Patient-Centered Standards for Medically Integrated Dispensing: ASCO/NCODA Standards

2020 ◽  
Vol 38 (6) ◽  
pp. 633-644 ◽  
Author(s):  
Melissa S. Dillmon ◽  
Erin B. Kennedy ◽  
Mary K. Anderson ◽  
Michael Brodersen ◽  
Howard Cohen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Supportive Care ◽  
Evidence Base ◽  
Patient Centered ◽  
Additional Information ◽  
Community Oncology ◽  
Included Patient ◽  
American Society ◽  
Data Documentation ◽  
Patient Relationships

PURPOSE To provide standards for medically integrated dispensing of oral anticancer drugs and supportive care medications. METHODS An Expert Panel was formed, and a systematic review of the literature on patient-centered best practices for the delivery of oral anticancer and supportive care drugs was performed to April 2019 using PubMed and Google Scholar. Available patient-centered standards, including one previously developed by the National Community Oncology Dispensing Association (NCODA), were considered for endorsement. Public comments were solicited and considered in preparation of the final manuscript. RESULTS A high-quality systematic review that was current to May 2016 was adopted into the evidence base. Five additional primary studies of multifaceted interventions met the inclusion criteria. These studies generally included a multicomponent intervention, often led by an oncology pharmacist, and also included patient education and regular follow-up and monitoring. These interventions resulted in significant improvements to patient quality and safety and demonstrated improvements in adherence and other patient outcomes. CONCLUSION The findings of the systematic review were consistent with the NCODA patient-centered standards for patient relationships and education, adherence, safety, collection of data, documentation, and other areas. NCODA standards were adopted and used as basis for these American Society of Clinical Oncology/NCODA standards. Additional information is available at www.asco.org/mid-standards .

scholarly journals Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review

2016 ◽  
Vol 24 (e1) ◽  
pp. e207-e215 ◽  
Author(s):  
Minal R Patel ◽  
Jennifer Vichich ◽  
Ian Lang ◽  
Jessica Lin ◽  
Kai Zheng
Keyword(s):  
Systematic Review ◽  
Best Practices ◽  
Clinical Care ◽  
Strong Support ◽  
Evidence Base ◽  
Evidence Based ◽  
Patient Centered ◽  
Exam Room ◽  
Communication Practices ◽  
Electronic Health

Objective: The introduction of health information technology systems, electronic health records in particular, is changing the nature of how clinicians interact with patients. Lack of knowledge remains on how best to integrate such systems in the exam room. The purpose of this systematic review was to (1) distill “best” behavioral and communication practices recommended in the literature for clinicians when interacting with patients in the presence of computerized systems during a clinical encounter, (2) weigh the evidence of each recommendation, and (3) rank evidence-based recommendations for electronic health record communication training initiatives for clinicians. Methods: We conducted a literature search of 6 databases, resulting in 52 articles included in the analysis. We extracted information such as study setting, research design, sample, findings, and implications. Recommendations were distilled based on consistent support for behavioral and communication practices across studies. Results: Eight behavioral and communication practices received strong support of evidence in the literature and included specific aspects of using computerized systems to facilitate conversation and transparency in the exam room, such as spatial (re)organization of the exam room, maintaining nonverbal communication, and specific techniques that integrate the computerized system into the visit and engage the patient. Four practices, although patient-centered, have received insufficient evidence to date. Discussion and Conclusion: We developed an evidence base of best practices for clinicians to maintain patient-centered communications in the presence of computerized systems in the exam room. Further work includes development and empirical evaluation of evidence-based guidelines to better integrate computerized systems into clinical care.

scholarly journals Treatment of Malignant Pleural Mesothelioma: American Society of Clinical Oncology Clinical Practice Guideline

2018 ◽  
Vol 36 (13) ◽  
pp. 1343-1373 ◽  
Author(s):  
Hedy L. Kindler ◽  
Nofisat Ismaila ◽  
Samuel G. Armato ◽  
Raphael Bueno ◽  
Mary Hesdorffer ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Literature Search ◽  
Expert Panel ◽  
Evidence Base ◽  
Evidence Based ◽  
Pleural Mesothelioma ◽  
Additional Information ◽  
Thoracic Cancer ◽  
American Society ◽  
Meta Analyses

Purpose To provide evidence-based recommendations to practicing physicians and others on the management of malignant pleural mesothelioma. Methods ASCO convened an Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary, pathology, imaging, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1990 through 2017. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. Results The literature search identified 222 relevant studies to inform the evidence base for this guideline. Recommendations Evidence-based recommendations were developed for diagnosis, staging, chemotherapy, surgical cytoreduction, radiation therapy, and multimodality therapy in patients with malignant pleural mesothelioma. Additional information is available at www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki .

Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline

2017 ◽  
Vol 35 (31) ◽  
pp. 3618-3632 ◽  
Author(s):  
Timothy Gilligan ◽  
Nessa Coyle ◽  
Richard M. Frankel ◽  
Donna L. Berry ◽  
Kari Bohlke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Communication Skills ◽  
Family Involvement ◽  
Guideline Development ◽  
Well Being ◽  
Clinician Training ◽  
Additional Information ◽  
Care Guidelines ◽  
American Society ◽  
Meta Analyses

Purpose To provide guidance to oncology clinicians on how to use effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and family well-being. Methods ASCO convened a multidisciplinary panel of medical oncology, psychiatry, nursing, hospice and palliative medicine, communication skills, health disparities, and advocacy experts to produce recommendations. Guideline development involved a systematic review of the literature and a formal consensus process. The systematic review focused on guidelines, systematic reviews and meta-analyses, and randomized controlled trials published from 2006 through October 1, 2016. Results The systematic review included 47 publications. With the exception of clinician training in communication skills, evidence for many of the clinical questions was limited. Draft recommendations underwent two rounds of consensus voting before being finalized. Recommendations In addition to providing guidance regarding core communication skills and tasks that apply across the continuum of cancer care, recommendations address specific topics, such as discussion of goals of care and prognosis, treatment selection, end-of-life care, facilitating family involvement in care, and clinician training in communication skills. Recommendations are accompanied by suggested strategies for implementation. Additional information is available at www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki .

Conversational Agents for Chronic Disease Self-Management: A Systematic Review (Preprint)

2019 ◽  
Author(s):  
Ashley Clara Griffin ◽  
Zhaopeng Xing ◽  
Saif Khairat ◽  
Yue Wang ◽  
Stacy Bailey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Disease ◽  
Randomized Controlled Trials ◽  
Experimental Studies ◽  
Evidence Base ◽  
Self Management ◽  
Controlled Trials ◽  
Conversational Agents ◽  
Patient Centered ◽  
Randomized Controlled

BACKGROUND Conversational agents have the potential to deliver patient-centered interventions that focus on goal setting, feedback, and education. However, little is known how these agents may be utilized to assist patients with chronic disease self-management. OBJECTIVE The objective of this study was to systematically review the literature to assess how conversational agents have been used to facilitate chronic disease self-management and to identify gaps in the evidence base. METHODS The systematic review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across five databases. We included full-text journal articles or conference proceedings that contained primary research findings for text-based conversational agents focused on self-management for chronic diseases in adults. Two reviewers independently extracted information from the included studies, analyzed the data, grouped the studies into themes, and rated the quality of the studies. RESULTS 1,606 studies were identified, and 12 studies met inclusion criteria. There were five randomized controlled trials, five quasi-experimental studies, and two non-experimental studies. Studies were heterogeneous in design and many lacked methodological rigor. Participants mostly reported positive attitudes towards conversational agents, and there were improvements on the Patient Health Questionnaire (P<.05), Generalized Anxiety Disorder Scale (P=.004), Perceived Stress Scale (P=.048), Flourishing Scale (P=.032), and Overall Anxiety Severity and Impairment Scale (P<.05) between the conversational agent intervention and control groups in three randomized controlled trials. Major themes related to user perceptions were personalization, engagement, and social support. The majority of conversational agents were based upon theoretical grounding, but few studies reported using established design principles and no studies used heuristic evaluation. CONCLUSIONS Our findings suggest that conversational agents are acceptable and have the potential to support self-management particularly for mental health conditions. As this is an emerging area of research, efficacy of long-term use of conversational agents for chronic disease self-management is unknown but shows promise. Future studies should assess the characteristics of agents that may be most useful for self-management based on the patient’s clinical and sociodemographic characteristics, motivation, and preferences.

scholarly journals Management of Dyspnea in Advanced Cancer: ASCO Guideline

2021 ◽  
Vol 39 (12) ◽  
pp. 1389-1411
Author(s):  
David Hui ◽  
Kari Bohlke ◽  
Ting Bao ◽  
Toby C. Campbell ◽  
Patrick J. Coyne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Advanced Cancer ◽  
Expert Panel ◽  
Meta Analysis ◽  
Supplemental Oxygen ◽  
Evidence Base ◽  
Healthcare Research ◽  
Additional Information ◽  
Dyspnea Assessment

PURPOSE To provide guidance on the clinical management of dyspnea in adult patients with advanced cancer. METHODS ASCO convened an Expert Panel to review the evidence and formulate recommendations. An Agency for Healthcare Research and Quality (AHRQ) systematic review provided the evidence base for nonpharmacologic and pharmacologic interventions to alleviate dyspnea. The review included randomized controlled trials (RCTs) and observational studies with a concurrent comparison group published through early May 2020. The ASCO Expert Panel also wished to address dyspnea assessment, management of underlying conditions, and palliative care referrals, and for these questions, an additional systematic review identified RCTs, systematic reviews, and guidelines published through July 2020. RESULTS The AHRQ systematic review included 48 RCTs and two retrospective cohort studies. Lung cancer and mesothelioma were the most commonly addressed types of cancer. Nonpharmacologic interventions such as fans provided some relief from breathlessness. Support for pharmacologic interventions was limited. A meta-analysis of specialty breathlessness services reported improvements in distress because of dyspnea. RECOMMENDATIONS A hierarchical approach to dyspnea management is recommended, beginning with dyspnea assessment, ascertainment and management of potentially reversible causes, and referral to an interdisciplinary palliative care team. Nonpharmacologic interventions that may be offered to relieve dyspnea include airflow interventions (eg, a fan directed at the cheek), standard supplemental oxygen for patients with hypoxemia, and other psychoeducational, self-management, or complementary approaches. For patients who derive inadequate relief from nonpharmacologic interventions, systemic opioids should be offered. Other pharmacologic interventions, such as corticosteroids and benzodiazepines, are also discussed. Additional information is available at www.asco.org/supportive-care-guidelines .

Small talk as work talk: Enacting the patient-centered approach in nurse-practitioner-patient visits

2018 ◽  
Vol 14 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Staci Defibaugh
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Visit ◽  
Patient Centered ◽  
Small Talk ◽  
Medical Visits ◽  
Relational Work ◽  
The Us ◽  
The Individual ◽  
Patient Relationships

Small talk in medical visits has received ample attention; however, small talk that occurs at the close of a medical visit has not been explored. Small talk, with its focus on relational work, is an important aspect of medical care, particularly so considering the current focus in the US on the patient-centered approach and the desire to construct positive provider– patient relationships, which have been shown to contribute to higher patient satisfaction and better health outcomes. Therefore, even small talk that is unrelated to the transactional aspect of the medical visit in fact serves an important function. In this article, I analyze small talk exchanges between nurse practitioners (NPs) and their patients which occur after the transactional work of the visit is completed. I focus on two exchanges which highlight different interactional goals. I argue that these examples illustrate a willingness on the part of all participants to extend the visit solely for the purpose of constructing positive provider–patient relationships. Furthermore, because exchanges occur after the ‘work’ of the visit has been completed, they have the potential to construct positive relationships that extend beyond the individual visit.

scholarly journals Assessing Parent Behaviours in Parent–Child Interactions with Deaf and Hard of Hearing Infants Aged 0–3 Years: A Systematic Review

2021 ◽  
Vol 10 (15) ◽  
pp. 3345
Author(s):  
Martina Curtin ◽  
Evelien Dirks ◽  
Madeline Cruice ◽  
Rosalind Herman ◽  
Lauren Newman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Child Language ◽  
Evidence Base ◽  
Deaf Children ◽  
Clinical Tool ◽  
Coding Systems ◽  
Child Interaction ◽  
Parent Child Interaction ◽  
Parent Child

Background: Despite early identification and advancements in cochlear implant and hearing aid technology, delays in language skills in deaf children continue to exist. Good-quality parent–child interaction (PCI) is a key predictor for the successful development of deaf children’s signed and/or spoken language. Though professionals have standard assessments to monitor child language, a clinical tool to observe the quality of parental interaction is yet to be developed. Aims and methods: This systematic review with narrative synthesis aims to uncover which parent behaviours are assessed in PCI studies with deaf infants aged 0–3 years, how these behaviours are assessed, and which are correlated with higher scores in child language. Results: Sixty-one papers were included, spanning 40 years of research. Research included in the review assessed parents’ skills in gaining attention, joint engagement, emotional sensitivity, and language input. PCI was mostly assessed using coding systems and frame-by-frame video analysis. Some of the parent behaviours mentioned previously are associated with more words produced by deaf children. Conclusion: The results of the review provide the evidence base required to develop the content of a future clinical assessment tool for parent–child interaction in deafness.

Sign in / Sign up

Export Citation Format

Share Document