scholarly journals Providers’ mediating role for medication adherence among cancer survivors

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260358
Author(s):  
Justin G. Trogdon ◽  
Krutika Amin ◽  
Parul Gupta ◽  
Benjamin Y. Urick ◽  
Katherine E. Reeder-Hayes ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Chronic Condition ◽  
Cancer Control ◽  
Cancer Site ◽  
Control Group ◽  
Medicare Beneficiaries ◽  
Mediating Role ◽  
After Cancer

Background We conducted a mediation analysis of the provider team’s role in changes to chronic condition medication adherence among cancer survivors. Methods We used a retrospective, longitudinal cohort design following Medicare beneficiaries from 18-months before through 24-months following cancer diagnosis. We included beneficiaries aged ≥66 years newly diagnosed with breast, colorectal, lung or prostate cancer and using medication for non-insulin anti-diabetics, statins, and/or anti-hypertensives and similar individuals without cancer from Surveillance, Epidemiology, and End Results-Medicare data, 2008–2014. Chronic condition medication adherence was defined as a proportion of days covered ≥ 80%. Provider team structure was measured using two factors capturing the number of providers seen and the historical amount of patient sharing among providers. Linear regressions relying on within-survivor variation were run separately for each cancer site, chronic condition, and follow-up period. Results The number of providers and patient sharing among providers increased after cancer diagnosis relative to the non-cancer control group. Changes in provider team complexity explained only small changes in medication adherence. Provider team effects were statistically insignificant in 13 of 17 analytic samples with significant changes in adherence. Statistically significant provider team effects were small in magnitude (<0.5 percentage points). Conclusions Increased complexity in the provider team associated with cancer diagnosis did not lead to meaningful reductions in medication adherence. Interventions aimed at improving chronic condition medication adherence should be targeted based on the type of cancer and chronic condition and focus on other provider, systemic, or patient factors.

scholarly journals Longitudinal Changes in Sports Activity From Pre-diagnosis to First Five Years Post-diagnosis: a Prospective Chinese Breast Cancer Cohort Study

2020 ◽  
Author(s):  
Yuanyuan Lei ◽  
Suzanne C. Ho ◽  
Carol Kwok ◽  
Ashley Cheng ◽  
Ka Li Cheung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Physical Activity Level ◽  
Chinese Women ◽  
Early Stage ◽  
Activity Level ◽  
Significant Difference ◽  
After Cancer

Abstract Background: To compare change in level of physical activitybetween pre-and post- diagnosis of breast cancer in Chinese women.Methods:Based on an on-going prospective study consisting of 1462 Chinese women with early-stage breast cancer, a validated modified Chinese Baecke questionnaire was used to measure physical activity at baseline (12 months before cancer diagnosis), 18-, 36- and 60-months after diagnosis (over the previous 12 months before each interview). Results:The overall physical activity level at post-diagnosis was 5.8 MET-hours/week, which was significantly higher than that at pre-diagnosis at a median level of 0.6 MET-hours/week (P <0.001).The median levels of physical activity at 18-, 36- and 60-months follow-up were5.3, 4.4 and 3.9 MET-hours/week, respectively. There was no significant difference between any two of the three follow-ups at post-diagnosis. The proportions of participant who met WCRF/AICR recommendation before and after cancer diagnosis were both low, being 20.7% and 35.1%, respectively.Compared to pre-diagnosis, most of the patients improved or had no change on level of physical activity at post-diagnosis, with the respective proportion being 48.2% and 43.8%. Conclusions:Adherence to current lifestyle recommendation for cancer survivors, Chinese women with breast cancer significantly increasedlevel of physical activity level after cancer diagnosis, and such improvement was sustained to five years post-diagnosis. The proportion of patients who met the exercise recommendation for cancer survivors was still low. Encouraging patients on the importance of durable high level of physical activity in breast cancer survivorship is warranted.

Divorce after breast cancer diagnosis and its impact on quality of life

2021 ◽  
pp. 1-6
Author(s):  
Danbee Kang ◽  
Nayeon Kim ◽  
Gayeon Han ◽  
Sooyeon Kim ◽  
Hoyoung Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Breast Cancer Survivors ◽  
Breast Cancer Diagnosis ◽  
Factors Associated ◽  
After Cancer ◽  
The Impact

Abstract Objective This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients. Methods We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors. Results Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss. Conclusion Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.

scholarly journals Long-term employment status and quality of life after cancer: A longitudinal prospective cohort study from diagnosis up to and including 5 years post diagnosis

Work ◽  
2020 ◽  
Vol 66 (4) ◽  
pp. 901-907
Author(s):  
Sietske J. Tamminga ◽  
Lyanne P. Jansen ◽  
Monique H.W. Frings-Dresen ◽  
Angela G.E.M. de Boer
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Employment Status ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
Multi Level ◽  
After Cancer ◽  
Level Analysis

BACKGROUND: Accumulating evidence suggests that cancer survivors are able to return to work. However, little is known about their work situation 5 years after diagnosis. OBJECTIVE: To explore fluctuations in employment status and its association with quality of life 2, 3, and 5 years after cancer diagnosis of 65 cancer survivors employed at diagnosis. METHODS: In association with a randomised controlled trial (RCT), questionnaires were administrated to eligible cancer survivors at diagnosis, 2, 3, and 5 years thereafter comprising of validated questionnaires related to work (i.e. Work Ability Index (WAI), cancer, and quality of life (QOL) (i.e. SF-36, VAS QOL). The RCT studied a hospital-based work support intervention in female breast and gynaecological cancer survivors who were treated with curative intent and had paid work at diagnosis. Descriptive statistics and longitudinal multi-level analysis were employed. RESULTS: Sixty-five of the 102 eligible cancer survivors participated, who were primarily diagnosed with breast cancer (63%). Two and 5 years after cancer diagnosis respectively 63 (97%) and 48 (81%) participants were employed. Reasons for not being employed after 5 years included receiving unemployment benefits (7%), voluntary unemployment (3%), receiving disability benefits (3%), and early retirement (3%). Longitudinal multi-level analysis showed that employed cancer survivors reported in general statistically significant better quality of life outcomes at 5 years follow-up compared to those not being employed. CONCLUSIONS: We found high employment rates and few fluctuations in employment status. The steepest decline in employment rate occurs after the first two years of diagnosis. Employed participants reported better quality of life outcomes. Survivorship care should therefore focus on the population at risk possibly within the first two years after diagnosis.

Genitourinary disease risks among 5-year ovarian cancer survivors in a population-based cohort study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10073-10073
Author(s):  
Mia Hashibe ◽  
Yuji Chen ◽  
Brenna Blackburn ◽  
Yuan Wan ◽  
Kerry G. Rowe ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Population Based ◽  
General Population Cohort ◽  
Disease Risks ◽  
After Cancer

10073 Background: In the US, there are approximately 235,200 ovarian cancer survivors today. Five-year survival for ovarian cancer has increased from 36% for women who were diagnosed in 1975-1977 to 46% for women diagnosed between 2005-2011. Long term follow-up studies among ovarian cancer survivors are uncommon and late effects have not been well characterized in a population-based cohort. Although genitourinary complications during treatment are well known, long term impacts need to be investigated. Methods: A total of 602 first primary invasive ovarian cancer cases diagnosed between 1996-2012 who survived for > 5 years were identified in the Utah Population Database and compared to a general population cohort of women. Genitourinary disease diagnoses were identified through ICD codes from hospital electronic medical records and statewide ambulatory surgery and inpatient data. Cox regression models were used to estimate hazard ratios for disease risks by time since cancer diagnosis with adjustments on matching factors, baseline BMI, baseline Charlson Comorbidity Index (CCI), and race. Results: The overall risk of genitourinary diseases for ovarian cancer patients in comparison to the general population cohort was 1.51 (95%CI = 1.30-1.74) 5-10 years after cancer diagnosis. Approximately 54.6% of ovarian cancer survivors were diagnosed with a genitourinary disease 5-10 years after cancer diagnosis. The most common genitourinary diseases among the ovarian cancer survivors were urinary tract infections (10.1%), acute renal failure (5.5%), and chronic kidney disease (4.4%). The greatest risks were observed for hydronephrosis (HR = 10.65, 95%CI = 3.68-30.80), pelvic peritoneal adhesions (HR = 5.81, 95%CI = 1.11-30.39), cystitis and urethritis (HR = 2.67, 95%CI = 1.21-6.38), and acute renal failure (HR = 2.30, 95%CI = 1.36-3.88). Conclusions: Ovarian cancer survivors experience increased risks of various genitourinary diseases in the 5-10 year period following cancer diagnosis. Understanding the multimorbidity trajectory among ovarian cancer survivors is of vital importance to improve their clinical care after cancer diagnosis and allow for increased attention to these potential late effects.

Hippocampal Volume and First Major Depressive Episode After Cancer Diagnosis in Breast Cancer Survivors

2004 ◽  
Vol 161 (12) ◽  
pp. 2263-2270 ◽  
Author(s):  
Masatoshi Inagaki ◽  
Yutaka Matsuoka ◽  
Yuriko Sugahara ◽  
Tomohito Nakano ◽  
Tatsuo Akechi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Depressive Episode ◽  
Breast Cancer Survivors ◽  
Major Depressive Episode ◽  
Hippocampal Volume ◽  
Major Depressive ◽  
After Cancer

scholarly journals Longitudinal changes in sports activity from pre-diagnosis to first five years post-diagnosis: a prospective Chinese breast cancer cohort study

2020 ◽  
Author(s):  
Yuanyuan Lei ◽  
Suzanne C. Ho ◽  
Carol Kwok ◽  
Ashley Cheng ◽  
Ka Li Cheung ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Cancer Research ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Chinese Women ◽  
Activity Level ◽  
Significant Difference ◽  
The Mean ◽  
After Cancer

Abstract Background: To compare change in level of physical activity between pre-and post- diagnosis of breast cancer in Chinese women.Methods: Based on an on-going prospective study consisting of 1462 Chinese women with early-stage breast cancer, a validated modified Chinese Baecke questionnaire was used to measure physical activity at baseline (12 months before cancer diagnosis), 18-, 36- and 60-months after diagnosis (over the previous 12 months before each interview).Results: The mean level of physical activity at post-diagnosis was 9.6 metabolic equivalent of task (MET)-hours/week, which was significantly higher than that at pre-diagnosis with mean level of 5.9 MET-hours/week ( P < 0.001). The mean levels of physical activity at 18-, 36- and 60-months follow-up were 9.9, 9.8 and 9.3 MET-hours/week, respectively. There was no significant difference between any two of the three follow-ups at post-diagnosis. The proportions of participant who met World Cancer Research Fund/ American Institute for Cancer Research (WCRF/AICR) recommendation before and after cancer diagnosis were both low, being 20.7% and 35.1%, respectively. Compared to pre-diagnosis, most of the patients improved or had no change on level of physical activity at post-diagnosis, with the respective proportion being 48.2% and 43.8%.Conclusions: Adherence to current lifestyle recommendation for cancer survivors, Chinese women with breast cancer significantly increased level of physical activity level after cancer diagnosis, and such improvement was sustained to five years post-diagnosis. The proportion of patients who met the exercise recommendation for cancer survivors was still low. Encouraging patients on the importance of durable high level of physical activity in breast cancer survivorship is warranted.

scholarly journals Real-World Effectiveness of A Digital-Based Coaching Intervention for Cancer Survivors with Job Loss

2021 ◽  
Author(s):  
Jonathon Lo ◽  
Kieran Ballurkar ◽  
Simonie Fox ◽  
kate Tynan ◽  
Nghiep Luu ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Real World ◽  
Matched Control ◽  
Cox Model ◽  
Cohort Analysis ◽  
Intervention Group ◽  
Control Group ◽  
Matched Control Group ◽  
Real World Setting

Abstract Purpose:Return-to-work (RTW) is a key unmet need for working age cancer survivors. This study sought to evaluate RTW outcomes of a multidisciplinary intervention provided as routine employee support.Method:In a retrospective cohort analysis, patients with cancer and more than 3 months absent from work were provided an intervention consisting of digital resources and calls with a health coach. A logit regression model was used to calculate a propensity score using covariates of age, gender, insurance benefit type, date of cancer diagnosis and time from diagnosis derived from insurance-claims data and captured as standard business practice. Participants were matched on a 1:1 basis using the nearest-neighbor method without replacement to create a matched control group from a further 1,856 participants who did not receive the intervention.Results:220 participants enrolled in the intervention, of which 125 met the criteria for analysis. The median follow-up from cancer diagnosis was 79 weeks (IQR 60-106). In the matched control group, 22 returned to work (17.6%) compared with 38 (30.4%) in the intervention group (P=.02). Nineteen matched controls died prior to claim closure (15.2%) compared with 13 in the intervention group (10.4%; P=.26). Cox model estimated median time for the first 15% of the cohorts to RTW was 87.1 weeks for the matched control (CI 60.0-109.1 weeks) compared with 70.6 weeks for the intervention (CI 52.6-79.6 weeks; P=.08).Conclusion:A digitally delivered coaching program in a real-world setting for patients diagnosed with cancer improves the likelihood of RTW.Implications for cancer survivors: a remotely delivered coaching program in a real-world setting for cancer survivors can improve the likelihood of RTW.

scholarly journals Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer

2020 ◽  
Author(s):  
Andrew W Roberts ◽  
Samantha Eiffert ◽  
Elizabeth M Wulff-Burchfield ◽  
Stacie B Dusetzina ◽  
Devon K Check
Keyword(s):  
Prostate Cancer ◽  
Cancer Survivors ◽  
Cancer Diagnosis ◽  
Opioid Therapy ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Medicare Data ◽  
End Results

Abstract Background Despite high rates of opioid therapy, evidence about the risk of preventable opioid harms among cancer survivors is underdeveloped. Our objective was to estimate the odds of opioid use disorder (OUD) and overdose following breast, colorectal, or prostate cancer diagnosis among Medicare beneficiaries. Methods We conducted a retrospective cohort study using 2007-2014 Surveillance, Epidemiology, and End Results-Medicare data for cancer survivors with a first cancer diagnosis of stage 0-III breast, colorectal, or prostate cancer at age 66-89 years between 2008 and 2013. Cancer survivors were matched to up to 2 noncancer controls on age, sex, and Surveillance, Epidemiology, and End Results region. Using Firth logistic regression, we estimated adjusted 1-year odds of OUD or nonfatal opioid overdose associated with a cancer diagnosis. We also estimated adjusted odds of OUD and overdose separately and by cancer stage, prior opioid use, and follow-up time. Results Among 69 889 cancer survivors and 125 007 controls, the unadjusted rates of OUD or nonfatal overdose were 25.2, 27.1, 38.9, and 12.4 events per 10 000 patients in the noncancer, breast, colorectal, and prostate samples, respectively. There was no association between cancer and OUD. Colorectal survivors had 2.3 times higher odds of opioid overdose compared with matched controls (adjusted odds ratio = 2.33, 95% confidence interval  = 1.49 to 3.67). Additionally, overdose risk was greater in those with more advanced disease, no prior opioid use, and preexisting mental health conditions. Conclusions Opioid overdose was a rare, but statistically significant, outcome following stage II-III colorectal cancer diagnosis, particularly among previously opioid-naïve patients. These patients may require heightened screening and intervention to prevent inadvertent adverse opioid harms.

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