Older adult guidelines: What is patient reported experience across five cancer programs?

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 186-186
Author(s):  
Lindsey Bandini ◽  
Christine B. Weldon ◽  
Julia R. Trosman ◽  
Sheetal Mehta Kircher ◽  
Nisha Anjali Mohindra ◽  
...  
Keyword(s):  
Older Adult ◽  
Older Patients ◽  
Geriatric Oncology ◽  
Daily Activities ◽  
Head Neck Cancer ◽  
Adult Care ◽  
Self Assessment ◽  
Chi Square ◽  
Patient Reported ◽  
Quality Improvement Interventions

186 Background: ASCO’s Guideline for Geriatric Oncology (Mohile SG, Et al 2018) and NCCN’s Guideline for Older Adult Oncology (v1.2021) include patient self-assessment for falls, memory/concentration, and activities of daily living. Our study collected patient reported experience with self-assessing these concerns, discussing them with clinicians, and receiving relevant referrals across adult patients with cancer. We also examined differences in reported experiences between younger and older patients. Methods: We surveyed patients 18 and over with breast, colorectal, lung or head neck cancer who received care from January 2020 to April 2021 across 5 cancer programs in Chicago: 3 academic and 2 community based. Survey included 7 items adapted from older adult oncology guidelines and associated instruments including PROMIS. Analyses used chi-square method with Yate’s correction. Results: 243 patients completed a survey, about half over and half under 65. Only 16% of patients reported that clinicians asked them about falls/walking, concentration/memory, or daily activity concerns; an additional 28% of patients brought up these concerns with clinicians (Table). Over half (51%) of all patients had at least once concern, 17% falls/walking, 30% concentration/memory and 35% daily activities. About 1/3 (35%) of patients were referred to services. Importantly, the rates of experiencing concerns associated with older adult care, initiating relevant discussions with clinicians, and receiving referrals were similar between younger and older patients (Table). Patients with concerns were more likely to get PT/OT, Geriatrics, or home health support, p =.02, p =.03, p =.04, respectively (data not shown). Conclusions: Regardless of age, half of patients reported at least one concern that is typically associated with older cancer patients. Future studies should study concerns for falls, memory, concentration, and daily activities among younger patients, with the potential to expand the guidelines accordingly. We also found gaps in identifying these concerns even within the older patient cohort, suggesting that quality improvement interventions are necessary.[Table: see text]

Comparison of older adult symptom occurrence rates in a geriatric-oncology clinic with meta-analysis for adults receiving chemotherapy.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 102-102
Author(s):  
Marie Anne Flannery ◽  
Allison Magnuson ◽  
Joseph John Guido ◽  
Luke Joseph Peppone ◽  
William Dale ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Patients ◽  
Meta Analysis ◽  
Geriatric Oncology ◽  
Psychological Status ◽  
Published Data ◽  
Limited Information ◽  
Symptom Experience ◽  
Chi Square ◽  
Significant Difference

102 Background: The majority of cancers occur in older adults, yet there is limited information on their symptom experience because they are under-represented in studies. To address this gap we examined registry data from two partnered geriatric oncology clinics, our aims are to: 1) identify older patients’ symptom occurrence rates and 2) compare symptom occurrence rates to published norms for adults with cancer. Methods: At presentation, patients completed the MD Anderson Symptom Inventory with symptoms coded as present or absent. Prevalence rates were compared to rates from a meta-analysis (Reilly et al., 2013) of adult cancer patients receiving chemotherapy which included pooled data from 21 studies (age M = 58 years, Range 118 = 97 years.) Differences were tested with Chi-Square. Results: As compared to published data, older patients (N = 291, M = 80.6 years, SD = 6.47, 52% > 80 yrs.) reported higher rates for the following symptoms: drowsiness (65% vs. 43%), trouble remembering (60% vs. 44%), distress (50% vs. 41%), sadness (49% vs.34%) (p’s < .01), and dry mouth (55% vs. 48%, p = .03). Lower rates were reported for nausea/vomiting (23% vs 40%/ 13 vs 27%, p’s < .001). There was no significant difference for the rates of fatigue (60%), difficulty sleeping (52%), pain (50%), decreased appetite (49%), dyspnea (48%), and numbness/tingling (38%). Conclusions: Older adults referred to specialized geriatric oncology clinic present with multiple symptoms. These patients had a mean age of eighty, may reflect the frail and vulnerable and were not often receiving active treatment. Results reinforce that it is especially important to assess and intervene on cognitive and psychological status in older patients. Nausea/Vomiting were less common in older adults perhaps due to lower chemotherapy rates. Limitations exist as we were not able to control for other factors affecting symptoms in the analysis. Nonetheless, results are consistent with older adults reporting many symptoms at a similar or higher rate than prior studies including all adults receiving chemotherapy. Increased study of the symptom experience in older oncology patients is critical to advance palliative care and symptom science.

scholarly journals Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology Summary

2018 ◽  
Vol 14 (7) ◽  
pp. 442-446 ◽  
Author(s):  
Supriya G. Mohile ◽  
William Dale ◽  
Mark R. Somerfield ◽  
Arti Hurria
Keyword(s):  
Older Patients ◽  
Geriatric Oncology

scholarly journals Patient-reported effectiveness and safety of Pamidronate in NSAIDs-refractory chronic recurrent multifocal osteomyelitis in children

2021 ◽  
Author(s):  
Bartłomiej Juszczak ◽  
Jerzy Sułko
Keyword(s):  
Adverse Drug Reactions ◽  
Social Life ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Daily Activities ◽  
Drug Reactions ◽  
Patient Reported ◽  
Multifocal Osteomyelitis ◽  
Drug Dependent ◽  
Treatment Onset ◽  
The Impact

AbstractTo evaluate patient-reported effectiveness, safety and social influence of Pamidronate in the therapy of NSAIDs-refractory Chronic Recurrent Multifocal Osteomyelitis in children. Authors reviewed self-created questionnaires, which asked patients for symptoms alleviation, adverse drug reactions frequency and degree of severity and daily activities self-reliance. Only surveys with complete answers, which were returned to authors by an e-mail from juvenile patients treated for NSAIDs-refractory Chronic Recurrent Multifocal Osteomyelitis at the University Children’s Hospital of Cracow were analyzed. Between 2010 and 2019, 61 children were diagnosed with NSAIDs-refractory Chronic Recurrent Multifocal Osteomyelitis at our department. Out of 61 requests sent, 42 complete replies (33 females, 9 males) were gathered and analyzed. All patients included in this research were administered with at least one set of Pamidronate intravenously in the dose of 1 mg/kg/day for 3 consecutive days. Our analysis shows remarkable in terms of patient’s impressions decrease of pain intensity after 2.5 series of Pamidronate on average, and total pain resolution after 5.9 series on average. Overall number of adverse drug reaction events reported by responders was 105. One patient developed drug-dependent renal insufficiency in the course of therapy. Outcome assessment indicates that nearly 50% of the studied population was more eager to participate in social life just after the first infusion of the drug. 95% of the surveyed unanimously agreed to recommend Pamidronate therapy to cure NSAIDs-refractory CRMO. 39 out of 42 (93%) patients considered Pamidronate effective at the end of the treatment. Onset of Pamidronate’s action is gradual and differs in terms of symptoms alleviation between sexes. The therapy can induce considerable number of adverse drug reactions (2.5 per patient). Only 3 out of 42 (7%) patients were free from any ADRs. To demonstrate the impact of the use of Pamidronate on daily activities more precisely, further research with quantification of the quality of life is warranted.

scholarly journals Clinical Characteristics and Prognostic Factors of Early-Onset Pancreatic Neuroendocrine Tumors

2021 ◽  
Vol 28 ◽  
pp. 107327482098682
Author(s):  
Min Shi ◽  
Biao Zhou
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumors ◽  
Early Onset ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Clinicopathological Characteristics ◽  
Pancreatic Neuroendocrine Tumors ◽  
Chi Square ◽  
Younger Patients ◽  
Significant Difference

Background: The incidence of pancreatic neuroendocrine tumors (PNETs) has increased significantly. The purpose of this study was to analyze the clinical characteristics and prognosis of patients under 50 years old. Methods: Patients with PNETs recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 were analyzed. The clinical characteristics were analyzed by Chi-square test. The Kaplan-Meier method was used to estimate overall survival (OS). Multivariate Cox proportional risk regression analysis was used to determine independent prognostic factors. Results: 2,303 patients included, of which 547 (23.8%) patients were younger than 50 years old. The number of younger patients has increased steadily, while the proportion in total PNETs decreased recently. Compared with older group, the proportion of the Black, grade I/II, and surgery were higher in early-onset PNETs. Liver was the most frequent metastatic site. There was no significant difference in the incidence of different metastatic sites between younger and older PNETs patients, while younger patients had better OS (P < 0.05). Grade, N stage, M stage, and surgery were independent prognostic factors for OS in early-onset PNETs. Conclusions: Younger patients have unique clinicopathological characteristics compared with older patients in PNETs. Better OS was observed in younger patients which might due to the higher proportion of well-differentiated tumor and surgery than older patients.

Effect of Augmentative Technology on Communication and Quality of Life After Tracheostomy or Total Laryngectomy

2021 ◽  
pp. 019459982110137
Author(s):  
Catherine T. Haring ◽  
Janice L. Farlow ◽  
Marie Leginza ◽  
Kaitlin Vance ◽  
Anna Blakely ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Laryngectomy ◽  
Electronic Communication ◽  
Well Being ◽  
Chi Square ◽  
Communication Device ◽  
Patient Reported ◽  
Communication Devices ◽  
Related Quality

Objective Surgical procedures that render patients acutely aphonic can cause them to experience significant anxiety and distress. We queried patient perceptions after tracheostomy or laryngectomy and investigated whether introducing augmentative technology was associated with improvement in patient-reported outcomes. Methods Participants included hospitalized patients who acutely lost the ability to speak due to tracheostomy or total laryngectomy from April 2018 to December 2019. We distributed questions regarding the patient communication experience and relevant questions from the validated V-RQOL questionnaire (Voice-Related Quality of Life). Patients were offered a tablet with the electronic communication application Verbally. Pre- and postintervention groups were compared with chi-square analyses. Results Surveys were completed by 35 patients (n = 18, preintervention; n = 17, postintervention). Prior to using augmentative technology, 89% of patients who were aphonic reported difficulty communicating, specifically noting breathing or suctioning (56%), treatment and discharge plans (78%), or immediate needs, such as pain and using the bathroom (39%). Communication difficulties caused anxiety (55%), depression (44%), or frustration (62%), and 92% of patients were interested in using an electronic communication device. Patients reported less trouble communicating after the intervention versus before (53% vs 89%, P = .03), including less difficulty communicating about treatment or discharge plans (35% vs 78%, P < .01). V-RQOL scores were unchanged. Discussion Acute loss of phonation arising from surgery can be highly distressing for patients, and use of augmentative technology may alleviate some of these challenges by improving communication. Further studies are needed to identify what additional strategies may improve overall well-being. Implications for Practice Electronic communication devices may benefit patients with acute aphonia.

scholarly journals Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042351
Author(s):  
Kathryn Eastwood ◽  
Dhanya Nambiar ◽  
Rosamond Dwyer ◽  
Judy A Lowthian ◽  
Peter Cameron ◽  
...  
Keyword(s):  
Cohort Study ◽  
Older Adult ◽  
Retrospective Cohort Study ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Vital Signs ◽  
Telephone Triage ◽  
Ambulance Dispatch ◽  
Emergency Ambulance ◽  
Primary Triage

BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

Body mass index affects postoperative daily activities of older patients after gastrectomy

2021 ◽  
Author(s):  
Tatsuro Inoue ◽  
Hidetaka Wakabayashi ◽  
Keisuke Maeda ◽  
Ryo Momosaki
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Older Patients ◽  
Daily Activities

Health-related quality of life and symptoms of conservative care versus dialysis in patients with end-stage kidney disease: a systematic review

2020 ◽  
Author(s):  
Wouter R Verberne ◽  
Iris D van den Wittenboer ◽  
Carlijn G N Voorend ◽  
Alferso C Abrahams ◽  
Marjolijn van Buren ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Older Patients ◽  
Health Related Quality ◽  
End Stage Kidney Disease ◽  
Conservative Care ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
End Stage

Abstract Background Non-dialytic conservative care (CC) has been proposed as a viable alternative to maintenance dialysis for selected older patients to treat end-stage kidney disease (ESKD). This systematic review compares both treatment pathways on health-related quality of life (HRQoL) and symptoms, which are major outcomes for patients and clinicians when deciding on preferred treatment. Methods We searched PubMed, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus and PsycINFO from inception to 1 October 2019 for studies comparing patient-reported HRQoL outcomes or symptoms between patients who chose either CC or dialysis for ESKD. Results Eleven observational cohort studies were identified comprising 1718 patients overall. There were no randomized controlled trials. Studies were susceptible to selection bias and confounding. In most studies, patients who chose CC were older and had more comorbidities and worse functional status than patients who chose dialysis. Results were broadly consistent across studies, despite considerable clinical and methodological heterogeneity. Patient-reported physical health outcomes and symptoms appeared to be worse in patients who chose CC compared with patients who chose dialysis but had not yet started, but similar compared with patients on dialysis. Mental health outcomes were similar between patients who chose CC or dialysis, including before and after dialysis start. In patients who chose dialysis, the burden of kidney disease and impact on daily life increased after dialysis start. Conclusions The available data, while heterogeneous, suggest that in selected older patients, CC has the potential to achieve similar HRQoL and symptoms compared with a dialysis pathway. High-quality prospective studies are needed to confirm these provisional findings.

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