Patient experience of an intervention combining nurse navigators and e-Health technologies for use of oral anticancer agents.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23149-e23149
Author(s):  
Marie Ferrua ◽  
FATIMA YATIM ◽  
Aude Fourcade ◽  
Marilène Guillet Lacaze ◽  
Etienne Minvielle ◽  
...  
Keyword(s):  
Anticancer Agents ◽  
Mobile Application ◽  
Care Needs ◽  
Secure Messaging ◽  
Clinical Criteria ◽  
Health Technologies ◽  
Human Contact ◽  
Patients Experience ◽  
The Impact ◽  
Oral Anticancer Agents

e23149 Background: An intervention (named CAPRI) combining Nurse Navigators (NN) and a mobile application dedicated to patients treated with oral anticancer agents was implemented in 2016 at Gustave Roussy (Villejuif, France). NN provide regular telephone follow-ups to manage patients' symptoms and assess toxicities, adherence to treatment and supportive care needs. Patients can have access to a mobile application to record tracking data, contact NN via secure messaging, view therapy and side effect information or store documents. Methods: A questionnaire was addressed to patients after using for 5 months the CAPRI intervention in order to assess their experience with the device. In parallel, interviews were conducted with patients. To determine patient utilization of the mobile application, data were extracted over a 24-month period. Results: 148 patients completed the evaluation (response rate = 81%). 15 interviews were conducted. Patients' experience with CAPRI intervention is very positive: The open-ended comments on the questionnaires and interviews with patients highlighted the importance of listening, having a contact person who is easily reachable, available and empathetic. 83% of patients preferred contacting NN by phone rather than through the mobile application. Only 50% (n = 74) of patients reported having tried to connect to the mobile application and 38% reported monitoring data at least once. Conclusions: Patients' experience is highly positive about the intervention. However, the application is poorly used, patients seems to prefer human contact. In perspective, results from the randomized trial currently conducted will evaluate the impact of the intervention on clinical criteria.[Table: see text]

Intervention combining nurse navigators (NNs) and a mobile application versus standard of care (SOC) in cancer patients (pts) treated with oral anticancer agents (OAA): Results of CapRI, a single-center, randomized phase III trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 2000-2000 ◽  
Author(s):  
Olivier Mir ◽  
Marie Ferrua ◽  
Aude Fourcade ◽  
Delphine Mathivon ◽  
Adeline Duflot-Boukobza ◽  
...  
Keyword(s):  
Anticancer Agents ◽  
Mobile Application ◽  
Life Support ◽  
Dose Intensity ◽  
Phase Iii ◽  
Cancer Center ◽  
Care Needs ◽  
Health Technologies ◽  
Grade 3

2000 Background: Various interventions aiming to improve a safe use of oral anti-cancer agents have previously been reported. These retrospective studies involved nurse-led follow-up and use of health technologies. However, the potential impact of these combined strategies is limited by a lack of rigorous methodology. Methods: We performed a randomized phase 3 trial comparing an intervention combining NNs and a mobile application vs. SOC in cancer pts treated with OAA (excluding hormonal therapy) in our tertiary cancer center. Pts initiating OAA (all types of cancer, PS < 3, life expectancy > 6 months), were randomized in a 1:1 basis. The intervention combined a nursing-led follow-up and a mobile application for patients. NNs provided regular phone follow-ups to manage symptoms and assess toxicities, adherence and supportive care needs. Pts had access to a mobile application to record tracking data, contact NNs via secure messaging or a dedicated phone line. The intervention lasted 6 months. The primary endpoint was the Relative Dose Intensity (RDI). Secondary endpoints included adherence, toxicity, response and survival, quality of life, pts experience (PACIC Score), end-of-life support, and economic estimation of the use of healthcare resources. Results: From October 2016 to May 2019, 609 pts (median age: 62 years, 20-92; PS2: 11.8%) were included. 39% were receiving oral chemotherapy, and 61% other OAA. The RDI was significantly higher in the CAPRI arm (93.4% ±0.26 vs. 89.4% ±0.19, p = 0.04). The CAPRI intervention also improved PACIC scores (mean: 2.94±0.83 vs. 2.67±0.89, p = 0.01), the number of unplanned hospitalizations (15.1% vs. 22.0%, p = 0.04), hospitalization duration (mean: 2.82±6.96 days vs. 4.44±9.60, p = 0.02), and treatment-related grade≥3 toxicities (27.6% vs. 36.9%, p = 0.02). Conclusions: Compared to SOC, the CAPRI intervention improved RDI, pts experience, hospitalizations and their duration, as well as the rate of treatment-related grade≥3 toxicities. This type of intervention should represent a new standard in pts receiving OAA. Clinical trial information: NCT02828462.

TECHNOLOGIES FOR HEALTH EDUCATION IN THE CARE OF PATIENTS WITH URINARY INCONTINENCE: AN INTEGRATIVE REVIEW

2021 ◽  
Author(s):  
Francisca das Chagas Sheyla Almeida Gomes Braga ◽  
Andrea Pinto da Costa ◽  
Nisleide Vanessa Pereira das Neves ◽  
Grazielle Roberta Freitas da Silva ◽  
Ana Roberta Vilarouca da Silva ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Health Education ◽  
Mobile Application ◽  
Web Of Science ◽  
Integrative Review ◽  
National Library ◽  
Exclusion Criteria ◽  
Health Technologies ◽  
The Individual ◽  
The Impact

Objective: analyze the technologies available in the literature used for health education in the care of people with urinary incontinence. Methods: integrative review, with database searches: Índice Bibliográfico Espanhol de Ciências da Saúde (IBECS), Base de Dados em Enfermagem (BDENF) via Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online via Pubmed (MEDLINE/PubMed) from the National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science and Embase. The collection was carried out in February 2021, with the main descriptors: Urinary Incontinence, Educational Technology and Health Education. Results: 91 articles were selected, after analyzing the inclusion and exclusion criteria, there were only 5 productions that were selected, presenting as a strategy the technologies: multimedia course, videos, mobile application and book/booklet. The articles were published between 1997 and 2020. The dimensions considered were: development of health technologies for the treatment of urinary incontinence and knowledge, adherence and the effect of using health technologies for the treatment of urinary incontinence. Conclusion: the technologies used were diversified, with the adherence and the effect being directly proportional, and it depends on how the individual understands urinary incontinence and the impact it brings on each person’s life.

scholarly journals Delivering an efficient and effective support group for patients with implantable cardioverter-defibrillators (ICDs): patient perspectives of key concerns and predictors of inclination to attend

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathryn Murray ◽  
Kelly Buttigieg ◽  
Michelle Todd ◽  
Vicky McKechnie
Keyword(s):  
Support Groups ◽  
Support Group ◽  
Qualitative Data ◽  
Implantable Cardioverter Defibrillators ◽  
Cardioverter Defibrillator ◽  
And Coping ◽  
Patients Experience ◽  
The Impact ◽  
Cardioverter Defibrillators ◽  
Patient Concerns

Abstract Background A subset of patients experience psychological distress following insertion of an implantable cardioverter-defibrillator (ICD) and ICD support groups are recommended, however access to these groups is limited. This study aimed: to gauge a better understanding of patients’ key ICD-related concerns; to determine patient interest in a support group and topics deemed helpful to address in a support group; and to examine factors which affect patient inclination to attend. Methods One hundred and thirty nine patients completed the ICD Patient Concerns Questionnaire – Brief (ICDC-B) and a semi-structured survey. Non-parametric tests were used to examine associations and differences in the quantitative data. Qualitative data were analysed using thematic analysis. Results 42% of respondents said they would attend a support group and inclination to attend was associated with higher ICD concerns and a shorter time since implant. Topics considered important to address in a group were information about heart conditions and devices, the impact of an ICD on daily life and coping with fear of shocks. Conclusion We concluded that there is interest in further support amongst many patients and that ICD support groups may be delivered efficiently by targeting patients who have higher levels of ICD concerns and within the first few years after implant.

scholarly journals Impact of Roommates on MDRO Spread in Nursing Homes

2020 ◽  
Vol 41 (S1) ◽  
pp. s66-s67
Author(s):  
Gabrielle M. Gussin ◽  
Ken Kleinman ◽  
Raveena D. Singh ◽  
Raheeb Saavedra ◽  
Lauren Heim ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Healthcare Intervention ◽  
Odds Ratios ◽  
Care Needs ◽  
Environmental Cleaning ◽  
The Impact

Background: Addressing the high burden of multidrug-resistant organisms (MDROs) in nursing homes is a public health priority. High interfacility transmission may be attributed to inadequate infection prevention practices, shared living spaces, and frequent care needs. We assessed the contribution of roommates to the likelihood of MDRO carriage in nursing homes. Methods: We performed a secondary analysis of the SHIELD OC (Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, CA) Project, a CDC-funded regional decolonization intervention to reduce MDROs among 38 regional facilities (18 nursing homes, 3 long-term acute-care hospitals, and 17 hospitals). Decolonization in participating nursing homes involved routine chlorhexidine bathing plus nasal iodophor (Monday through Friday, twice daily every other week) from April 2017 through July 2019. MDRO point-prevalence assessments involving all residents at 16 nursing homes conducted at the end of the intervention period were used to determine whether having a roommate was associated with MDRO carriage. Nares, bilateral axilla/groin, and perirectal swabs were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). Generalized linear mixed models assessed the impact of maximum room occupancy on MDRO prevalence when clustering by room and hallway, and adjusting for the following factors: nursing home facility, age, gender, length-of-stay at time of swabbing, bedbound status, known MDRO history, and presence of urinary or gastrointestinal devices. CRE models were not run due to low counts. Results: During the intervention phase, 1,451 residents were sampled across 16 nursing homes. Overall MDRO prevalence was 49%. In multivariable models, we detected a significant increasing association of maximum room occupants and MDRO carriage for MRSA but not other MDROs. For MRSA, the adjusted odds ratios for quadruple-, triple-, and double-occupancy rooms were 3.5, 3.6, and 2.8, respectively, compared to residents in single rooms (P = .013). For VRE, these adjusted odds ratios were 0.3, 0.3, and 0.4, respectively, compared to residents in single rooms (P = NS). For ESBL, the adjusted odds ratios were 0.9, 1.1, and 1.5, respectively, compared to residents in single rooms (P = nonsignificant). Conclusions: Nursing home residents in shared rooms were more likely to harbor MRSA, suggesting MRSA transmission between roommates. Although decolonization was previously shown to reduce MDRO prevalence by 22% in SHIELD nursing homes, this strategy did not appear to prevent all MRSA transmission between roommates. Additional efforts involving high adherence hand hygiene, environmental cleaning, and judicious use of contact precautions are likely needed to reduce transmission between roommates in nursing homes.Funding: NoneDisclosures: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

scholarly journals Student-Led Fall Prevention Care Management Reduced Fall Risks at Assisted Living Facilities

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 238-238
Author(s):  
Hiroko Kiyoshi-Teo ◽  
Claire McKinley-Yoder ◽  
Erin Lemon ◽  
Olivia Ochoa
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Fall Prevention ◽  
Fall Risk ◽  
Care Management ◽  
Assisted Living Facilities ◽  
Care Needs ◽  
Term Care ◽  
Fall Risks ◽  
The Impact

Abstract Older adults in residential care settings are four times more likely than those not living in care facilities to experience falls. Yet, fall prevention efforts at long-term care settings are under-resourced, under-regulated, and under-studied. To address this gap, we developed and studied the impact of a specialty clinical, Fall Prevention Care Management (FPCM), for nursing students to decrease older adults’ fall risks. We enrolled assisted living residents that facility liaison identified as being high fall risk (fall rates or fall risk were not tracked at the study sites) and MOCA ≥15, in 2 assisted living facilities in Northwest USA. Participants received weekly, 1-hour, individual, semi-structured, Motivational Interviewing-based care management visits by same students over 6 visits. Changes in fall risks were measured by the CDC STEADI assessment (unsteadiness & worry), Falls Self-Efficacy Scale International-Short (FESI-S), and Falls Behavioral Scale (FAB). Twenty-five residents completed the study. Students addressed the following (multiple responses possible): emotional needs (n=23), improved motivation to prevent falls (n=21), and individualized education/coaching (i.e., exercise, mobility aids) (n=10-17). FESI-S score improved from 16.0 to 14.4 (p=.001; decreased fear. FAB score improved from 2.94 to 3.10 (p=.05; more frequent fall prevention behaviors). Frequency of those who felt steady while standing or walking increased (24% to 40%, p=.07) and those who did not worry about falling increased (20% to 36%, p=.08). FPCM clinical offered valuable opportunity to address unmet care needs of older adults to reduce fall risks.

scholarly journals Real-World Utilization of Oral Anticancer Agents Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States

Kidney Cancer ◽  
2021 ◽  
pp. 1-13
Author(s):  
Lauren E. Wilson ◽  
Lisa Spees ◽  
Jessica Pritchard ◽  
Melissa A. Greiner ◽  
Charles D. Scales ◽  
...  
Keyword(s):  
United States ◽  
Anticancer Agents ◽  
Patient Characteristics ◽  
The United States ◽  
Socioeconomic Indicators ◽  
Economic Implications ◽  
Southern Us ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Oral Anticancer Agents

Background: Substantial racial and socioeconomic disparities in metastatic RCC (mRCC) have persisted following the introduction of targeted oral anticancer agents (OAAs). The relationship between patient characteristics and OAA access and costs that may underlie persistent disparities in mRCC outcomes have not been examined in a nationally representative patient population. Methods: Retrospective SEER-Medicare analysis of patients diagnosed with mRCC between 2007–2015 over age 65 with Medicare part D prescription drug coverage. Associations between patient characteristics, OAA receipt, and associated costs were analyzed in the 12 months following mRCC diagnosis and adjusted to 2015 dollars. Results: 2,792 patients met inclusion criteria, of which 32.4%received an OAA. Most patients received sunitinib (57%) or pazopanib (28%) as their first oral therapy. Receipt of OAA did not differ by race/ethnicity or socioeconomic indicators. Patients of advanced age (>  80 years), unmarried patients, and patients residing in the Southern US were less likely to receive OAAs. The mean inflation-adjusted 30-day cost to Medicare of a patient’s first OAA prescription nearly doubled from $3864 in 2007 to $7482 in 2015, while patient out-of-pocket cost decreased from $2409 to $1477. Conclusion: Race, ethnicity, and socioeconomic status were not associated with decreased OAA receipt in patients with mRCC; however, residing in the Southern United States was, as was marital status. Surprisingly, the cost to Medicare of an initial OAA prescription nearly doubled from 2007 to 2015, while patient out-of-pocket costs decreased substantially. Shifts in OAA costs may have significant economic implications in the era of personalized medicine.

scholarly journals Increased Emergency Calls during the COVID-19 Pandemic in Saudi Arabia: A National Retrospective Study

Healthcare ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 14
Author(s):  
Ahmed Al-Wathinani ◽  
Attila J. Hertelendy ◽  
Sultana Alhurishi ◽  
Abdulmajeed Mobrad ◽  
Riyadh Alhazmi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Retrospective Study ◽  
Emergency Medical Services ◽  
Indirect Effect ◽  
Mobile Application ◽  
Healthcare Systems ◽  
Emergency Calls ◽  
The World ◽  
Staffing Patterns ◽  
The Impact

The coronavirus 2019 (COVID-19) pandemic has a direct and indirect effect on the different healthcare systems around the world. In this study, we aim to describe the impact on the utilization of emergency medical services (EMS) in Saudi Arabia during the COVID-19 pandemic. We studied cumulative data from emergency calls collected from the SRCA. Data were separated into three periods: before COVID-19 (1 January–29 February 2020), during COVID-19 (1 March–23 April 2020), and during the Holy Month of Ramadan (24 April–23 May 2020). A marked increase of cases was handled during the COVID-19 period compared to the number before pandemic. Increases in all types of cases, except for those related to trauma, occurred during COVID-19, with all regions experiencing increased call volumes during COVID-19 compared with before pandemic. Demand for EMS significantly increased throughout Saudi Arabia during the pandemic period. Use of the mobile application ASAFNY to request an ambulance almost doubled during the pandemic but remained a small fraction of total calls. Altered weekly call patterns and increased call volume during the pandemic indicated not only a need for increased staff but an alteration in staffing patterns.

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