Uptake and efficacy of using a state quitline to address tobacco use by cancer patients treated in community cancer centers.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e18530-e18530 ◽  
Author(s):  
Anna E Schulze ◽  
Karen Brown ◽  
Polly Hager ◽  
Laura Petersen ◽  
Hilary Baca ◽  
...  
2018 ◽  
Vol 14 (2) ◽  
pp. 112-124
Author(s):  
Daniel J. Kilpatrick ◽  
Kathleen B. Cartmell ◽  
Abdoulaye Diedhiou ◽  
K. Michael Cummings ◽  
Graham W. Warren ◽  
...  

Introduction: Continued smoking by cancer patients causes adverse cancer treatment outcomes, but few patients receive evidence-based smoking cessation as a standard of care.Aim: To evaluate practical strategies to promote wide-scale dissemination and implementation of evidence-based tobacco cessation services within state cancer centers.Methods: A Collaborative Learning Model (CLM) for Quality Improvement was evaluated with three community oncology practices to identify barriers and facilitate practice change to deliver evidence-based smoking cessation treatments to cancer patients using standardized assessments and referrals to statewide smoking cessation resources. Patients were enrolled and tracked through an automated data system and received follow-up cessation support post-enrollment. Monthly quantitative reports and qualitative data gathered through interviews and collaborative learning sessions were used to evaluate meaningful quality improvement changes in each cancer center.Results: Baseline practice evaluation for the CLM identified the lack of tobacco use documentation, awareness of cessation guidelines, and awareness of services for patients as common barriers. Implementation of a structured assessment and referral process demonstrated that of 1,632 newly registered cancer patients,1,581 (97%) were screened for tobacco use. Among those screened, 283 (18%) were found to be tobacco users. Of identified tobacco users, 207 (73%) were advised to quit. Referral of new patients who reported using tobacco to an evidence-based cessation program increased from 0% at baseline across all three cancer centers to 64% (range = 30%–89%) during the project period.Conclusions: Implementation of quality improvement learning collaborative models can dramatically improve delivery of guideline-based tobacco cessation treatments to cancer patients.


2012 ◽  
Vol 15 (1) ◽  
pp. 52-58 ◽  
Author(s):  
A. O. Goldstein ◽  
C. E. Ripley-Moffitt ◽  
D. E. Pathman ◽  
K. M. Patsakham
Keyword(s):  

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6041-6041
Author(s):  
J. A. Lee ◽  
M. A. Mathiason ◽  
C. A. Czeczok ◽  
J. K. Keller ◽  
R. S. Go

6041 Background: Most cancer patients are diagnosed and treated in the community but clinical trial accrual rate is low. Published data on trial accrual from community-based cancer centers throughout the U.S. are limited. The Association of Community Cancer Centers (ACCC) is a national multidisciplinary education and advocacy organization that maintains a membership caring for over 60% of all patients with cancer in the U.S. In order to determine the clinical trial accrual patterns in the community across various geographic regions in the U.S., we performed a retrospective study utilizing the data from ACCC membership maintained at their web site. Methods: Data available from the most recent year (2003–2005) were obtained from 621 centers throughout the U.S., representing 49 states (no data for WY) and the DC. We investigated the number of patients (new and old) accrued into trials per year relative to the number of new analytical patients seen in the same year, a value we termed accrual ratio (AR). In addition, we studied the effects of geographic location, size of the cancer program, number of affiliations with National Cancer Institute sponsored cancer cooperative groups, and the number of medical/support/data management staffs on trial accrual. Results: A total of 670,215 new patients were seen across the ACCC membership with 43,743 patients accrued into trials for a median AR of 6.5% (range, 0.3–16.9). The top and bottom 5 accruing states were VT, MD, SD, LA, ID and KS, ND, VA, NH, AR, respectively. Regionally, the AR for Midwest, Middle Atlantic, West, South, Southwest, and New England were as follows: 7.4%, 7.0%, 6.2%, 6.0%, 5.7%, and 5.4% (p < 0.001). One hundred (16.1%) centers representing 11.8% of all new patients were not affiliated with any of the cooperative groups. This group had the lowest AR (3.1%). AR increased when centers were affiliated with more cooperative groups (p < 0.001) or cared for more new patients (p < 0.001). The number of medical, support, and data management staffs did not influence accrual. Conclusions: Overall, clinical trial accrual in the U.S. community cancer centers is low. Accrual patterns differed significantly among various geographic locations. Better access to trials is needed in order to improve participation of cancer patients. No significant financial relationships to disclose.


2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 74-74
Author(s):  
Jane Alcyne Severson ◽  
Hilary Baca ◽  
Douglas W. Blayney ◽  
Karen Brown ◽  
Grayce Galiyas ◽  
...  

74 Background: Tobacco use by cancer patients decreases the effectiveness of cancer treatment, increases treatment toxicity, increases the risk of developing a second primary cancer, and increases mortality. Stopping tobacco use may reduce many of these adverse effects in cancer patients. Methods: The Michigan Oncology Quality Consortium (MOQC) collaborated with the Michigan Cancer Consortium (MCC) to implement the Tobacco Cessation Demonstration Project. This entailed designing a standard workflow and other lean tools to assist oncology practices in referring all cancer patients who use tobacco to the free Michigan Tobacco QuitLine or other cessation services. 19 practices participated in three learning sessions during which the following were provided: education by subject matter experts, use of data management and lean tools, and the sharing of barriers and successes. Results: Examination of baseline MOQC Quality Oncology Practice Initiative (QOPI) data demonstrated that < 47% of patients who use tobacco were advised to quit or referred for tobacco cessation (n = 574 charts/44 sites), which was equivalent to the national QOPI mean in Fall 2012. Root cause analysis of this lack of action in tobacco cessation identified limited knowledge to the risks of continued smoking and the lack of available resources as barriers to adopting necessary change. Implementation of the MOQC/MCC Tobacco Cessation Demonstration Project increased total statewide referrals to the QuitLine by 30.9% over the first 2 months with an increasing proportion of patients (41%) being cancer patients referred by MOQC participating sites. Conclusions: Supplying scientific evidence, collaboration, and the use of lean tools improved the referral rate to a tobacco cessation program for oncology patients. [Table: see text]


2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 65-65
Author(s):  
Rony Dev ◽  
Yu Jung Kim ◽  
Akhila Sunkepally Reddy ◽  
David Hui ◽  
Kimberson Cochien Tanco ◽  
...  

65 Background: Cancer patients who smoke have been reported to have higher pain expression and increased risk for opioid abuse. The purpose of our study is to evaluate the association between tobacco use, symptom expression, and maladaptive coping in advanced cancer patients. Methods: We prospectively enrolled advanced cancer patients evaluated in an outpatient Supportive Care Center and collected data on patient demographics, cancer diagnosis, morphine equivalent daily dose (MEDD), cigarette smoking status using Behavioral Risk Factor Surveillance System, symptom expression as measured by Edmonton Symptom Assessment Scale, Cut down/Annoyed/Guilty/Eye opener (CAGE alcoholism questionnaire), short form Screener and Opioid Assessment for Patients with Pain (SOAP-SF) survey, and Brief COPE Questionnaire. Results: Among399 patients, 195 (49%) were never smokers, 158 (40%) former smokers, and 46 (11%) current smokers. The most common malignancies were gastrointestinal (21.1%) and breast (19.5%). Never smokers were more likely to be female (p = 0.005). Current smokers expressed significantly higher pain scores at consultation than former or never smokers [median 7 vs. 6 vs. 5, respectively (p = 0.015)], increased MEDD (median 90 vs. 60 vs. 50, p = 0.002), and more likely to screen CAGE positive (33% vs. 24% vs. 8.7%, p < 0.0001). Compared with former and never smokers, current smokers were significantly more likely to cope with substance use (p = 0.02), denial (p = 0.007), and self-blame (< 0.0001), while both current and former smokers significantly more likely to use venting (p = 0.04). In addition, current smokers compared with former and never smokers were significantly more likely screen positive (≥ 4) on the SOAP-SF survey (74% vs. 13% vs. 9.3%, p = < 0.0001) and clinicians rated patients to be at higher risk for maladaptive coping (6.5% vs 2.5% vs. 1.5%, p = 0.003). Conclusions: In advanced cancer, current and former smokers were significantly more likely to have higher pain expression, CAGE positivity, and increased MEDD at consultation. In addition, a history of current or past tobacco use in advanced cancer patients was associated with increased risk of maladaptive coping.


2003 ◽  
Vol 31 (04) ◽  
pp. 649-658 ◽  
Author(s):  
Abu S.M. Abdullah ◽  
Yvonne Lau ◽  
Louis W.C. Chow

The study examined the pattern of and factors associated with use of alternative medicine (AM) among Chinese breast cancer patients. An analytical, cross-sectional survey of 352 breast cancer patients from two breast cancer centers was conducted in 1997. Amongst the respondents, the usage rate of alternative medicine was 27.8%. Factors forming the use of AM included being young to middle-aged, having higher education and a belief that AM would enhance orthodox treatment. A substantial proportion of Chinese breast cancer patients use AM besides conventional medicine. There is a need to integrate AM with conventional medicine to improve the service provision for cancer patients.


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