scholarly journals Cancer as a Chronic Illness in Colombia: A Normative Consensus Approach to Improving Healthcare Services for those Living with and beyond Cancer and Its Treatment

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1655
Author(s):  
Cindy V. Mendieta ◽  
Maria Elizabeth Gómez-Neva ◽  
Laura Victoria Rivera-Amézquita ◽  
Esther de Vries ◽  
Martha Lucía Arévalo-Reyez ◽  
...  
Keyword(s):  
Cancer Survivorship ◽  
Cancer Care ◽  
Cancer Survival ◽  
Psychosocial Support ◽  
Cancer Recurrence ◽  
Healthcare Services ◽  
Survivorship Care ◽  
Consensus Approach ◽  
Care Needs ◽  
Normative Consensus

Cancer survivorship care in Colombia is of increasing importance. International survivorship initiatives and studies show that continuing symptoms, psychological distress, and late effects impact the quality of life for survivors. Priorities for quality survivorship according to Colombian patients and clinicians are unknown. We undertook a nominal consensus approach with 24 participants using virtual meeting technology to identify the priorities for cancer survivorship. We applied an iterative approach conducted over eight weeks with five workshops and one patient focus group followed by a priority setting survey. The consensus group established six main themes, which were subsequently evaluated by experts: (i) symptoms and secondary effects of cancer; (ii) care coordination to increase patient access and integration of cancer care; (iii) psychosocial support after cancer treatment; (iv) mapping information resources and available support services for long-term cancer care; (v) identifying socioeconomic and regional inequalities in cancer survival to improve care and outcomes; and (vi) health promotion and encouraging lifestyle change. The order of priorities differed between clinicians and patients: patients mentioned psychosocial support as the number one priority, and clinicians prioritized symptoms and surveillance for cancer recurrence. Developing survivorship care needs consideration of both views, including barriers such as access to services and socioeconomic disparities.

scholarly journals Identifying Determinants of Intervention Sustainability in Cancer Survivorship Care

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 95s-95s
Author(s):  
R. Urquhart ◽  
C. Kendell ◽  
E. Cornelissen ◽  
L.L. Madden ◽  
B.J. Powell ◽  
...  
Keyword(s):  
Cancer Survivorship ◽  
Cancer Care ◽  
Scientific Evidence ◽  
Evidence Base ◽  
World Health ◽  
Evidence Based ◽  
Theory Approach ◽  
Survivorship Care ◽  
Sustained Use ◽  
Health Organization

Background: Substantial gains could be made in reducing the cancer burden if current scientific evidence was applied in practice. The World Health Organization estimates that, worldwide, one-third of cancer cases could be prevented and another one-third cured if evidence was consistently implemented and sustained in cancer care. However, moving evidence-based interventions into care has proven a significant challenge. Even when interventions are put into practice, they often fail to become integrated into the long-term routines of organizations. This poor sustainability means many patients do not benefit from the best care possible. There is little empirical data on the factors that influence the sustainability of interventions in clinical settings. Aim: To identify the determinants of, and explore the processes that facilitate, sustainability of interventions in cancer care survivorship. Sustainability was defined as the continued use of an intervention and its associated components and/or the continued achievement of the intended benefits after the initial funding or support period. Methods: We first conducted an environmental scan to identify interventions in cancer survivorship care implemented in Canada. This was followed by a literature review to ascertain the evidence base for each intervention and identify those meeting the US National Cancer Institute's criteria for evidence-based interventions. We then recruited key individuals relevant to the evidence-based interventions for semistructured in-depth interviews to explore issues related to their sustainability. Interview data are being analyzed through an inductive grounded theory approach using constant comparative analysis. Results: Twenty-seven individuals participated in the interviews. Preliminary findings reveal five factors that influenced whether, and the extent to which, interventions were sustained in cancer survivorship care. Participants emphasized (1) access to sufficient resources and funding is critical to sustaining interventions after the initial funding period. The ability of a team or organization to (2) evaluate a new intervention and demonstrate its quality and usefulness was often perceived as necessary to obtain continued funding as well as ongoing buy in and support from key stakeholders. In addition, the (3) extent to which the intervention can be adapted, (4) support of senior management, and (5) existence of an on-the-ground champion to continuously promote, adapt, lead, and spread the intervention were perceived as important factors that contribute to an intervention's sustained use. Conclusion: Research into determinants and processes of sustainability is critical to ensure we plan and act in ways that maximize the sustained use of interventions shown to benefit patients and our cancer systems. Issues related to evaluation, adaptability, and ongoing moral and material supports should be considered before, during, and after implementation efforts.

Assuring Quality Cancer Survivorship Care: We've Only Just Begun

2015 ◽  
pp. e583-e591 ◽  
Author(s):  
Deborah K. Mayer ◽  
Charles L. Shapiro ◽  
Paul Jacobson ◽  
Mary S. McCabe
Keyword(s):  
Cancer Survivorship ◽  
Cancer Care ◽  
Outcome Measurement ◽  
Quality Metrics ◽  
Leadership Role ◽  
Care Plan ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Cancer Society ◽  
Quality Cancer Care

Clinical practice guidelines, quality metrics, and performance improvement projects are the key tools of the national movement to improve and assure quality cancer care. Each of these evaluation instruments is intended to assess quality from a unique perspective, including that of the individual provider, the practice/hospital, and the health care system. A number of organizations have developed or endorsed quality measures specific to cancer, however, these have not formally included survivorship measures. Fortunately, the American Society of Clinical Oncology (ASCO), the National Comprehensive Cancer Network, the American Cancer Society, and the American College of Surgeons (ACoS) have taken a leadership role in developing survivorship guidelines and quality metrics. Both ASCO and ACoS have focused their efforts on the treatment summary and care plan, a document that was proposed in the 2006 Institute of Medicine report on cancer survivorship. ASCO has proposed a care plan template for implementation and incorporation into the electronic health records (EHR), which will lend itself to structure, process, and outcome measurement. ACoS, conversely, has included the care plan in its cancer program standards with annual evaluation metrics. In addition, ASCO has developed a number of key survivorship-relevant metrics as part of its Quality Oncology Practice Initiative (QOPI), a tool developed to measure quality cancer care and assess adherence to guidelines across academic and community practices. Together, these efforts will direct us to more effective ways to disseminate guideline recommendations and to better methods of assessing quality survivorship care nationally.

scholarly journals American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline

2016 ◽  
Vol 34 (6) ◽  
pp. 611-635 ◽  
Author(s):  
Carolyn D. Runowicz ◽  
Corinne R. Leach ◽  
N. Lynn Henry ◽  
Karen S. Henry ◽  
Heather T. Mackey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Clinical Oncology ◽  
Cancer Survivorship ◽  
Cancer Recurrence ◽  
American Cancer Society ◽  
Survivorship Care ◽  
Breast Cancer Survivorship ◽  
Cancer Society ◽  
American Society

The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1,073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made. This guideline was developed through a collaboration between the American Cancer Society and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both CA: A Cancer Journal for Clinicians and Journal of Clinical Oncology. Copyright © 2015 American Cancer Society and American Society of Clinical Oncology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by the American Cancer Society or the American Society of Clinical Oncology.

Precision lung cancer survivorship care: Accrual to the Kentucky LEADS Collaborative Lung Cancer Survivorship Care Program.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 144-144
Author(s):  
Jamie L Studts ◽  
Keyword(s):  
Lung Cancer ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Cancer Care ◽  
Symptom Burden ◽  
Care Program ◽  
Electronic Record ◽  
Baseline Survey ◽  
Survivorship Care ◽  
Cancer Care Facilities

144 Background: Recent innovations in lung cancer care create an urgent need to generate survivorship care interventions that target lung cancer survivors and tailor content and services to this unique community. In addition to suffering significant distress and symptom burden, individuals diagnosed with lung cancer suffer the additional burden of stigma and bias and may not receive optimal social support. The Kentucky LEADS Collaborative Lung Cancer Survivorship Care Program adopts a precision survivorship approach by combining shared decision making and motivational interviewing to address specific threats to quality of life experienced by an individual facing lung cancer. Methods: A single-arm trial was conducted at nine cancer care facilities across Kentucky to assess intervention feasibility, acceptability, and preliminary efficacy. Eligible participants included individuals diagnosed with lung cancer who did not evince acute psychiatric or substance abuse issues. Upon consent, participants completed a baseline survey (T1) and medical data was extracted from the electronic record. Participants also completed the survey following intervention completion (T2) and six months post-baseline (T3). Analyses evaluate accrual and completion rates as well as participant demographics. Results: Over an approximately 12-month accrual period, nine sites accrued 142 participants. Three sites exceeded the accrual goal of 20. Of the participants accrued, 138 (97%) completed T1, 84 (58%) completed T2, 74 (52%) completed T3, and 70 (49%) provided complete data. The majority of participants were female (64%), the mean age was 63.4 (9.3) years, and nearly all participants were white/non-Hispanic (96%). Most participants had a high school degree or less (52%), described household incomes of $35K or less, but nearly all reported carrying health insurance (98%). Conclusions: The Kentucky LEADS program offers an intriguing approach to engaging lung cancer survivors by incorporating precision care strategies that may circumvent some of the more common challenges to reaching individuals diagnosed with lung cancer. Clinical trial information: NCT02989974.

Implementation of a novel primary care-centered clinic for survivorship care.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 41-41
Author(s):  
Archana Radhakrishnan ◽  
Youngjee Choi ◽  
Zackary Berger ◽  
Craig Evan Pollack ◽  
Sydney Morss Dy ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Cancer Care ◽  
Psychosocial Support ◽  
Primary Care Providers ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Survivorship Care ◽  
Care Providers

41 Background: Patients often face challenges in transitioning to the survivorship stage of cancer care and coordinating with primary care. Prior research has highlighted the uncertainty in who provides survivorship care, leaving patients “lost in transition”. Integrating primary care providers (PCP) into cancer care offers one potential solution. Expanding traditional PCP roles to participating throughout the cancer continuum and familiarizing PCPs with cancer patients’ needs can address this gap. We describe an innovative model of incorporating PCPs to delivering primary care to cancer survivors at a large academic institution. Methods: As one part of a plan to address an identified need for improving survivorship care for cancer patients at Johns Hopkins, PCPs and cancer survivorship care experts developed the Primary Care for Cancer Survivors clinic (PCCS) in 11/2015. The clinic receives referrals from the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center and patients are seen for either a one-time consultation or can transition their primary care to the clinic. We also are creating a database of internal and external referrals to meet the specific needs identified by patients. We descriptively analyzed the utilization of PCCS from 11/2015 through 9/2016. Results: A total of 35 patients have been seen at PCCS. The average age of patients was 56.8 (SD 12.4) and 32 were female and 3 were male. 24 patients identified as white, 8 black, 1 Asian, and 2 others. Most patients transitioned their PC to the clinic (n = 30). The majority of patients had breast (n = 19) and colorectal cancer (n = 5); 10 patients had metastatic disease (3 have deceased). Commonly, referrals were made to physical therapy, including pelvic rehabilitation and lymphedema management, and nutrition counseling. Conclusions: Patients with a wide variety of cancers and at all stages of disease were seen for survivorship care in the PCCS clinic. Integrating nutrition care, psychosocial support, exercise programs, and palliative care were key early factors in meeting patients’ needs. Continuing to assess and meet survivors’ individual needs and build referral networks are important next steps in the development of the clinic.

Digital Solutions for Cancer Survivorship Care (Preprint)

2018 ◽  
Author(s):  
Ingrid Oakley-Girvan ◽  
Sharon Davis ◽  
Dale G. O'Brien ◽  
Lidia Schapira ◽  
Allison W. Kurian ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Informal Care ◽  
Cancer Survivorship ◽  
Care Coordination ◽  
Cancer Care ◽  
Mobile App ◽  
Clinical Staff ◽  
Survivorship Care ◽  
Convenience Sample ◽  
Care Partners

BACKGROUND Both the National Cancer Institute (NCI) and the National Academy of Medicine have stressed the importance of survivorship care plans (SCP) for cancer survivors and discussed the significance of input from survivors and their advocates. However, there are many barriers to cancer care coordination and the creation of SCPs, including oncology staff time required to write them. Although survivors valued SCPs and liked them, few survivors or care partners report receiving survivorship information. Digital platforms can support cancer survivorship care by integrating with the existing Electronic Health Record and presenting information in a dynamic and user-friendly format that improves coordination and communication. OBJECTIVE In this paper, we describe including medical staff, survivors, and informal care partners in developing a user-centered design for TOGETHERCareTM, (Track Outcomes & Guidance, Technology for Health & Effective Resources for Care) a smartphone mobile app envisioned to provide critical functionality, including planning and sharing the SCP among survivors, physicians, and informal care partners. METHODS Two interviewers conducted a total of nine semi-structured interviews, including a convenience sample of three clinical staff who work with cancer survivors, three cancer survivors, and three informal care partners currently caring for cancer survivors. The interviews with Spanish-speaking survivors and care partners were conducted with a translator. Notes from the interviews were transcribed into a prepared template. The results were compiled and coded by two members of the team. RESULTS We identified areas of consistency in responses between the three different groups in terms of how the mobile app should work, as well as areas of difference. Additional suggestions for features for the mobile app are also presented. Clinical teams focused on the efficiency of using the app, and features that would improve follow-up visits with survivors. Survivors and care partners were more focused on features that would provide assistance with at-home medical tasks and activities of daily living. Although all three groups agreed that there is currently no systematic way for specialists to keep in touch with survivors once they have moved to community care, and that SCPs would be useful, they currently do not receive or provide a SCP. Survivors, care partners, and clinical staff all agreed that they have smartphones and that a mobile app including the ability to communicate between the different groups, along with other features would be welcome and useful. CONCLUSIONS The ubiquity of smartphones and mobile app use provides an opportunity to incorporate patient outcomes and make information and survivorship plans more readily available to informal care partners and cancer survivors. Clinical teams, cancer survivors, and informal care partners all responded positively to a variety of features that could improve the efficiency of cancer care coordination and rapidly improve SCP provision. CLINICALTRIAL None.

Looking Beyond Survival: How Are We Looking at Survivorship?

2006 ◽  
Vol 24 (32) ◽  
pp. 5166-5169 ◽  
Author(s):  
Eva Grunfeld
Keyword(s):  
Cancer Survivorship ◽  
Cancer Care ◽  
Cancer Survival ◽  
Control Strategies ◽  
Cancer Control ◽  
International Perspective ◽  
Access To Treatment ◽  
Follow Up Care

Background The prevalence of cancer survivors is increasing worldwide. This creates the imperative to look beyond cancer survival to cancer survivorship. This review explores cancer survivorship from an international perspective in two ways: from a cancer control perspective through a review of cancer control strategies and from a cancer care perspective through a review of clinical practice guidelines and research on cancer follow-up care. Results Many national cancer control strategies or cancer charities consider survivorship obliquely, primarily under the umbrellas of quality of life and rehabilitation. Few have well-developed policies or plans specifically directed at survivorship. Cancer follow-up care is recognized internationally as a pressing health care issue. Many countries have tested new and innovative models to deliver follow-up care. Similarly, many countries have developed guidelines that specifically address follow-up care. Few studies or guidelines address the broader, multifaceted aspects of cancer survivorship. Discussion This review suggests that research and recognition of cancer survivorship as a unique phase of the cancer care trajectory need to be improved. In many of the poorer countries of the world, the imperative remains the basics of cancer care: timely diagnosis, access to treatment, and alleviation of suffering.

Survivorship: Leveraging the EMR to better care.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 283-283
Author(s):  
Amy Walde ◽  
Emma Bootle
Keyword(s):  
Cancer Survivorship ◽  
Cancer Care ◽  
Governance Structure ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Front Range ◽  
Communication Plan ◽  
Care Plans ◽  
Response Plan ◽  
Treatment Summary

283 Background: UCHealth is a 10-hospital health system located on the Front Range of the Rocky Mountains. In 2018, UCHealth Cancer Care diagnosed or treated more than 8,400 analytic cases. In this presentation, we will discuss how we formulated a response to our organizational need for the creation of a Cancer Survivorship Program that not only met the ASCO QOPI & Commission on Cancer (CoC) Standards but also the needs of our patients. Methods: Our response plan included devising processes for the development and delivery of treatment summary care plans (TS/SCP). The development phase comprised the formation of UCHealth Cancer Care governance structure, creation of 22 disease specific templates containing the Institute of Medicine (IOM) / National Comprehensive Care Network (NCCN) recommended elements of survivorship care, Electronic Health Record (EHR) automation to increase efficiency and finally designing dashboard reports to identify eligible patients and capture compliance. The delivery phase consisted of securing dedicated resources, a communication plan and education for staff and providers regarding the benefits of a Cancer Survivorship program. Results: A jump in compliance from 7% in 2015 to 29% in 2018, demonstrates the success and impact of TS/SCPs at UCHealth. We will also discuss the 2019 work plan to achieve 50% compliance as required by the CoC. Conclusions: Leveraging the EHR is necessary when developing a Cancer Survivorship Program. UCHealth will provide examples of the treatment summary care plans, reference and reporting metrics to get other programs started on their journey.

Palliative care for cancer in Turkey: A comprehensive review of the literature.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24088-e24088
Author(s):  
M. Tezer Kutluk ◽  
Fahad Ahmed ◽  
Mustafa Cemaloğlu ◽  
Burca Aydin ◽  
Meltem Sengelen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Care ◽  
Professional Training ◽  
Psychosocial Support ◽  
Public Awareness ◽  
Health Coverage ◽  
Care Providers ◽  
Care Needs ◽  
Policy Makers ◽  
Centered Care

e24088 Background: Palliative care is patient and family-centered care provided to optimize the quality of life in serious illness, and is an essential health service under Universal Health Coverage. Given the burden of cancer and other chronic disease diseases along with demographic changes, the need for palliative care is growing in Turkey. This study aimed to review of the available scientific literature on palliative cancer care needs, models and outcomes Turkey. Methods: A comprehensive literature review was conducted with English and Turkish keywords in PubMed, Scopus, Embase, ScienceDirect, Web of Science, Google Scholar, The Turkish Academic Network and Information Centre databases, Turkish Ministry of Health documents, Turkish Council of Higher Education’s doctoral thesis, and renowned national and international palliative care as well as cancer conferences 01/ 2000 to 07/ 2020. Results: Out of 27489 papers identified, 320 met the criteria for inclusion. The main focus of these studies was; historical development in palliative care, legislative regulation, professional training, use of opioids, symptom management, care for patients, palliative care centers, public awareness, psychosocial support, and end of life ethics. The majority of this literature used descriptive design, although a few case-control, cohort, and randomized control trials were also found. Our analysis showed that the development of PC in Turkey can be divided into three period. The first (early initiatives, before 2000), the second (dissemination phase, 2000-2010), and the third stage (government & societial engagement, after 2010). Several studies also analyzed the barriers such as low public & professional awareness, disconnection from cancer care, the opioidfobia and the lack of trained palliative care providers. The lack of integration of palliative care to cancer care is a major challenge for palliative care implementation. Conclusions: This review presents the evidence of the significant progress in PC during the last 20 years and the opportunities for further progress. Bringing research into practice is needed for shaping the integration of palliative care to cancer care in Turkey. The stakeholders and policy makers should not neglect the need for PC under the current pressure of COVID-19 pandemic on health and economy.

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