Initial experience with an innovative pilot program evaluating a multidisciplinary approach to supportive care planning in a survivorship clinic setting.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 242-242
Author(s):  
Lisa M. Radice ◽  
Jeffrey Eagan ◽  
Kathleen Y. Michie ◽  
Marianne Pearson ◽  
Joshua H. Petit
Keyword(s):  
Cancer Therapy ◽  
Supportive Care ◽  
Rehabilitation Services ◽  
Pilot Program ◽  
Care Planning ◽  
Optimal Care ◽  
Curative Intent ◽  
Patient Reported ◽  
Survivorship Care Planning ◽  
Specific Care

242 Background: The supportive care and rehabilitative needs of cancer patients are highly varied and complex, and optimal care planning often requires the provision and coordination of multiple modalities. To address these needs, an innovative model for multi-disciplinary evaluation and management within a survivorship clinic was piloted. Methods: Between November 2013 and May 2014, 50 patients who had completed cancer therapy with curative intent were seen in a multi-disciplinary survivorship clinic (MDSC) sequentially by an advanced practice practitioner (nurse practitioner or physician assistant), oncology social worker, and oncology rehabilitation therapist. Data regarding specific care planning resulting from this encounter, compliance with recommended therapies, and patient-reported satisfaction were collected. These data were compared against the remaining cohort of patients (N = 402) who completed curative intent cancer therapy in our cancer program during the same period. Results: Rate of referral for rehabilitation services (83.3% vs 13.9%, p < 0.01) and compliance with recommended therapy visits (85.7% vs 44.6%, p < 0.01) were significantly increased among patients seen within the MDSC pilot when compared with similar patients who were not seen in this setting. The number of referred therapy modalities was also increased among patients seen in the MDSC pilot, median 2 (range 1-3 modalities) vs 1 (range 1-2 modalities), respectively. Of patients who completed an assessment following the multi-disciplinary visit, 86% scored their overall experience as excellent which was the highest possible score. Conclusions: Patients seen within an innovative pilot program of multi-disciplinary survivorship care planning appreciated increased rates of referral for rehabilitation services, were referred for a greater number of therapy modalities, and were more compliant with recommended interventions than similar patients who were not seen in this setting. This patient cohort also reported high rates of satisfaction with the pilot program.

Supportive care plans: Harnessing technology and patient-reported outcomes to drive quality care across the cancer continuum.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 167-167
Author(s):  
Jeannine Brant ◽  
Carrie Tompkins Stricker ◽  
Paul B. Jacobsen
Keyword(s):  
Supportive Care ◽  
Quality Care ◽  
Planning System ◽  
Care Plan ◽  
Current Evidence ◽  
Comprehensive Cancer Center ◽  
Care Planning ◽  
Care Plans ◽  
Patient Reported ◽  
Post Test

167 Background: Cancer care is increasingly complex. Clinicians lack time to stay current on evolving evidence and resources to implement quality standards. Health information technology solutions have proliferated, including electronic patient-reported outcome (ePRO) and care pathway technologies, but adoption has been slow. The goal of this study is to explore feasibility, usability, and acceptability of incorporating a novel supportive care planning technology into clinic workflow. The On Q Care Planning System (CPS) collects ePRO and clinical data to generate a personalized supportive care plan aligned with quality care standards and current evidence. Plans promote self-management and patient-provider communication. Methods: Prospective, multi-center pilot study at 2 NCI-affiliated centers (a comprehensive community cancer program [NCCCP] in the Western U.S., and a NCI-designated comprehensive cancer center [NCCC] in the Southeastern U.S.). 100 patients and their providers will participate; 50 women with gynecological cancers on chemotherapy; 50 women post-active treatment for breast cancer. Patients complete an ePRO assessment and are given an electronically generated, personalized supportive care plan by their providers during office visit(s) over a 3-month period. Study outcomes evaluated at baseline and 6 weeks include feasibility/usability of the platform (patient/provider, post-test only; surveys/platform statistics), patient satisfaction with care (pre/post-test; CG-CAHPS), and adherence to care plan recommendations (post-test survey). Results: To date, 10 patients have enrolled at the NCCCP and 7 completed baseline and 6 week measures; 5 at the NCCC have completed baseline measures. Four providers each at the NCCCP and the NCCC are scheduled for post-test assessments. Updated enrollment and results will be presented at the meeting. Conclusions: The On Q CPS is a novel supportive care planning technology developed to improve care processes and patient outcomes through the delivery of personalized electronic care plans. Feasibility, usability, acceptability, satisfaction and exploratory outcome data will be presented.

scholarly journals Results of a Patient Reported Experience Measure (PREM) to measure the rare disease patients and caregivers experience: a Spanish cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mercedes Guilabert ◽  
Alba Martínez-García ◽  
Marina Sala-González ◽  
Olga Solas ◽  
José Joaquín Mira
Keyword(s):  
Rare Disease ◽  
Rare Diseases ◽  
Healthcare Services ◽  
Paediatric Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Optimal Care ◽  
Cross Sectional ◽  
Patient Reported ◽  
Mean Time

Abstract Objective To measure the experience of the person having a rare disease in order to identify objectives for optimal care in the health care received by these patients. Methods. A cross-sectional study was conducted in Spain involving patients associated with the Spanish Rare Diseases Federation [Federación Española de Enfermedades Raras] (FEDER). A modified version of the PREM IEXPAC [Instrumento para evaluar la Experiencia del Paciente Crónico] instrument was used (IEXPAC-rare-diseases). Scores ranged between 0 (worst experience) and 10 (best experience). Results A total of 261 caregivers (in the case of paediatric population) and patients with rare diseases (response rate 54.4%) replied. 232 (88.9%) were adult patients and 29 (11.1%) caregivers of minor patients. Most males, 227 (87%), with an average age of 38 (SD 13.6) years. The mean time since confirmation of diagnosis was 7.8 (SD 8.0) years. The score in this PREM was 3.5 points out to 10 (95%CI 3.2–3.8, SD 2.0). Caregivers of paediatric patients scored higher, except for coordination of social and healthcare services. Conclusions There are wide and important areas for improvement in the care of patients with rare diseases. This study involves a first assesment of the experience of patients with rare diseases in Spain.

The timing and the dose of advanced care planning in patients with resectable pancreatic cancer: Who makes the call?

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 397-397 ◽  
Author(s):  
Lyudmyla Demyan ◽  
Grace Wu ◽  
Dina Moumin ◽  
Gary B Deutsch ◽  
William Nealon ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Median Number ◽  
Ductal Adenocarcinoma ◽  
Care Planning ◽  
Theory Approach ◽  
Advanced Care Planning ◽  
Curative Intent ◽  
Convenience Sample ◽  
Potential Benefits ◽  
Preoperative Counseling

397 Background:The timing and the extent of Advanced Care Planning (ACP) in patients with pancreatic ductal adenocarcinoma (PDAC) undergoing curative-intent resection are generally dictated by the surgeon performing the operation. The aim of this study is to evaluate surgeons’ insights, perceptions, and biases regarding preoperative ACP. We hypothesize that many surgeons harbor significant reservations about extensive preoperative ACP. Methods:A qualitative investigation using 1:1 interviews with 40 open-ended questions were conducted with convenience sample. Data accrual continued until theme saturation was achieved. Grounded theory approach was used for data coding and analysis. Results:A total of 10 interviews were conducted with expert pancreatic surgeons from 6 medical centers—6 males and 4 females. The median number of years in practice was 15 (IQR 13-30) and the median number of pancreatic cancer cases performed per year was 52 (IQR 39-75). During preoperative counseling all surgeons discuss the possibility of recurrence and postoperative complications but attempt to motivate patients by emphasizing hope, optimism, and fact that surgery offers the only opportunity for cure. 90% of surgeons report no formal training in ACP. All surgeons report comfort with end of life conversations when death is imminent, but most lack experience with in-depth preoperative ACP. All surgeons emphasized that ACP should be led by a physician that both knows the patient well and understands the complexity of PDAC management. All surgeons recognized potential benefits of ACP, including delivery of goal-concordant care (60%), increased prognostic awareness (40%), and better life planning (40%). 50% report discussing in-depth ACP related to perioperative complications, but not long-term oncologic outcome. 80% of surgeons report that they actively steer away from in-depth ACP during preoperative counseling. Barriers to in-depth ACP reported by surgeons include taking away hope (70%), lack of time (50%) and concern for sending “mixed messages” (50%). Further, 50% of surgeons perceived that extensive preoperative ACP is not appropriate for patients with PDAC undergoing curative-intent resection. Most surgeons (60%) believe that ACP should occur as a process throughout the disease and in-depth discussions were more appropriate during postoperative visits (30%) and/or recurrence (60%). Conclusions:Despite recognizing potential benefits, most pancreatic surgeons report actively avoiding in-depth ACP conversations prior to curative-intent surgery. Surgeons had difficulty articulating the best time for ACP and felt that ACP should occur as a continuum throughout the course of treatment, with the depth of the discussion echoing the disease progression and patients’ readiness for such conversation. Future studies could evaluate patients’ perspective on the timing and the dose of ACP.

Sign in / Sign up

Export Citation Format

Share Document