Interest and Willingness to Pay for Integrative Therapies of Patients With Cancer and Caregivers

2021 ◽  
pp. OP.20.00471 ◽  
Author(s):  
Olivia M. Larbi ◽  
Cherry Jiang ◽  
Bethanny McLane ◽  
Gi-Ming Wang ◽  
Katherine Daunov ◽  
...  
Keyword(s):  
Willingness To Pay ◽  
Significant Proportion ◽  
College Education ◽  
Medical Professional ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Annual Household Income ◽  
Therapeutic Massage ◽  
Chi Squared ◽  
Integrative Therapies

PURPOSE: Complementary and integrative medicine (CIM) services are more prevalent in cancer centers but continue to be underutilized by patients. This study examines perspectives from patients and caregivers about these services being offered at a comprehensive cancer center. METHODS: Patients and caregivers were surveyed about their familiarity, interest, and experience with five CIM therapies: acupuncture, massage, meditation, music therapy, and yoga. Respondents were also asked about their interest when recommended by their medical team and when offered in a clinical trial as well as their willingness to pay for these services. Respondents were also asked about perceived barriers to accessing these services. Chi-squared tests were performed to explore associations between past experience, interest levels, and willingness to pay. RESULTS: A total of 576 surveys were obtained (464 patients and 112 caregivers). Most respondents identified as White or Caucasian (65.6%), female (57.2%), had been a patient for < 3 years (74.2%), had some college education (73.8%), and made > $40,000 in US dollars as their annual household income (69.1%). Respondents were most familiar with therapeutic massage (34.2%) and least familiar with acupuncture (20.0%). The average interest in these services increased from 53.3% to 64.1% when recommended by a medical professional. Respondents were most willing to pay $1-60 for therapeutic massage (62.3%) and least willing to pay for meditation (43.7%). The main barriers to accessing CIM services were cost (56.0%) and lack of knowledge (52.1%). CONCLUSION: Overall, a significant proportion of patients and caregivers were unfamiliar with these five integrative therapies. Increasing education, decreasing cost, and a recommendation by medical professionals would improve CIM usage.

Assessing the impact of the COVID-19 pandemic on patients with genitourinary malignancies.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 38-38
Author(s):  
Hala Borno ◽  
Sylvia Zhang ◽  
Scarlett Lin Gomez ◽  
Celia Kaplan ◽  
Christine Miaskowski ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Household Income ◽  
Negative Impact ◽  
Survey Study ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cross Sectional Survey ◽  
Annual Household Income ◽  
Ongoing Research ◽  
The Impact

38 Background: The COVID-19 pandemic has vast implications on the health system. Patients with a cancer diagnosis may face greater challenges in the context of the current COVID-19 pandemic. Methods: We sought to assess the impact of the COVID-19 pandemic among patients with genitourinary malignancies. We performed a cross-sectional survey study at a Comprehensive Cancer Center during the current pandemic. Results: A total of 86 participants were recruited to the study to date, 72.1% had prostate, 19.8% had kidney, and 12.8% had bladder cancer. A subset (n = 5) had more than one primary tumor. The mean time from diagnosis was 6.47 years (std dev 6.01, range from 0 to 27 years). Overall, 73% reported having metastatic disease and prior treatment with surgery (62%), radiation (71%), or systemic therapy (68%), with 68.6% currently receiving cancer treatment. In the study, 78.9% of patients were >65 years of age and 88.2% were White. The majority of participants had a bachelor’s degree or higher level of education (74.4%), were legally married (82.6%), were homeowners (91.9%), and reported an annual household income of >$100,000 (56.0%). Among respondents, 7% reported loss/change of health insurance and 30% reported a decrease in household income. Among patients with reduced household income, 23% reported a reduction of more than 50%. In this study, 28% of patients reported that the pandemic impacted their cancer treatment. Overall 7% reported decrease in frequency of labs, 11% reported a delay in obtaining a scan, 5% reported treatment delays, and 96% reported use of telemedicine (video or telephone) visit. Overall, 59% reported fear of hospitalization, 23% reported delays in seeking medical care, and 16% reported missing required medications. Conclusions: The negative impact of the COVID-19 pandemic on patients with genitourinary malignancies is extensive. Ongoing research is evaluating the impact across socio-demographically groups and examine clinical outcomes associated with delays in care and medication non-adherence.

scholarly journals 327. Barriers to Positive Health Outcomes in the HIV-Infected Cancer Clinic Population

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S173-S174
Author(s):  
Alexa Goldstein ◽  
David J Riedel
Keyword(s):  
Cancer Care ◽  
Significant Proportion ◽  
Behavioral Model ◽  
Self Esteem ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Health Services Use ◽  
Positive Health ◽  
Cancer Subtypes ◽  
Cancer Clinic

Abstract Background Significant disparities in morbidity and mortality from cancer in HIV-infected persons exist compared with those with cancer in the general population. This study sought to identify psychological, social and economic factors impacting or impeding cancer care in the HIV-infected population. Methods A voluntary, anonymous one-time questionnaire was completed by patients diagnosed with cancer who are HIV-infected and HIV-uninfected at the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC). Andersen’s Behavioral Model of Health Services Use served as the theoretical framework for assessing psychological, social, and economic barriers to care. We used the chi-square test to evaluate the association between HIV status and barriers to accessing cancer care. Results A total of 25 HIV-infected and 100 HIV-uninfected cases were included. More HIV-infected patients with cancer experienced self-esteem and fear barriers to a greater degree than their HIV-uninfected counterparts (28% vs. 15% for self-esteem, and 40% vs. 21%). A significant proportion of HIV-infected individuals reported experiencing insufficient social support (32% vs. 10% in the HIV-uninfected population, P = 0.01). HIV-infected individuals reported that they did not feel looked down upon in the cancer clinic. They also described that their cancer and HIV diagnoses were delivered in a similar manner by the provider. Conclusion Given that HIV-infected persons are experiencing lower survival rates for most cancer subtypes when compared with their HIV-uninfected counterparts, there is a need to further investigate the feelings of fear, low self-esteem, and insufficient support reported in the HIV-infected sample. Cancer care may need to be tailored to reflect the differences in psychological barriers and enabling resources that continue to be disproportionately prevalent in HIV-infected patients. Disclosures All authors: No reported disclosures.

Usability and acceptance of novel personal health technology to support early palliative care for patients with cancer and caregivers.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 73-73 ◽  
Author(s):  
Janice Bell ◽  
Sarah C. Reed ◽  
Katherine Kim ◽  
Victoria Ngo ◽  
Wendy Wait ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Healthcare Providers ◽  
College Education ◽  
Comprehensive Cancer Center ◽  
Acceptance Testing ◽  
Cancer Center ◽  
Personal Health ◽  
Desktop Computer ◽  
Early Palliative Care

73 Background: Little research has assessed whether and how technology can support early palliative care. Our team developed a HIPAA-compliant, cloud-based Personal Health Network (PHN) with a secure, online network of family, caregivers, clinicians and service providers designated by the patient; symptom reporting/management resources; and support for communication among network members via audio/video conferencing, messaging, and document sharing. This study examines PHN usability and acceptance, and identifies additional functions for early palliative care. Methods: Patients undergoing chemotherapy in a Comprehensive Cancer Center (n = 19) and their caregivers (n = 17) watched video demonstrations of the technology, participated in semi-structured interviews, and completed surveys measuring computer self-efficacy, PHN usability and acceptance. Results: Most participants were male with college education; mean age was 58 years. Most had a tablet or desktop computer (75%), a mobile phone (94%) and believed that technology improves the security of medication information (66%). At the same time, only 44% used email to contact healthcare providers and 30% used the internet to connect with others for support and information. Most reported the PHN was easy to learn and use and was an efficient and useful tool for patient-driven social networking, team communication, care coordination and symptom management. Participants suggested adapting the PHN to support spiritual and emotional needs and advance care planning. Common concerns included skepticism about receipt of timely responses from providers to symptom reports and the need for ongoing support for older adults with limited technology experience. Conclusions: These preliminary findings support adaption of the PHN to support palliative care components identified as important to patients and caregivers and further PHN usability and acceptance testing in larger, more diverse samples. The results also underscore the need for systems to support technology users, to clarify expectations of response time with patients and caregivers, and to assure these expectations can be met by healthcare providers.

Designing a survivorship and supportive care center at a comprehensive cancer center.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 159-159
Author(s):  
Katharine Amato ◽  
Kathryn M. Glaser ◽  
Lynda M. Beaupin ◽  
Denise A. Rokitka ◽  
Mary E. Reid
Keyword(s):  
Supportive Care ◽  
Cancer Survivors ◽  
Cancer Treatment ◽  
Nutrition Education ◽  
Care Center ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Care Clinic ◽  
Gastrointestinal Problems ◽  
Integrative Therapies

159 Background: Unmet physical, psychosocial, and other support needs of cancer survivors may lead to increased distress, anxiety, and decreased quality of life. Survivorship Clinics may be tailored for specific issues identified through a needs assessment. Methods: An invitation to complete a web-based survey was mailed to 35,420 active patients at a comprehensive cancer center in November 2015. The survey domains included demographics, cancer history, comorbidities, lifestyle, cancer prevention, spiritual and emotional support, symptom management, and interest in specific services. Results: 1,054 surveys were completed. The majority of respondents were female (55.2%; n = 582/1054), had Stage I cancer at diagnosis (43.9%; n = 360/820), and had completed treatment (69.0%; n = 727/1054). Genitourinary (23.0%; n = 238/1034) and breast (20.5%; n = 212/1034) were the most common cancer types among the respondents. Participants identified an average of 4.60 side effects experienced during or after treatment (n = 804); the most common were fatigue (64.5%), pain (37.3%), weight change (33.4%), sleep disturbance (30.2%), and gastrointestinal problems (29.4%). One third of participants reported having a physical side effect that caused anxiety and emotional distress (33.3%; n = 331/995), in particular, sexual function (69.7%; n = 136/195) and cognitive dysfunction (43.6%; n = 85/195). A total of 23.9% of participants had financial concerns due to costs of cancer treatment (n = 238/955). Participants were interested in integrative therapies, most notably yoga (75.1%; n = 289/385), acupuncture (72.4%; n = 155/214), aerobics (62.3%; n = 240/385), Swedish massage (60.5%; n = 225/372), aromatherapy (60.2%; n = 224/372), and homeopathy (55.1%; n = 118/214). Most respondents endorsed wanting information on nutrition (81.5%; n = 380/466). Conclusions: Cancer survivors report vast physical and psychosocial needs during and after cancer treatment, and they have a high interest in nutrition education and integrative therapies. Improved care coordination from a dedicated cancer survivorship and supportive care clinic at a comprehensive cancer center may specifically address survivors’ issues.

Clinician perspectives of complementary and integrative medicine (CIM) at an academic cancer center.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24047-e24047
Author(s):  
Marium Husain ◽  
Sherise C. Rogers ◽  
Dori Klemanski ◽  
Michelle Fullmer ◽  
Catherine Hreachmack ◽  
...  
Keyword(s):  
Solid Tumor ◽  
Radiation Oncology ◽  
Online Survey ◽  
Gynecologic Oncology ◽  
Surgical Oncology ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Patients With Cancer ◽  
Complementary And Integrative Medicine ◽  
Integrative Therapies

e24047 Background: Surveys suggest up to 87% of patients with cancer use complementary and integrative (CIM) therapies such as herbal medicine, acupuncture, massage and mind-body practices. These therapies may assist with symptoms of pain, nausea and anxiety. However, several studies have demonstrated that many clinicians do not inquire about CIM use, which may be due to lack of education and/or limited evidence-based data. We sought to explore the perspectives of clinicians at an academic comprehensive cancer center on the use of CIM therapies. Methods: Physicians and advanced practice providers (APPs) who practice medical oncology, hematology, radiation oncology, surgical oncology and neuro-oncology in a Midwest tertiary comprehensive cancer center were asked to participate in a 9-question online survey which inquired about their personal knowledge and recommendation for 21 different CIM therapies (not all are offered at the cancer center). Responses were summarized using descriptive statistics. Results: The response rate for this survey was 24.5% (n = 49). Responders were from the following specialties: hematology (n = 17; 35%); solid tumor (n = 18; 37%); both hematology and solid tumor (n = 8; 16%), surgical oncology (n = 3; 6%); gynecologic oncology (n = 2; 4%) and radiation oncology (n = 1; 2%). Sixty-seven percent were attending physicians and hematology/oncology fellows (n = 33), and 33% were APPs (n = 16). Median age range was 30-39 years (range 20-59). The most recommended CIM therapy for cancer treatment-related effects was massage (80%), followed by deep breathing (55%). The least recommended CIM therapies were traditional Chinese medicine (TCM) and Ayurvedic medicine (2%), followed by vitamins/minerals and homeopathy (both 6%). Participants requested more education on CBD/CBD oil (59%) and herbs/botanicals (49%). Up to 14% of respondents already had education on five integrative therapies. Conclusions: Hematology/oncology clinicians do not routinely recommend most CIM therapies, except for massage therapy. Efforts should be made to educate clinicians regarding CIM therapies used by patients with cancer as well resources that appraise the efficacy, safety, and potential drug interactions of these therapies. Education could encourage informed decision-making and improved patient-clinician communication and satisfaction.

ASCO-GU 2019: Fortgeschrittenes Nierenzellkarzinom

2019 ◽  
Vol 10 (02) ◽  
pp. 75-76
Author(s):  
Ine Schmale
Keyword(s):  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Washington Dc

Das Armamentarium zur Behandlung des Nierenzellkarzinoms (RCC) hat sich um effektive Therapien erweitert, durch die der Therapiealgorithmus komplett umgestellt werden musste. Prof. Michael B. Atkins vom Georgetown-Lombardi Comprehensive Cancer Center, Washington DC/USA, und Prof. Daniel Y. C. Heng vom Tom Baker Cancer Center, Calgary/Kanada, teilten beim ASCO-GU ihre Einschätzung zur optimalen Behandlung des Nierenzellkarzinoms in der Erst- und Zweitlinientherapie für das Jahr 2019.

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