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Multisite Quality Improvement Initiative to Identify and Address Racial Disparities and Deficiencies in Delivering Equitable, Patient-Centered Care for Multiple Myeloma-Exploring the Differences between Academic and Community Oncology Centers.

Treatment of multiple myeloma (MM) is complex; however, with equal access to care, clinical outcomes for Black patients match those in other patient groups. To reveal and begin to address clinical practice barriers to equitable, patient-centered MM care, this quality improvement (QI) initiative assessed patient electronic medical records (EMRs) and surveyed patients and providers at two large hospital systems and four community-based practices. For the educational intervention, providers participated in feedback-focused grand rounds sessions to reflect on system barriers and develop action pla

Healthcare Disparities and Outcomes of Cancer Patients in a Community Setting from a COVID-19 Epicenter.

There have been numerous studies demonstrating how cancer patients are at an increased risk of mortality. Within New York City, our community hospital emerged as an epicenter of the first wave of the pandemic in the spring of 2020 and serves a unique population that is predominately uninsured, of a lower income, and racially/ethnically diverse. In this single institution retrospective study, the authors seek to investigate COVID-19 diagnosis, severity and mortality in patients with an active cancer diagnosis. Demographic, clinical characteristics, treatment, SARS-CoV-2 laboratory results, and

Ambulatory care after acute kidney injury: an opportunity to improve patient outcomes.

Purpose of reviewAcute kidney injury (AKI) is an increasingly common problem among hospitalized patients. Patients who survive an AKI-associated hospitalization are at higher risk of de novo and worsening chronic kidney disease, end-stage kidney disease, cardiovascular disease, and death. For hospitalized patients with dialysis-requiring AKI, outpatient follow-up with a nephrologist within 90 days of hospital discharge has been associated with enhanced survival. However, most patients who survive an AKI episode do not receive any follow-up nephrology care. This narrative review describes the e

Multiple Myeloma Outpatient Transplant Program in the Era of Novel Agents: State-of-the-Art.

Multiple myeloma (MM) is the most common indication for autologous stem cell transplantation (ASCT), and outpatient models have been widely developed in this setting. Although numerous studies have demonstrated the safety and feasibility of outpatient ASCT, it is not a routine procedure. Stringent guidelines for patient selection and clinical management, including functional status, caregiver support, and psychological aspects, are essential to identify eligible patients. However, there is still no general agreement on these criteria. Quality of life data are limited and contradictory. There i

Autologous stem cell transplantation in an older adult population.

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Real-world treatment utilization in adults with chronic inflammatory demyelinating polyneuropathy in the United States.

BackgroundManagement of chronic inflammatory demyelinating polyneuropathy (CIDP) is challenged by heterogeneity in severity, comorbidities, potential adverse effects, and treatment accessibility. This study aimed to elucidate treatment utilization among patients with CIDP in the United States (US) to identify potential unmet needs.MethodsAdult patients with CIDP were identified using Komodo Health's Healthcare Map™ (January 2016-December 2020). Descriptive statistics related to utilization of CIDP treatments over 1-year post-index were analyzed. Among patients who used immunoglobulin (Ig), chr

Социальные детерминанты здоровья, качества ухода за больными и результаты лечения неврологических расстройств: систематический обзор.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Социальные детерминанты здоровья (SDOH) оказывают значительное влияние на оказание медицинской помощи и ее результаты, однако их конкретное воздействие на качество неврологической медицинской помощи по-прежнему недостаточно синтезировано. ЦЕЛЬ: Цель этого систематического обзора заключалась в обобщении данных о связях между СДОГ и качеством медицинского обслуживания и результатах лечения пациентов в связи с серьезными неврологическими расстройствами. МЕТОДЫ: ПОСЛЕ ПРИСМА 2020 Руководящие принципы, мы систематически искали Пуббмеда, Интернет науки и Эмбазу для исследовани

Efficacy and safety of vertebral augmentation techniques in patients with osteoporotic vertebral compression fractures: A single center, retrospective, observational study.

BACKGROUND: Back pain secondary to osteoporotic vertebral compression fractures (OVCF) is a common global health problem that is frequently overlooked. For some patients, conservative management (CM) is inadequate to treat the pain associated with OVCF. This subset of patients are often candidates for interventional vertebral augmentation techniques (VAT). Multiple studies have shown significant pain reduction, height restoration, reduction in hospitalization time, morbidity and mortality in patients treated with VAT as compared with those patients treated with CM. This study examines if the p

Резюме докладов 38th - ежегодное собрание общества общей внутренней медицины.

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Defining the psychiatric and financial burden of mental and substance use disorders in cancer patients.

PurposeTo identify the proportion of Emergency Department (ED) visits in cancer patients associated with a mental and substance use disorder (MSUD) and the subsequent healthcare costs.MethodsNationally representative data on ED visits from 2009 to 2018 was obtained from the Nationwide Emergency Department Sample (NEDS). We identified cancer-related visits with or without a MSUD using the Clinical Classifications Software diagnoses documented during the ED visit. Survey-adjusted frequencies and proportions of ED visits among adult cancer patients with or without a MSUD was evaluated. Survey-adj

Orthopaedic Oncology in Contemporary Practice: A Comprehensive Review of Primary Bone Tumours, Metastatic Pathways, and Evolving Surgical Techniques.

Orthopaedic oncology encompasses the diagnosis and management of primary bone sarcomas and metastatic skeletal disease, requiring integration of oncologic principles with complex musculoskeletal reconstruction. Advances in molecular classification, cross-sectional imaging, systemic therapy, and surgical technology have substantially transformed contemporary clinical practice. This comprehensive review synthesises current evidence across epidemiology, tumour biology, diagnostic strategies, staging systems, multidisciplinary management, reconstructive techniques, complication profiles, and survi

2019 ASCO Annual Meeting Highlights for the Advanced Practitioner: Issues in Oncology.

Several abstracts presented at the ASCO Annual Meeting reflected the meeting theme of providing high-quality care to every patient. Following coverage by The ASCO Post, Editor-in-Chief to JADPRO, Pamela Hallquist Viale, RN, MS, CNS, ANP, comments on abstracts revealing disparities afflicting both providers and patients in the cancer care community, as well as initiatives designed to combat them.

The role of social, economic, and medical marginalization in cancer clinical trial participation inequities: A systematic review.

Extant literature reveals how patients of marginalized social identities, socioeconomic status (SES), and medical experiences - especially patients of color and older adults - are underrepresented in cancer clinical trials (CCTs). Emerging evidence increasingly indicates CCT underrepresentation among patients of lower SES or rural origin, sexual and gender minorities, and patients with comorbid disability. This review applies an intersectional perspective to characterizing CCT representativeness across race and ethnicity, age, sexual and gender identity, SES, and disability. Four databases wer

Treatment Satisfaction and Burden of Illness in Patients with Newly Diagnosed Multiple Myeloma.

ObjectivesThis observational study identified attributes of patient-reported satisfaction with therapy for multiple myeloma (MM), described the treatment-related time burden and indirect costs, and investigated the effect of administration route (oral vs. injectable) on these outcomes among patients with newly diagnosed MM (NDMM) and among caregivers.MethodsPatients residing in the USA with a self-reported diagnosis of NDMM were recruited from PatientsLikeMe, MyelomaCrowd, and Facebook (16 December 2016 and 6 July 2017) to complete an electronic survey including questions on treatment experien

Воздействие амбулаторного и стационарного лечения на результаты клинической, экономической и гуманистической терапии у пациентов с гематологическим раком: системный анализ литературы.

Хотя клеточная терапия химерика антигенного рецептора (КАР)-Т, как правило, проводится в стационарных условиях, быстро расширяется амбулаторное лечение. Вместе с тем имеются лишь ограниченные обобщенные данные о сопоставлении результатов работы амбулаторного и стационарного административных органов. Цель этого систематического обзора литературы состоит в том, чтобы сопоставить показатели безопасности, эффективности, качества жизни (QoL), затрат и использования медицинских ресурсов (HCRU) у пациентов с гематологическим раком, которые проходят терапию CAR-T в амбулаторном и стационарном условиях

Совпадение в полном тексте источника
… The authors, however, attributed this to the inadequate reimbursement for CAR-T infusion in the inpatient setting whereas the outpatient setting reimbursement, which is covered under Medicare Part B, covers not only the CAR-T product cost more completely but also the handling, storage, and a portion …

Balancing Quality, Cost, and Access During Delivery of Newer Cellular and Immunotherapy Treatments.

Purpose of reviewThe chimeric antigen receptor (CAR) T-cell therapy is currently changing the landscape of hematologic malignancies with multiple FDA-approved cell therapy products in the USA. The current administration process of the CAR T-cell therapy is complicated, labor-intensive, and expensive.Recent findingsThe chimeric antigen receptor (CAR) T-cell therapy is currently changing the landscape of hematologic malignancies with multiple FDA-approved cell therapy products in the USA. The current administration process of the CAR T-cell therapy is complicated, labor-intensive, and expensive.

Financial burden among older, long-term cancer survivors: Results from the LILAC study.

BackgroundIncreasing attention is being paid to financial burdens of cancer survivorship, but little is known about the prevalence and predictors of these burdens in older, long-term survivors.MethodsWe used data from 6012 participants diagnosed with cancer since enrolling in the Women's Health Initiative, and who participated in the Life and Longevity After Cancer (LILAC) ancillary study to estimate prevalence and identify predictors of financial burden. We used logistic regression to identify sociodemographic, socioeconomic, health- and cancer-related factors associated with financial burden

Impact of hospital safety-net status on in-hospital and short-outcomes after hematopoietic stem cell transplantation.

Safety-net hospitals (SNHs) cater to the medical needs of underserved populations, but their impact on the outcomes of hematopoietic stem cell transplantation (HSCT) remains unclear. The aim of this study was to evaluate the relationship between safety-net status and posttransplant outcomes using the National Readmission Database (NRD), including in-hospital mortality, in-hospital complications, and readmission. This was a retrospective cohort study. Adult patients who underwent allogeneic or autologous HSCT were identified using ICD-9 and ICD-10 procedure codes. Hospitals were classified as S

Utilization and quality of palliative care in patients with hematological and solid cancers: a population-based study.

BackgroundPalliative care (PC) contributes to improved end-of-life care for patients with hematologic malignancies (HM) and solid tumors (ST) by addressing physical and psychological symptoms and spiritual needs. Research on PC in HM vs. ST patients is fragmented and suggests less use.MethodsWe analyzed claims data of all deceased members of a large German health insurance provider for the year before death. First, we analyzed the frequency and the beginning of different types of PC and compared patients with HM vs. ST. Second, we analyzed the adjusted impact of PC use on several end-of-life q

Financial Toxicity of Hematologic Malignancy Therapies, Including Cellular Therapy and Its Impact on Access to Care: Prospective Pilot Study.

BackgroundPatients with cancer often face significant financial challenges, known as financial toxicity (FT), which is associated with reduced quality of life. Patients with hematologic malignancies (HMs) are especially vulnerable due to intensive and prolonged treatments, frequent hospital visits, and a high risk of complications. While FT affects many in the general population, it is particularly severe among racial and ethnic minorities, especially those below the poverty line. To our knowledge, no studies have specifically examined FT in this vulnerable group in the United States.Objective