scholarly journals Importance of Patient Education for At-home Yoga Practice in Women With Hormonal Therapy-induced Pain During Adjuvant Breast Cancer Treatment: A Feasibility Study

2021 ◽  
Vol 20 ◽  
pp. 153473542110637
Author(s):  
Kerstin Faravel ◽  
Marie-Eve Huteau ◽  
Marta Jarlier ◽  
Hélène de Forges ◽  
Laetitia Meignant ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Education ◽  
Hormonal Therapy ◽  
Patient Adherence ◽  
Adherence Rate ◽  
Yoga Practice ◽  
Therapy Discontinuation ◽  
Adjuvant Breast Cancer ◽  
Articular Pain ◽  
At Home

Background Osteo-articular pain (OAP) is experienced by approximately 50% of women under hormonal therapy (HT) for breast cancer (BC), which increases the risk for therapy discontinuation. This study was aimed to assess benefits of yoga practice combined with patient education (PE) for at-home practice by evaluating feasibility among BC patients under HT and measuring OAP, flexibility and satisfaction. Methods Feasibility was evaluated by patient adherence as accomplishment of at least 4 out of 6 supervised yoga-PE sessions along with 70% or more at-home yoga sessions. Intervention (12 weeks) included two 6-weeks periods: P1 comprising one 90-minutes supervised yoga-PE session/week and 15-minutes daily at-home yoga and P2, daily autonomous at-home yoga sessions. Evaluations (at inclusion and by the end of each period) consisted in assessment of OAP on Visual Analog Scale (VAS), forward flexibility (cm) and patient satisfaction on Likert (0-10 points) scale. Results Between September 2018 and May 2019 we included 24 patients of median 53 years (range 36-72). Feasibility was validated by 83% successful adherence rate. Pain was significantly reduced from median VAS of 6 [range 4-10] to 4 [range 0-7] at the end of both P1 and P2 ( p < 0.01), albeit with no difference between P1 and P2. Forward flexibility improved by a median gain of 8 cm (end of P2) and median satisfaction score of 10/10 [range 8-10]. Conclusion Combined physiotherapy-yoga-PE intervention is a feasible strategy to increase at-home yoga practice with potential benefit on pain, flexibility, and satisfaction, thus prompting further evaluations in larger randomized multicenter trials. ClinicalTrials.gov NCT04001751

scholarly journals 21-Gene Recurrence Score and Adjuvant Chemotherapy Decision for Breast Cancer Patients with Positive Lymph Nodes

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yiwei Tong ◽  
Jiayi Wu ◽  
Ou Huang ◽  
Jianrong He ◽  
Li Zhu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Patient Adherence ◽  
Recurrence Score ◽  
Adherence Rate ◽  
Breast Cancer Patients ◽  
Clinical Value ◽  
Actual Usage ◽  
Additional Information ◽  
Pathological Characteristics

Abstract The 21-gene recurrence score (RS) assay is prognostic and predictive for hormone receptor (HR)+/HER2-/node- breast cancer (BC) patients. However, its clinical value in node + patients hasn’t been elucidated. HR+/HER2-/pN1 patients operated in Comprehensive Breast Health Center, Shanghai Ruijin Hospital from January 2014 to December 2018, with available RS results were retrospectively included. Clinico-pathological characteristics were compared. Adjuvant chemotherapy recommendations pre-/post- RS assay and actual usage were analyzed. A total of 303 patients were included, with 59, 178, 66 RS < 18, 18–30 and ≥ 31. Age (P < 0.001), comorbidity (P = 0.013), and RS category (P < 0.001) were independently associated with chemotherapy recommendation. Compared with low RS patients, those with intermediate (OR 6.58, 95% CI 2.37–18.31, P < 0.001) or high (OR 54.14, 95% CI 3.77–776.54, P = 0.003) RS were more likely to be recommended with chemotherapy. RS independently influence chemotherapy decision in postmenopausal population as well. Chemotherapy recommendation changed for 9.57% patients after RS assay. Patient adherence rate to chemotherapy recommendation was 94.72% (287/303). The 21-gene RS independently influenced chemotherapy recommendation in pN1 BC patients, which could provide additional information to guide chemotherapy decision with relatively good treatment adherence rate.

Incidental Breast Cancer on Chest CT: Is the Radiology Report Enough?

2021 ◽  
Author(s):  
Allison Aripoli ◽  
Joley Beeler ◽  
Lauren Clark ◽  
Carissa Walter ◽  
Marc Inciardi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Imaging ◽  
Patient Adherence ◽  
Statistical Significance ◽  
Chest Ct ◽  
Adherence Rate ◽  
Prior History ◽  
Breast Malignancy ◽  
Significant Difference

Abstract Objective To determine the frequency of incidental breast findings reported on chest CT for which breast imaging follow-up is recommended, the follow-up adherence rate, and the breast malignancy rate. The relationship between strength of recommendation verbiage and follow-up was also explored. Methods A retrospective review was conducted of chest CT reports from July 1, 2018, to June 30, 2019, to identify those with recommendation for breast imaging follow-up. Patients with recently diagnosed or prior history of breast malignancy were excluded. Medical records were reviewed to evaluate patient adherence to follow-up, subsequent BI-RADS assessment, and diagnosis (if tissue sampling performed). Adherence was defined as diagnostic breast imaging performed within 6 months of CT recommendation. Chi-square and Mann-Whitney U tests were used to determine statistical significance of categorical and continuous variables, respectively. Results A follow-up recommendation for breast imaging was included in chest CT reports of 210 patients; 23% (48/210) returned for follow-up breast imaging. All patients assessed as BI-RADS 4 or 5 underwent image-guided biopsy. Incidental breast cancer was diagnosed in 15% (7/48) of patients who underwent follow-up breast imaging as a result of a CT report recommendation and 78% (7/9) of patients undergoing biopsy. There was no significant difference in follow-up adherence when comparing report verbiage strength. Conclusion It is imperative that incidental breast findings detected on chest CT undergo follow-up breast imaging to establish accurate and timely diagnosis of breast malignancy. Outreach to referring providers and patients may have greater impact on the diagnosis of previously unsuspected breast cancer.

scholarly journals Experiences of Complex Patients With Telemonitoring in a Nurse-Led Model of Care: Multimethod Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Kayleigh Gordon ◽  
Katie N Dainty ◽  
Carolyn Steele Gray ◽  
Jane DeLacy ◽  
Amika Shah ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Patient Adherence ◽  
Care Delivery ◽  
Qualitative Interviews ◽  
Perceived Usefulness ◽  
Adherence Rate ◽  
Model Of Care ◽  
Care Needs ◽  
Complex Patients ◽  
At Home

BACKGROUND Telemonitoring (TM) interventions have been designed to support care delivery and engage patients in their care at home, but little research exists on TM of complex chronic conditions (CCCs). Given the growing prevalence of complex patients, an evaluation of multi-condition TM is needed to expand TM interventions and tailor opportunities to manage complex chronic care needs. OBJECTIVE This study aims to evaluate the feasibility and patients’ perceived usefulness of a multi-condition TM platform in a nurse-led model of care. METHODS A pragmatic, multimethod feasibility study was conducted with patients with heart failure (HF), hypertension (HTN), and/or diabetes. Patients were asked to take physiological readings at home via a smartphone-based TM app for 6 months. The recommended frequency of taking readings was dependent on the condition, and adherence data were obtained through the TM system database. Patient questionnaires were administered, and patient interviews were conducted at the end of the study. An inductive analysis was performed, and codes were then mapped to the normalization process theory and Implementation Outcomes constructs by Proctor. RESULTS In total, 26 participants were recruited, 17 of whom used the TM app for 6 months. Qualitative interviews were conducted with 14 patients, and 8 patients were interviewed with their informal caregiver present. Patient adherence was high, with patients with HF taking readings on average 76.6% (141/184) of the days they were asked to use the system and patients with diabetes taking readings on average 72% (19/26) of the days. The HTN adherence rate was 55% (29/52) of the days they were asked to use the system. The qualitative findings of the patient experience can be grouped into 4 main themes and 13 subthemes. The main themes were (1) making sense of the purpose of TM, (2) engaging and investing in TM, (3) implementing and adopting TM, and (4) perceived usefulness and the perceived benefits of TM in CCCs. CONCLUSIONS Multi-condition TM in nurse-led care was found to be feasible and was perceived as useful. Patients accepted and adopted the technology by demonstrating a moderate to high level of adherence across conditions. These results demonstrate how TM can address the needs of patients with CCCs through virtual TM assessments in a nurse-led care model by supporting patient self-care and keeping patients connected to their clinical team.

Prescription Patterns, Initiation, and 5-Year Adherence to Adjuvant Hormonal Therapy Among Commercially Insured Patients With Breast Cancer

2021 ◽  
pp. OP.20.00248
Author(s):  
Hui Zhao ◽  
Xiudong Lei ◽  
Jiangong Niu ◽  
Ning Zhang ◽  
Zhigang Duan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Insurance ◽  
Hormonal Therapy ◽  
Private Health Insurance ◽  
Breast Cancer Incidence ◽  
Medication Possession Ratio ◽  
Adherence Rate ◽  
Research Database ◽  
Adjuvant Hormonal Therapy ◽  
Female Patients

BACKGROUND: Tamoxifen and aromatase inhibitors (AIs) are used as adjuvant hormonal therapy (AHT) for early-stage hormone receptor–positive (HR+) breast cancer. Treatment for 5 years reduces cancer mortality by 30%. Despite this benefit, adherence to AHT has been suboptimal. Here, we evaluated AHT initiation and patient adherence in women with private health insurance. MATERIALS AND METHODS: Female patients with breast cancer ≥ 18 years of age who underwent mastectomy or lumpectomy between 1999 and 2015 were identified in the IBM MarketScan Research Database. AHT initiation and adherence rates were estimated for all AHT users regardless of HR+ status. Initiation rates were standardized using HR+ breast cancer incidence rates in the Surveillance, Epidemiology, and End Results (SEER) program. Adherence was defined as medication possession ratio ≥ 80%. Risk ratios, odds ratios, and their 95% CIs were calculated for factors associated with patients' initiation and adherence. RESULTS: Among 80,224 patients, the raw initiation rate was 71.8% and the standardized rate was 87.5%. We found 61.2% patients initiated treatment with AIs and 38.8% with tamoxifen. Patients' 1-year adherence rate was 84.4% and the 5-year rate was 65.2%. Prescription by mail-in order, using a single AHT regimen, 50 to 69 years of age, monthly out-of-pocket drug payment ≤ $11, in US dollars, no depression, no comorbidity, living in the Northeast, treatment in recent years, and receipt of a combination of chemotherapy, radiation, and surgery were associated with better adherence. CONCLUSION: Five-year AHT adherence rates are low among female patients with breast cancer with private health insurance. Effective approaches to improve AHT adherence are needed.

scholarly journals Experiences of Complex Patients With Telemonitoring in a Nurse-Led Model of Care: Multimethod Feasibility Study

JMIR Nursing ◽  
10.2196/22118 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e22118
Author(s):  
Kayleigh Gordon ◽  
Katie N Dainty ◽  
Carolyn Steele Gray ◽  
Jane DeLacy ◽  
Amika Shah ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Patient Adherence ◽  
Care Delivery ◽  
Qualitative Interviews ◽  
Perceived Usefulness ◽  
Adherence Rate ◽  
Model Of Care ◽  
Care Needs ◽  
Complex Patients ◽  
At Home

Background Telemonitoring (TM) interventions have been designed to support care delivery and engage patients in their care at home, but little research exists on TM of complex chronic conditions (CCCs). Given the growing prevalence of complex patients, an evaluation of multi-condition TM is needed to expand TM interventions and tailor opportunities to manage complex chronic care needs. Objective This study aims to evaluate the feasibility and patients’ perceived usefulness of a multi-condition TM platform in a nurse-led model of care. Methods A pragmatic, multimethod feasibility study was conducted with patients with heart failure (HF), hypertension (HTN), and/or diabetes. Patients were asked to take physiological readings at home via a smartphone-based TM app for 6 months. The recommended frequency of taking readings was dependent on the condition, and adherence data were obtained through the TM system database. Patient questionnaires were administered, and patient interviews were conducted at the end of the study. An inductive analysis was performed, and codes were then mapped to the normalization process theory and Implementation Outcomes constructs by Proctor. Results In total, 26 participants were recruited, 17 of whom used the TM app for 6 months. Qualitative interviews were conducted with 14 patients, and 8 patients were interviewed with their informal caregiver present. Patient adherence was high, with patients with HF taking readings on average 76.6% (141/184) of the days they were asked to use the system and patients with diabetes taking readings on average 72% (19/26) of the days. The HTN adherence rate was 55% (29/52) of the days they were asked to use the system. The qualitative findings of the patient experience can be grouped into 4 main themes and 13 subthemes. The main themes were (1) making sense of the purpose of TM, (2) engaging and investing in TM, (3) implementing and adopting TM, and (4) perceived usefulness and the perceived benefits of TM in CCCs. Conclusions Multi-condition TM in nurse-led care was found to be feasible and was perceived as useful. Patients accepted and adopted the technology by demonstrating a moderate to high level of adherence across conditions. These results demonstrate how TM can address the needs of patients with CCCs through virtual TM assessments in a nurse-led care model by supporting patient self-care and keeping patients connected to their clinical team.

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