Feasibility of pharmacist co-management for patients prescribed oral anticancer therapy for gastrointestinal cancers.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 77-77
Author(s):  
Cathy Cao ◽  
James M. Cleary ◽  
Anuj K. Patel ◽  
Matthew B. Yurgelun ◽  
Kimmie Ng ◽  
...  

77 Background: There is an increased use of oral anti-cancer therapies (OACTs) for treatment of gastrointestinal (GI) cancers. While OACTs provide convenience compared to IV agents, they carry similar risks for drug-drug interactions (DDI), toxicities, and unique challenges like adherence and drug access. Patients on OACTs have fewer touch-points with clinicians, requiring more patient ownership of treatment. Pharmacist co-management of pts has been shown to be successful in teaching and monitoring of IV therapy. We sought to assess feasibility of pharmacist co-management for pts prescribed OACTs for treatment of GI cancers. Methods: In 2019, the Dana-Farber GI Cancer Center (GCC) had an embedded pharmacist 8 hrs/week to help with co-management of pts on OACTs. The pharmacist provided (1) in-person and telephone teaching; (2) comprehensive medication reconciliation; (3) DDI review; and (4) supportive care recommendations. Patients were identified by reviewing provider schedules and through provider referrals. The initial teach visit was one-on-one with each patient before initiation, with joint visits with providers thereafter for monitoring and adherence checks. Data were collected to quantify the types of support/recommendation provided by pharmacist and the impact on clinical workflow. Results: After 4 months in the GCC clinic, the pharmacist has co-managed 26 new pts, 61% seen in-person. In initial visits, the pharmacist identified 3 DDI, updated 15 medication lists, and assisted 11 pts/or providers with drug access and drug information. The pharmacist saw 10 of 26 pts for follow up, totaling 21 encounters. The pharmacist assisted in 17 of the 21 encounters with drug access and drug information. Pharmacist spent 20 min/pt on teaching. For follow-up visits, the pharmacist did not additional incur clinic resources as patients were seen with providers. Conclusions: Pharmacist co-management of patients on OACTs is feasible and offers an added safety resource to pts and providers from initial teaching to monitoring. Future research will focus on the impacts of co-management on clinical outcomes, such as the use of emergency/hospital visits, the duration of therapy, and adherence.

2021 ◽  
Author(s):  
Negeen Aghassibake ◽  
Lynly Beard ◽  
Jackie Belanger ◽  
Diana Louden ◽  
Robin Chin Roemer ◽  
...  

As part of ARL’s Research Library Impact Framework initiative, the University of Washington (UW) Libraries explored UW faculty and postdoctoral researcher needs for understanding and communicating the impact of their work, with a focus on researchers in science, technology, engineering, and math (STEM) and health sciences fields. The project was designed to understand the challenges researchers face in this area, identify how participants in these fields define and measure impact, and explore their priorities for research-impact support. The project team conducted a survey and follow-up interviews to investigate these questions. This research report presents the project team’s methodology, findings, and recommendations for future research.


2021 ◽  
Author(s):  
Ahmed M Badheeb ◽  
Mohamed A Badheeb ◽  
Hamdi A Alhakimi

Abstract Background: The aim of this paper is to compare the patterns and determinants of cancer mortality in Najran region before and after the COVID-19 epidemics. The association between cancer mortality and each of age, sex, site of cancer, stage, and the 30-days survival rate after the last dose of chemotherapy were assessed.Materials & Methods: Adult cancer patients who died of cancer in King Khalid Hospital in Najran Saudi Arabia, were included in this retrospective observational study. We compared mortality patterns in a period of 6 months in 2020 (March to August) with the corresponding period of 2019.Results: 50 dead adult cancer patients were included, 24 in 2019 and 26 in 2020. Among them, 21% vs 42% were younger than 65 years of age; 61% vs 62% were males, for the years 2019 & 2020 respectively. The top three killers in 2019 were colorectal, gastro-esophageal cancers, and hepatocellular carcinoma, while in 2020 were colorectal, hepatocellular carcinoma, and lymphomas. About 16.7% of patients died within 30 days of receiving anti-cancer treatment in 2019 in comparison with 7.7% in 2020. The difference in the 30-days mortality after receiving anti-cancer treatment was not statistically significant between 2019 and 2020 (p = 0.329).Conclusion: The Year 2020, the time of the COVID-19pandemic, was not associated with a significant increase in short-term mortality among patients with malignancy in Najran, Saudi Arabia. Our results generally reflect the crucial role of strict preventive national measures in saving lives and warrants further exploration.


2021 ◽  
Author(s):  
Judith Neve ◽  
Guillaume A Rousselet

Sharing data has many benefits. However, data sharing rates remain low, for the most part well below 50%. A variety of interventions encouraging data sharing have been proposed. We focus here on editorial policies. Kidwell et al. (2016) assessed the impact of the introduction of badges in Psychological Science; Hardwicke et al. (2018) assessed the impact of Cognition’s mandatory data sharing policy. Both studies found policies to improve data sharing practices, but only assessed the impact of the policy for up to 25 months after its implementation. We examined the effect of these policies over a longer term by reusing their data and collecting a follow-up sample including articles published up until December 31st, 2019. We fit generalized additive models as these allow for a flexible assessment of the effect of time, in particular to identify non-linear changes in the trend. These models were compared to generalized linear models to examine whether the non-linearity is needed. Descriptive results and the outputs from generalized additive and linear models were coherent with previous findings: following the policies in Cognition and Psychological Science, data sharing statement rates increased immediately and continued to increase beyond the timeframes examined previously, until reaching close to 100%. In Clinical Psychological Science, data sharing statement rates started to increase only two years following the implementation of badges. Reusability rates jumped from close to 0% to around 50% but did not show changes within the pre-policy nor the post-policy timeframes. Journals that did not implement a policy showed no change in data sharing rates or reusability over time. There was variability across journals in the levels of increase, so we suggest future research should examine a larger number of policies to draw conclusions about their efficacy. We also encourage future research to investigate the barriers to data sharing specific to psychology subfields to identify the best interventions to tackle them.


Author(s):  
Zhihui Li ◽  
Min Chen ◽  
Chunzhi Tang

Objective: The aim of this study is to investigate the impact of acupuncturetherapy on relapse of patients with gouty arthritis (GA). Methods: “gout ORgouty arthritis” AND “a cupuncture therapy OR acupuncture OR moxibustionOR electroacupuncture OR fire needle OR acupotomology OR blood lettingpuncture OR plum blossom needle” were used as search strategies forsearching related studies. Twenty two studies involving 2394 patient s wereenrolled in this research through the analysis of databases of CNKI, Wanfang,VIP, PubMed, Embase and Cochrane Library. Results: The results of pairwise metaanalysis and network meta analysis (NMA) indicated that patients withacupuncture therapy had a significantly lower relapse rate (RR) compared withthose without acupuncture therapy (OR = 0.21, 95% CI: 0.16 0.26, P <0.00001); the follow up time (TFU) and serum urate concentration (SUA)before treatment had no significant effect on the reductio n of RR caused byacupuncture therapy (P > 0.05); and patients treated with acupuncture plusWestern medicine (WM) had the lowest RR (surface under the cumulativeranking [SUCRA] = 85.0%), followed by acupuncture plus traditional Chinesemedicine (TCM, SUC RA = 73.5%), acupuncture only (SUCRA = 72.8%),fourthly acupuncture plus TCM and WM (SUCRA = 33.0%), then TCM(SUCRA = 28.7%), finally WM (SUCRA = 7.0%). Conclusion: Our findingmay facilitate the application of acupuncture therapy in patients with GA. Ourresearch also offered some information for the future research.


Cells ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 8 ◽  
Author(s):  
Xueqiao Jiao ◽  
Xianling Qian ◽  
Longyuan Wu ◽  
Bo Li ◽  
Yi Wang ◽  
...  

Cancer ranks as the second leading cause of death worldwide, causing a large social and economic burden. However, most anti-cancer treatments face the problems of tumor recurrence and metastasis. Therefore, finding an effective cure for cancer needs to be solved urgently. Recently, the discovery of cancer stem cells (CSCs) provides a new orientation for cancer research and therapy. CSCs share main characteristics with stem cells and are able to generate an entire tumor. Besides, CSCs usually escape from current anti-cancer therapies, which is partly responsible for tumor recurrence and poor prognosis. microRNAs (miRNAs) belong to small noncoding RNA and regulate gene post-transcriptional expression. The dysregulation of miRNAs leads to plenty of diseases, including cancer. The aberrant miRNA expression in CSCs enhances stemness maintenance. In this review, we summarize the role of miRNAs on CSCs in the eight most common cancers, hoping to bridge the research of miRNAs and CSCs with clinical applications. We found that miRNAs can act as tumor promoter or suppressor. The dysregulation of miRNAs enhances cell stemness and contributes to tumor metastasis and therapeutic resistance via the formation of feedback loops and constitutive activation of carcinogenic signaling pathways. More importantly, some miRNAs may be potential targets for diagnosis, prognosis, and cancer treatments.


2007 ◽  
Vol 25 (33) ◽  
pp. 5267-5274 ◽  
Author(s):  
Sung-Gyeong Kim ◽  
Eun-Cheol Park ◽  
Jae-Hyun Park ◽  
Myung-Il Hahm ◽  
Jin-Hwa Lim ◽  
...  

PurposeTo identify the initiation or discontinuation of complementary therapy (CT) and determine the impact of sociodemographic and clinical factors on CT use among cancer patients.Patients and MethodsEligible patients were age 20 or older; newly diagnosed with stomach, liver, or colorectal cancer; and started their initial treatment at the National Cancer Center, Korea, between April 1, 2001, and April 30, 2003. In total, 541 cancer patients were surveyed in face-to-face interviews at baseline, and telephone follow-up interviews were performed every 3 months for 3 years.ResultsA total of 281 patients commenced CT after diagnosis; 164 patients stopped using CT during the follow-up period. The overall cumulative probability of starting CT at 1, 2, and 3 years was 50%, 54%, and 55%, respectively. In a Cox multivariate analysis, stomach and liver cancer were associated with an increased probability of initiating CT compared with colorectal cancer. Patients who were classified as stage I, II, or III at diagnosis were associated with a decreased probability of discontinuing CT compared with stage IV.ConclusionMost cancer patients started to use CT during the initial treatment period. Thus, physicians should communicate with cancer patients about CT at this phase. In particular, more attention should be paid to women and individuals with higher household incomes because these groups are more likely to start CT.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Fukunaga ◽  
T Morinaga ◽  
K Yamaji ◽  
M Nagashima ◽  
K Ando

Abstract Background Advanced pacemakers feature atrial antitachycardia pacing (aATP) therapies for terminating atrial arrhythmia. Previous studies showed the efficacy of combined atrial preventive pacing and aATP in patients with pacemakers. The independent effect of aATP and the impact for patients outside the clinical trials has not been well elucidated. Methods In a single center, prospective, all-comers trial, we enrolled 567 patients implanted cardiac devices with Reactive ATP function. History of permanent atrial fibrillation (AF) was not included. After device interrogation of the AF burden and the longest AF duration in the last 6 months, aATP was programmed as a bit more aggressive setting than MINERVA trial (time interval was set as every 2 hours). As for newly implanted devices, aATP was activated after at least 3 months run-in period. Primary and secondary outcomes were the longest AF duration and cumulative percentage of progression into permanent AF, respectively. Results Of 541 eligible patients, aged 75.3±10.7 years, 356 pacemaker, 82 ICD and 103 CRT patients, the longest single episode of AF lasted ≤6 min in 439 patients (81.1%), >6 min to 6 h in 43 (8.0%), >6–24 h in 33 (6.1%), and >24 h in 26 (4.8%) at the enrollment. During mean follow-up of 1.9 years, the longest AF episode lasted >24 h in 49 patients (9.1%) and 14 patients (2.6%) progressed into permanent AF. According with baseline longest single episode of AF, patients with AF ≤6 min developed an episode >24 h in 0.8% at 1 year and 3.2% at 2 years follow up; patients with AF >6 min to 6 h developed an episode >24 h in none at 1 year and 7% at 2 years follow up; and patients with AF >6–24 h developed an episode >24 h in 19% at 1 year and 42% at 2 years follow up, respectively. In a subgroup analysis of in 192 patients with at least 1 aATP, 46 patients with high efficacy (>44%) did not developed an episode >24 h. Only one patient developed into permanent AF without aATP therapy. On multivariate analysis, neither ICD nor CRT was independent risk factor for developing the longest AF episode >24 h. Conclusions The independent use of aATP without atrial preventive pacing was effective for preventing AF progression in a real world cohort. Even without the previous AF episodes, aATP could prevent AF development, especially in patients showing high aATP efficacy. Future research is required to enhance the aATP success rate.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S129-S129
Author(s):  
Olga Grunwald ◽  
Marleen Damman ◽  
Kène Henkens

Abstract OBJECTIVE: Retirement is a major life transition. People gain a considerable amount of free time, but also loose the benefits from work. Volunteering has been identified as a gratifying way to fill that time and to compensate some retirement-related losses, but is stratified by educational level. Research on how retirement changes volunteering behavior, particularly among different educational groups, is scarce. This study aims to fill this gap. Based on role theory, we hypothesize that the transition into retirement expands levels of volunteering, and that this effect will be relatively strong for the higher educated. METHODS: We use two-wave panel data that were collected in 2015 and 2018 among 5,312 Dutch individuals who were aged 60-65 and employed at baseline. Around half has retired at follow-up (N=2,618). RESULTS: Descriptive findings show that the share of frequent volunteers (i.e., at least once a week) was around 18% at baseline. At follow-up, the share of frequent volunteers rose to 36% among those who retired, but did not change among those who remained employed. Conditional change models show that transitioning into retirement significantly increases volunteering frequency, when controlling for demographic factors and individual resources. As hypothesized, the effect of retirement is relatively strong for the higher educated. DISCUSSION: To deal with the life changes upon retirement, volunteering appears to be an often-used strategy, in particular among the higher educated. Whether this is motivated by work role loss (compensation), or reflects having more time to ‘do good’ (opportunity) is an important question for future research.


2006 ◽  
Vol 23 (1) ◽  
pp. 55-72 ◽  
Author(s):  
Carol Markie-Dadds ◽  
Matthew R. Sanders

AbstractFew studies have examined the impact of parenting interventions for families in rural and isolated areas who have children with conduct problems, where access to professional services can be difficult. The present investigation compared the effects of three conditions, two levels of self-directed behavioral family intervention: an enhanced self-directed program that combined a self-help program using written materials and a weekly telephone consultation (ESD), a self-help program (SD) and a waitlist control group (WL). At postintervention the ESD group reported significantly lower levels of disruptive behaviour, and lower levels of dysfunctional parenting than the SD and WL controls, and higher levels of consumer satisfaction. At 6 months follow-up the main effects for the ESD group had been maintained. The SD group continued to evidence improvement from postintervention to follow-up such that 65% of children in the ESD condition and 57% of children in the SD condition showed clinical reliable change on measures of disruptive behaviour. Implications of findings and directions for future research are discussed.


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 124-124
Author(s):  
Diane Portman ◽  
Sarah Thirlwell ◽  
Kristine A. Donovan

124 Background: Appetite and weight loss are common in patients with advanced cancer and specialized cachexia clinics have been established to address these symptoms. Given the association between anorexia/cachexia and other adverse symptoms, these patients may also benefit from specialty level palliative care (PC). However, referral to outpatient specialty level PC is often delayed or does not occur. We sought to examine the prevalence of other factors associated with appetite and weight loss in patients with advanced cancer and the impact of a specialized cachexia clinic on identification and treatment of other PC needs. Methods: The records of patients referred by their Oncologist to the cachexia clinic of a cancer center from August 2016 to June 2017 were reviewed retrospectively. Subjects who had been referred to PC by their Oncologist were excluded. Patients had been assessed for symptom burden using the Edmonton Symptom Assessment Scale (ESAS-r). Patients identified with PC needs had been referred to the PC clinic for follow-up within 30 days after cachexia clinic consultation. Results: Thirty subjects were evaluated in the cachexia clinic (average age 68 years; 63% female). The predominant diagnosis was lung cancer (70%). An average of 6 symptoms per patient were in the moderate to severe range on ESAS, excluding appetite. Depression, fatigue and pain were most common. The average cachexia clinic total ESAS score was 51.61. Only 17% of patients had completed advance directives. Ninety-three % of patients were referred to PC and 68% were seen. The average number of PC visits was 2.79. Within the PC clinic, advance directive completion increased to 37%, goals of care discussion occurred with 50% and 17% received hospice referrals. At the most recent follow-up in the PC clinic, the average total ESAS score had decreased by 11.44 (22%) and all ESAS item scores were improved on average. Conclusions: The cachexia clinic proved a useful means to identify other PC needs and achieve effective PC referrals. We suggest this is proof of concept that specialty clinics can be a meaningful way to achieve an earlier entry point to comprehensive PC in patients who were not previously referred by their Oncologists.


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