist consults in cancer services: Impacts to funding and time efficiency

2021 ◽  
Vol 27 (10) ◽  
pp. 680-684
Author(s):  
Marissa Ryan ◽  
Christine Carrington ◽  
Elizabeth C Ward ◽  
Clare L Burns ◽  
Katharine Cuff ◽  
...  
Keyword(s):  
Care Model ◽  
Staff Time ◽  
Medication History ◽  
Time Efficiency ◽  
Patients With Cancer ◽  
Equivalent Time ◽  
Cancer Services ◽  
Pre Treatment ◽  
Treatment Medication ◽  
Missed Opportunity

Introduction: This study examined the reimbursement opportunity and the time efficiency of a standard care model of unscheduled telephone consults compared to scheduled videoconference consults for obtaining pre-treatment medication histories for patients with cancer. Methods: Data related to (a) the available and the claimed activity-based funding for both models and (b) the number of contacts and the duration of each contact to complete the patient’s medication history via either unscheduled telephone or scheduled videoconference consults were collected and compared. Results: Data was collected for 86 telephone and 56 videoconference consults. The actual activity-based funding claimed for telephone consults was $0, even though $86 of activity-based funding was available for each consult. This represented a $0 reimbursement for the staff time spent conducting the telephone consults, and a missed opportunity to claim $86 per consult. Activity-based funding was claimed for all but one videoconference consult with an average of $205 received per consult, when $221 per consult was available. Videoconference consults were an average of 2.3 min shorter than telephone consults. Discussion: When compared to unscheduled telephone consults, the scheduled videoconference consults represented increased reimbursement and equivalent time efficiency for the cancer pharmacist completing pre-treatment medication histories.

scholarly journals Study of Adverse Effect Profile of Zoledronic Acid Infusion Among Patients with Cancer: A Retrospective Analysis

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Lina Elsalem ◽  
Haneen A. Basheer ◽  
Ayat Alshoh ◽  
Abdullah Abu-Aqoulah ◽  
Hussein Alsa'di ◽  
...  
Keyword(s):  
Zoledronic Acid ◽  
Adverse Effects ◽  
Biochemical Parameters ◽  
Symptomatic Treatment ◽  
Serum Levels ◽  
Mean Values ◽  
Protein Levels ◽  
Patients With Cancer ◽  
Significant Difference ◽  
Pre Treatment

Background: Zoledronic acid (ZA) is widely used in the management of cancer-related bone events. It, however, might be associated with serious adverse effects. Objectives: To evaluate ZA adverse effects and changes in biochemical parameters related to ZA toxicities among patients with cancer. Methods: Ninety-eight oncology patients, who were prescribed ZA intravenous (IV) infusion, were interviewed to assess whether they experienced ZA related symptoms, including acute events and serious adverse effects. ZA’s effects on the serum levels of different biochemical parameters were retrospectively assessed by checking patients’ electronic medical records. Results: The most commonly reported adverse effects were: myalgia (48%), bone pain (36.7%), influenza-like symptoms (34.7%), headache (31.6%), and pyrexia (22.45%) with decreasing frequency of such adverse effects upon repeated infusions. Serious side effects including jaw osteonecrosis, cardiac, and renal problems were not reported. A small, but statistically significant reduction in serum calcium, creatinine, and total protein levels was observed upon comparing levels before and after the first IV infusion of ZA (P ≤ 0.031). No significant change was recorded with other serum electrolytes including phosphorus, sodium, potassium, and magnesium as well as urea levels (P ≥ 0.271). No significant difference was determined in terms of final serum levels of all parameters in comparison to pre-treatment (P ≥ 0.059), except for potassium, where a significant reduction was observed (P = 0.003). Notably, the mean values of all parameters were within the normal range. Conclusions: ZA acute events resolved with symptomatic treatment and reduced with repeated IV infusions. ZA appears as a safe treatment modality for skeletal-related events among patients with cancer and the reported adverse effects should not affect patients’ compliance.

Amelioration of sperm count and sperm quality by lycopene supplementation in irradiated mice

2020 ◽  
Vol 32 (12) ◽  
pp. 1040
Author(s):  
Małgorzata M. Dobrzyńska ◽  
Aneta Gajowik
Keyword(s):  
Dna Damage ◽  
Sperm Quality ◽  
Sperm Count ◽  
Combined Treatment ◽  
Treatment Groups ◽  
Patients With Cancer ◽  
Equivalent Time ◽  
Radiation Induced ◽  
Almost All ◽  
Harmful Effects

Male mice were exposed to lycopene (LYC; 0.15 and 0.30mg kg−1) and irradiation (0.5, 1 Gy) alone or in combination (0.5 Gy+0.15mg kg−1 LYC; 0.5 Gy+0.30mg kg−1 LYC; 1 Gy+0.15mg kg−1 LYC; 1 Gy+0.30mg kg−1 LYC) for 2 weeks. LYC administration in the drinking water was started 24h or on Day 8 after the first irradiation dose or equivalent time point for groups treated with LYC alone. Sperm count, motility, morphology and DNA damage were determined at the end of the 2-week treatment period. Irradiation deteriorated sperm count and quality. Supplementation with LYC from 24h significantly increased the sperm count compared with irradiation alone. In almost all combined treatment groups, the percentage of abnormal spermatozoa was significantly decreased compared with that after irradiation alone. In some cases, combined treatment reduced levels of DNA damage in gametes. Both doses of LYC administered from Day 8 significantly reduced the percentage of morphologically abnormal spermatozoa compared with that seen after 1 Gy irradiation and reduced DNA damage in all combined treatment groups. In conclusion, LYC supplementation after irradiation can ameliorate the harmful effects of irradiation on gametes. Mitigation of radiation-induced damage in germ cells following LYC administration may be useful for radiological accidents and to protect non-treated tissues in patients with cancer undergoing radiotherapy.

scholarly journals Comparative evaluation of pre-treatment medication on post-instrumentation pain: Randomized control trial.

2020 ◽  
Vol 6 (2) ◽  
pp. 22-27
Author(s):  
Atul Jain ◽  
Chahat Chabra ◽  
Abinay Agarwal ◽  
Rohit Sharma ◽  
Faisal Khan ◽  
...  
Keyword(s):  
Single Dose ◽  
Lower Incidence ◽  
Randomized Control Trial ◽  
Comparative Evaluation ◽  
Endodontic Treatment ◽  
Rotary Instruments ◽  
Randomized Control ◽  
Pre Treatment ◽  
Treatment Medication

Aims and Objectives: To comparatively evaluate, the effect of preoperative single dose, of paracetamol and ibuprofen on PIP, using two different rotary instruments. Materials and Methods: 60 patients were randomly premedicated, with either paracetamol or ibuprofen and canal was instrumented, with either Hyflex or Protaper Gold files. PIP was evaluated at 6, 12, 24, 48 and 72 hrs. Results: Lower incidence and intensity of PIP, occurred in patients, premedicated with Ibuprofen and where canal was instrumented with Hyflex. Conclusion: Use of Ibuprofen, as a premedication during endodontic treatment, with Hyflex rotary instruments, decreases PIP.

Issues associated with medical tourism for cancer care in Japan

2019 ◽  
Vol 49 (8) ◽  
pp. 708-713 ◽  
Author(s):  
Nobuyasu Awano ◽  
Takeshi Takamoto ◽  
Junko Kawakami ◽  
Atsuko Genda ◽  
Akiko Ninomiya ◽  
...  
Keyword(s):  
Medical Staff ◽  
Medical Tourism ◽  
Treatment Phase ◽  
Disease Status ◽  
Language Differences ◽  
Self Evaluation ◽  
Patients With Cancer ◽  
Pre Treatment ◽  
Receive Treatment ◽  
To Receive

Abstract Background Medical tourism has grown globally, especially in oncology field, but it may cause serious problems. We aimed to elucidate concerns generated by medical tourism at a Japanese hospital and recommend solutions. Methods We evaluated 72 consecutive patients with cancer who had traveled from abroad to receive second opinions, clinical examinations or treatments at our hospital between January 2015 and December 2016. Data were retrospectively collected to include the purpose of patients’ visits, presence and content of referral documents, details of treatments provided at our hospital, concordance between treatments received and patients’ expectations, troublesome hospital incidents, risks of travel and problems with payment. Results The purpose of the visit was actual cancer treatment in the majority of the cases. Thirteen patients could speak neither Japanese nor English. Inadequate content in patient referral documents and discordance between information from the referring physician and findings at first examination were the main issues observed in the pre-treatment phase; 33 patients decided to receive treatment at our hospital. Language differences caused problems in patients’ understanding of instructions and explanations during treatment. Additional problems included inaccurate self-evaluation of disease status, differences in cultural habits and requests for inappropriate and/or unavailable therapies. No major issues that could lead to injury in patients or medical staff were observed. Risks involved with returning home and transfer of treatment to local physicians were the main post-treatment issues. Conclusion Medical tourism raises various issues. Institutional and medical staff should be adequately prepared by developing working systems.

scholarly journals Directly Observed Care: An Innovative Oncology Care Model in Belize

2019 ◽  
Vol 5 (Supplement_1) ◽  
pp. 13-13
Author(s):  
Yannis Valtis ◽  
Ramon Yacab ◽  
Franklin Huang
Keyword(s):  
Real Time ◽  
Patient Navigation ◽  
Barriers To Care ◽  
Psychosocial Support ◽  
The United States ◽  
Oncologic Outcomes ◽  
Care Model ◽  
Financial Barriers ◽  
Middle Income ◽  
Patients With Cancer

PURPOSE Patients with cancer in low- and middle-income countries face complex socioeconomic barriers within health systems that can lead to poor oncologic outcomes. Patient navigation has been shown to reduce disparities in oncologic outcomes in the United States. Belize, a middle-income country in Central America, has recently launched its first-ever public medical oncology program. Here, we report on the development of Directly Observed Care (DOC), a pilot patient navigation care model for patients with cancer in Belize, inspired from directly observed treatment for tuberculosis. METHODS DOC will be a patient-centered program, where a nurse trained in patient navigation will assume responsibility for proactively identifying barriers that Belizean patients with cancer face in access to care and working to remove them. This process will include patient education on cancer and its treatment, identification of financial barriers to care and potential funding sources, assistance with care logistics such as transportation and childcare, and referral to psychosocial support services for patients who need them. DOC will rely on an electronic patient-tracking platform, which will allow real-time tracking of all oncology patients and identify patients who miss or delay treatments. This will allow timely intervention and continuous quality monitoring of the program. In addition to patient navigation, DOC will seek to reduce delays in patient care by liaising with pathology and radiology services. RESULTS The program is in its development and pilot phase. So far, approximately 100 patients have been seen for consultation. We intend to capture epidemiologic data about cancer in Belize, as well as real-time data about the progression of patients through their treatment course. We aim to identify critical delays to patients’ care and design interventions to address them. CONCLUSION We believe that the DOC program will be particularly beneficial for the oncology patient population in Belize, because this population has a high burden of socioeconomic barriers to care and is largely unfamiliar with the complexity of oncologic care. We hypothesize that DOC can improve treatment appropriateness and timeliness and, thereby, patient outcomes in Belize.

scholarly journals The Influence of Surgery on Cytokines in Patients with Intra-Abdominal Sepsis

1996 ◽  
Vol 24 (4) ◽  
pp. 430-434 ◽  
Author(s):  
J. M. J. Hammond ◽  
P. D. Potgieter
Keyword(s):  
Organ Dysfunction ◽  
Perioperative Period ◽  
Serum Levels ◽  
Abdominal Sepsis ◽  
Controlled Study ◽  
Patients With Cancer ◽  
Tnf Α ◽  
Cytokine Levels ◽  
Pre Treatment ◽  
Cytokine Cascade

The cytokine cascade which is triggered by severe sepsis may contribute to progressive organ dysfunction and death from sepsis. This cascade may be accentuated by surgery for sepsis and pre-treatment with cytokine blockers could possibly ameliorate the response. This prospective controlled study determined the effect of surgery in 11 haemodynamically stable patients undergoing laparotomy for intra-abdominal sepsis. Serum levels of endotoxin, IL-1, IL-6, IL-8 and TNF-α were determined; blood cultures, features of systemic inflammatory response, and organ dysfunction were monitored over the perioperative period. There was considerable variation in the serum cytokine levels. The preoperative IL-6 levels were significantly elevated in the septic patients and a threefold increase in IL-6 levels occurred in both groups postoperatively. An increase in TNF-α did not achieve significance because of high levels in control patients with cancer. Cytokine release which occurs during abdominal surgery is increased in patients with intra-abdominal sepsis.

Use of videoconferencing in Wales to reduce carbon dioxide emissions, travel costs and time

2009 ◽  
Vol 15 (3) ◽  
pp. 137-138 ◽  
Author(s):  
Delyth Lewis ◽  
Glynis Tranter ◽  
Alan T Axford
Keyword(s):  
Climate Change ◽  
Carbon Dioxide ◽  
Carbon Dioxide Emissions ◽  
Multidisciplinary Teams ◽  
Staff Time ◽  
Telemedicine Service ◽  
Travel Costs ◽  
Cancer Services ◽  
Reduce Carbon Dioxide ◽  
Car Travel

In September 2005 a telemedicine service was started to assist multidisciplinary teams in Wales to improve cancer services. In October 2006 and October 2007 users of videoconferencing equipment at one site completed questionnaires. During October 2006 a total of 18,000 km of car travel were avoided, equivalent to 1696 kg of CO2 emission. During October 2007 a total of 20,800 km of car travel were avoided, equivalent to 2590 kg of CO2 emission. We estimate that 48 trees would take a year to absorb that quantity of CO2. The results of the surveys show that exploiting telemedicine makes better use of staff time, reduces the time spent travelling and assists in reducing climate change by limiting the emissions of CO2.

scholarly journals Fit for Cancer Treatment: a prospective feasibility study of primary care initiated prehabilitation for patients with suspected cancer

BJGP Open ◽  
2018 ◽  
Vol 2 (4) ◽  
pp. bjgpopen18X101608
Author(s):  
Rachael C Barlow ◽  
David Sheng Yi Chan ◽  
Sharon Mayor ◽  
Ceri Perkins ◽  
Helen L Lawton ◽  
...  
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Treatment Plan ◽  
Curative Treatment ◽  
Healthcare Intervention ◽  
Study Cohort ◽  
Patients With Cancer ◽  
Care Assessment ◽  
Assessment And Treatment ◽  
Pre Treatment

BackgroundRisk profile assessment and corrective interventions using optimisation of health status and prehabilitation represent an important strategy in the management of patients with a suspected cancer diagnosis.AimTo determine the feasibility of pre-treatment optimisation and prehabilitation commenced at index primary care consultation, to improve patients’ preparation for treatment by maximising the time available.Design & settingBetween January 2015 and May 2016, 195 patients presenting to 12 GP practices were deemed eligible to enter the study, of which 189 (96.9%, median age 60 [21–91] years and 65 months; 124 female) were recruited and consented to the prehabilitation bundle.MethodAll patients were simultaneously referred to secondary care using urgent suspected cancer (USC) pathways. The primary outcome measures were definitive diagnosis and treatment plan.ResultsFifteen patients (7.9%) were diagnosed with cancer (three breast, three colon, two lung, two skin [one melanoma, one sarcoma], one tonsil, one vocal cord, one pancreas, one prostate, one ependymoma) and 62 were diagnosed with other significant medical conditions (47 gastrointestinal, 13 sepsis, two respiratory) requiring secondary care assessment and treatment. Of the 15 patients with cancer, 11 (73.3%) underwent potentially curative treatment, and four (26.7%) palliative treatment. Of the total study cohort, 84 (44%) required a form of optimisation in primary care, and patients with cancer were more likely to require optimisation than others (n = 10 [63%] versus n = 74 [43%], χ2 9.384, P = 0.002).ConclusionOne in 12 primary care USC patients had cancer (5.6% receiving potentially curative treatment), one in three had other systemic health issues, and overall two in five benefited from healthcare intervention. Primary care optimisation was feasible and associated with important allied health benefits.

Cancer treatment and causation

Clinical Risk ◽  
2007 ◽  
Vol 13 (4) ◽  
pp. 151-153
Author(s):  
Victor Barley
Keyword(s):  
Cancer Treatment ◽  
Histological Examination ◽  
Multidisciplinary Team ◽  
Basic Knowledge ◽  
Delay In Diagnosis ◽  
Patients With Cancer ◽  
Cancer Services ◽  
Diagnosis Of Cancer ◽  
The Uk ◽  
Medicolegal Issues

A series of three articles exploring medicolegal issues arising out of the detection and treatment of cancer. The treatment of cancer involves several different specialists and, in the majority of cancer services in the UK, patients with cancer are seen by a multidisciplinary team. After the diagnosis of cancer has been confirmed by histological examination which shows the type and grade of the cancer, further tests are usually needed to determine the extent and spread of the tumour, i.e. the stage. Many cancers have already spread before the diagnosis can be made, even if the metastases cannot be detected at the time of the initial diagnosis. Many cancers are therefore not curable even though there is no indication of spread from the initial tests. Therefore, an unwarranted delay in diagnosis may not result in a poorer prognosis, although it is clearly important to give treatment at the earliest opportunity to reduce the possibility of spread. This article outlines the basic knowledge required by a clinical negligence practitioner when considering a potential oncology claim.

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