Patient utilization of supportive care services identified through the Athena Breast Health Questionnaire System.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 226-226 ◽  
Author(s):  
Emily Claire Wong ◽  
Celia Kaplan ◽  
Dianne Shumay ◽  
Yan Leykin ◽  
Laura Van't Veer ◽  
...  
Keyword(s):  
Genetic Counseling ◽  
Supportive Care ◽  
Care Center ◽  
Lifestyle Changes ◽  
Supportive Care Needs ◽  
Breast Health ◽  
Health Questionnaire ◽  
Care Needs ◽  
Care Services ◽  
Patient Reported

226 Background: Psychological wellbeing and lifestyle changes are important factors in long-term health of cancer survivors. As part of the Athena Breast Health Network, the UCSF Breast Care Center (BCC) incorporated an electronic health questionnaire system (HQS) that collects patient-reported data on physical and psychological symptoms, medical conditions, family history, and lifestyle to identify patients’ supportive care needs. Methods: Through a semi-automated process, patients whose HQS responses meet pre-established thresholds are referred to Psycho-Oncology, social work, genetic counseling, and Onco-Fertility. Referrals generated within the HQS are signed and routed by clinicians at the time of a BCC visit. When patients decline appointments with these services, staff members document reasons within the electronic medical record (EMR). A retrospective chart review identified patients who did not receive supportive care services to which they were referred and a qualitative analysis was performed. Results: From 7/1/14-12/31/14, 525 patients completed an HQS and agreed to have their data used for research. The table summarizes referral information. 45 patients referred to Psycho-Oncology did not complete an appointment. Of these, ten did not respond to phone contact to schedule visits. 35 were reached, but declined an appointment. 25 (71.4%) were not ready to make an appointment; 5 (14.3%) cited distance as a primary barrier; 3 (8.6%) were satisfied with the psychological services they were receiving elsewhere; and 2 (5.7%) did not have insurance coverage. Reasons women disregarded referrals for genetic counseling and fertility are being evaluated. Conclusions: HQS can assist in identifying patient supportive care needs, but despite automation of referrals, many patients do not follow through to use supportive care and clinical resources. Timing and resource accessibility may be key. Through analysis of reasons for non-utilization, we hope to better tailor the delivery of supportive care services, when indicated, to better serve patient needs. [Table: see text]

Understanding the supportive care needs of early-phase cancer clinical trial (CT) participants.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 26-26
Author(s):  
Debra Lundquist ◽  
Dejan Juric ◽  
Rachel Jimenez ◽  
Virginia Capasso ◽  
Casandra McIntyre ◽  
...  
Keyword(s):  
Supportive Care ◽  
Early Phase ◽  
Poor Prognosis ◽  
Phase 1 ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Targeted Interventions ◽  
Care Services ◽  
Patient Reported ◽  
Prognosis Score

26 Background: Early phase CTs investigate novel therapeutic approaches for patients with cancer, but little is known about the use of supportive care services among participants in early phase CTs. Methods: We conducted a retrospective chart review of consecutive patients enrolled in Phase 1 CTs from 2017-2019, capturing sociodemographics, clinical data, and use of supportive care services from the electronic health record. We calculated the Royal Marsden Hospital (RMH) prognostic score using data at the time of CT trial enrollment based on patients’ lactate dehydrogenase, albumin, and number of sites of metastasis. The RMH score ranges from 0-3, with scores of 2+ indicating a poor prognosis. We explored differences in patient characteristics, supportive care use, and clinical outcomes based on the RMH prognosis score. Results: Among 426 patients treated on Phase 1 CTs during the study period, the median age was 63.0 years (range 20.5-85.2 years), and most were female (56.1%), white race (85.1%), and had metastatic cancer (97.7%). The most common cancer types were gastrointestinal (22.1%), lung (20.0%), and breast (10.6%) cancer. Under half (31.6%) had an RMH score indicating a poor prognosis. Patients with a poor prognosis score had a worse performance status (ECOG ≥1: 80.2% v 58.3%, p < .001) and more prior treatment (3+ prior lines: 49.5% v 35.0%, p = .001) compared to those without a poor prognosis score. Those with a poor prognosis score were more likely to receive palliative care before or during CT participation (40.5% v 27.1%, p = .011). We observed no significant differences in the rates of nutrition (69.1% v 64.0%), social work (62.2% v 63.8%), or physical therapy (64.5% v 61.7%) consults between those with and without a poor prognosis score. We found that those with an RMH score indicating a poor prognosis had a shorter time on trial (median: 49 vs 87 days, p < .001) and worse survival (median: 139 v 379 days, p < .001). Conclusions: Early phase CT participants represent an advanced cancer population with unique supportive care needs, and we identified a group with a particularly poor prognosis for whom earlier intervention with supportive care services may be needed. Our findings highlight the need to prospectively examine these characteristics along with patient-reported outcomes to better understand the distinct supportive care needs of this population and guide the development of targeted interventions.

Patient-reported symptom burden and supportive care needs at cancer diagnosis: a retrospective cohort study

2020 ◽  
Vol 28 (12) ◽  
pp. 5889-5899 ◽  
Author(s):  
Colleen A. Cuthbert ◽  
Devon J. Boyne ◽  
Xu Yuan ◽  
Brenda R. Hemmelgarn ◽  
Winson Y. Cheung
Keyword(s):  
Cohort Study ◽  
Supportive Care ◽  
Cancer Diagnosis ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Symptom Burden ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Patient Reported

Using a patient-reported outcomes tool as a gateway to identifying patients who would benefit from palliative care.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 306-306
Author(s):  
Kathleen Dunn ◽  
Morgan Hannaford ◽  
Scott Hartman ◽  
Diane Denny, DBA
Keyword(s):  
Palliative Care ◽  
Supportive Care ◽  
Assessment Tool ◽  
Disease Stage ◽  
Care Needs ◽  
National Network ◽  
Care Services ◽  
Wide Range ◽  
Patient Reported ◽  
Self Assessments

306 Background: Palliative care provides a wide range of supportive care services that aim to enhance the patient’s quality of life, reduce complications, address supportive care needs earlier, and avoid unnecessary resource consumption. A national network of five hospitals providing comprehensive cancer care noted barriers in identification of patients that may benefit from these services. Technology and objective criteria can circumvent human barriers such as, prognostic uncertainty and psychology of decision making. Referred to as the SIT (symptom inventory tool) process, an externally validated assessment tool that captures patients’ perceived symptom burden from baseline and every 21 days was used as means of identifying patients who might benefit from referral. Methods: A three-month pilot was initiated at two centers using a report run on a weekly basis, generated from the SIT process utilizing the following criteria: six or > symptoms from 27 increasing in severity by two points or > since their last assessment. This subset of patients identified by this filter was reviewed by the palliative care nurse to determine if they meet the following criteria: any stage with metastatic disease, stage 3 not in remission, and stage 4 not already enrolled in palliative care. Results: During the pilot timeframe, 1,127 SIT self-assessments were completed by patients at Site 1 with 168 patients flagged for review by the palliative care RN. Of these 168 patients 75 (or 44.6%) met the criteria for palliative care services. At Site 2, 802 self-assessments were completed, with 82 identified for review of which 46 (or 56.1%) met the criteria. Conclusions: Patients with overwhelming symptoms were identified for intervention that might otherwise have been missed by relying solely on referral. This patient population resulted in a request for practice integration across centers recognizing the clinical and financial benefits outlined below. [Table: see text]

scholarly journals Integration of Health Questionnaire Systems to Facilitate Supportive Care Services for Patients at an Academic Breast Care Center

2018 ◽  
pp. 1-13 ◽  
Author(s):  
Emily C. Wong ◽  
Celia P. Kaplan ◽  
Nickolas Dreher ◽  
Jimmy Hwang ◽  
Laura van’t Veer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Supportive Care ◽  
San Francisco ◽  
Care Center ◽  
University Of California ◽  
Care Needs ◽  
Care Services ◽  
Breast Care ◽  
The University ◽  
To Receive

Purpose This study evaluated the use of an electronic Health Questionnaire System (HQS) within the University of California San Francisco Breast Care Center as a screening and triage tool to proactively recognize patients’ supportive care needs during new patient consultations and identify demographic characteristics associated with referrals to three supportive care services. Patients and Methods A total of 428 patients with and without breast cancer between the ages of 18 and 84 years completed HQS intake forms before appointments at the University of California San Francisco Breast Care Center between November 2014 and May 2015 and agreed to participate in this study. Patient HQS responses triggered referrals to supportive care services, and a review of electronic health records was conducted to determine the outcomes of these referrals. Results A total of 242 patients (56.5%) met criteria for at least one supportive care referral. Women with invasive breast cancer or ductal carcinoma in situ met criteria for supportive services more frequently than women without breast cancer diagnoses (76.9% v 23.8%; P < .001) and were most likely to receive referrals for genetic counseling (67.0%), psychological services (32.2%), and social services (12.1%). Multivariable logistic regression analysis showed that being married was associated with fewer referrals to social work (OR, 0.42; 95% CI, 0.21 to 0.81) and that those between 45 and 54 years of age were less likely to receive referrals to genetic counseling than those ≥ 55 years of age (OR, 0.41; 95% CI, 0.23 to 0.73). Among all referrals (n = 369), 26.8% resulted in completed appointments. Conclusion Using an automated intake form is an efficient way to identify and triage individuals in need of supportive care services and can provide insight into the populations with supportive care needs for targeted outreach.

scholarly journals Healthcare Providers’ Perspectives of the Supportive Care Needs of Women with Advanced Breast Cancer in Ghana

2021 ◽  
Author(s):  
Cynthia Pomaa Akuoko ◽  
Shirley Chambers ◽  
Patsy Yates
Keyword(s):  
Breast Cancer ◽  
Supportive Care ◽  
Advanced Breast Cancer ◽  
Healthcare Providers ◽  
Advanced Breast ◽  
Supportive Care Needs ◽  
Multidisciplinary Teams ◽  
Care Needs ◽  
Key Informants ◽  
Care Services

Abstract PurposeThe study sought to understand the supportive care needs of women with advanced breast cancer (ABC) from the perspectives of healthcare professionals (HCPs) and key informants of charitable/non-governmental organisations (NGOs), that provide supportive care services to women with advanced breast cancer, in Ghana.MethodsA qualitative descriptive approach was employed via one-to-one semi-structured interviews with 13 HCPs and key informants of charitable/NGOs in Ghana that provide supportive care services to women with advanced breast cancer. The study was underpinned by Bradshaw’s taxonomy of social needs and Fitch’s supportive care framework. The data were analysed using a deductive content analysis approach.ResultsHealthcare providers and key informants perceived that women with ABC in Ghana have numerous and complex supportive care needs in key areas that align with Fitch’s supportive care framework, including informational, psychological, emotional, physical, practical, social, sexuality and spiritual needs.ConclusionParticipants perceived that women who have ABC in Ghana require ongoing information about their condition, treatments and related effects, as well as spiritual support and guidance particularly due to the fatalistic beliefs they often associate with the condition. Tailored supportive care interventions and services, which address the unique sociocultural circumstances for this cohort, are required. Additional research is needed to explore how multidisciplinary teams can work collaboratively to provide comprehensive support to women in addressing their needs.

Differences among Asian/Asian American, and Caucasian breast and gynecologic cancer patient-reported survivorship needs, symptoms, and illness mindsets (N=220).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11620-11620
Author(s):  
Lidia Schapira ◽  
Elisa Hofmeister ◽  
Allison W. Kurian ◽  
Sean Zion ◽  
Hanyang Shen ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Asian American ◽  
Physical Symptoms ◽  
Supportive Care Needs ◽  
Depression Symptoms ◽  
Care Needs ◽  
Gynecologic Cancers ◽  
Patient Reported ◽  
Caucasian Patients

11620 Background: Cancer experiences are mediated by host and disease factors and affected by social and cultural determinants of health. We sought to characterize perceived supportive care needs and domains of psychosocial functioning among a diverse group of women attending routine appointments for treatment or follow-up of breast and gynecologic cancers. Methods: From July 2018 until January 2019, all patients seen at the Stanford Women’s Cancers Program (serving women treated for breast and gynecologic cancers) were approached to participate. 220 cancer patients (78% breast and 22% gynecologic), mean age 54 (SD = 12) completed an online survey on their supportive care needs assessment (The Short-form Supportive Care Needs Survey Questionnaire) which contains physical, social, information, sexual and psychological scales, anxiety and depression (Patient Health Questionnaire-4) and mindsets about illness and the body mindset (Brief Illness Mindset Inventory). Only 14% of patients refused to take part in the survey. Results: T-test showed that Asian/Asian-American cancer patients (n = 57, 26%) reported fewer needs related to coping with physical symptoms, side effects of treatment and performing usual tasks and activities compared to Caucasian patients (n = 137, 62%), p = .038. Moreover, Asian/Asian-American cancer patients reported fewer depression symptoms (p = .049). Chi-square analyses showed that Asian/Asian-American patients reported less use of psychotherapy over their lifetimes (24.6% vs. 54.0%, p < .001), but significantly higher utilization of Chinese Medicine for cancer symptom management (24.6% vs. 5.8%; p < . 001) compared to the Caucasian patients. T-tests showed that Asian/Asian American patients reported significantly greater agreement with the mindsets that ‘cancer is a catastrophe’ (p = .006) and that their ‘body is an adversary’ (p = .047). Conclusions: In this population of breast and gynecologic patients and survivors we found differences in cancer mindsets, coping and use of mental health and complementary therapies between Asian and Asian-American and Caucasian women. Further analysis to understand the cultural differences are ongoing.

Patient-Reported Outcome Measures for the Identification of Supportive Care Needs in People With Lung Cancer

2013 ◽  
Vol 36 (4) ◽  
pp. E1-E17 ◽  
Author(s):  
Roma Maguire ◽  
Grigorios Kotronoulas ◽  
Constantina Papadopoulou ◽  
Mhairi F. Simpson ◽  
John McPhelim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Supportive Care ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Supportive Care Needs ◽  
Care Needs ◽  
Patient Reported

scholarly journals Supportive Care Needs following Cancer Treatment: A Comparison of Breast and Brain Cancer in an Australian Cohort

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Bhasker Amatya ◽  
Fary Khan ◽  
Louisa Ng ◽  
Mary Galea
Keyword(s):  
Supportive Care ◽  
Unmet Needs ◽  
Supportive Care Needs ◽  
Psychological Morbidity ◽  
Definitive Treatment ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Reported ◽  
The Impact

Objective. To assess and identify patient-reported supportive care needs following definitive treatment in persons with breast cancer (BC) and primary brain tumours (gliomas) (BT) in an Australian community cohort and to assess the commonalities and/or discrepancies of the reported needs in these oncological populations. Methods. A prospective cross-sectional survey of persons with BC (n=85) and BT (n=106) using questionnaires for supportive care needs, psychological morbidity, and quality of life. Results. BT participants were younger than BC patients (mean ages 51 and 57 years). The median time since diagnosis for both groups was over 2 years. The level of psychological morbidity, mainly depression, was high in both groups: BC (22%) and BT (20%). Participants in both groups reported at least one need (“met” or “unmet”). The BC patients reported higher numbers of “needs” and “unmet” needs compared with BT patients (mean 13.7 versus 11.6 needs; “unmet” needs mean 6.0 versus 4.1). The common “met” and “unmet” needs highlighted by both groups were comparable; the domain for most “met” needs included comprehensive cancer care, while “unmet” needs related to existential survivorship issues. Conclusion. Despite successful treatment many cancer survivors experience unmet supportive care needs in longer term. Understanding the impact of these beyond the acute phase is important as care shifts to community settings. More research in existential survivorship issues is needed.

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