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Early palliative care for solid and blood cancer patients and caregivers: Quantitative and qualitative results of a long-term experience as a case of value-based medicine.

IntroductionCancer patients and their caregivers have substantial unmet needs, that negatively impact the clinical outcome and quality of life. However, interventions aimed to address such needs are still suboptimal, failing to answer the recent healthcare call for the adoption of value-based models of care. In the case of incurable oncologic and hematologic cancers, a value-based model of care should plan advanced care on patients' needs and include the quality of death as an outcome. The integration of early palliative care into standard oncologic care for patients with advanced cancers repr

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… A clear training pathway as dual board-certified medical hematologist/oncologist and (early) palliative care physician is worth pursuing, in order to avoid hematologists and oncologists still confusing palliative care with end-of-life care ( 85 , 86 ). … Education of early palliative care specialists among hematologists and oncologists to address patients' rather than physicians' rights . Ann Hematol. ( 2021 ) 100 : 2857 – 8 . 10.1007/s00277-021-04512-0 33839880 …

Exploring cancer care needs for Latinx adults: a qualitative evaluation.

PurposeLatinx adults with cancer, as compared with non-Latinx White adults, are diagnosed with more advanced stages and experience worse quality of life. Identifying barriers in cancer care among low-income Latinx adults is crucial to designing and implementing culturally appropriate interventions. The objective of this study was to explore the specific barriers encountered by Latinx adults after a cancer diagnosis and perspectives on the use of community health workers (CHWs) to address these barriers.MethodsWe conducted semi-structured qualitative interviews with low-income Latinx adults wit

Venous thromboembolism prevention program implementation in a community oncology practice: a cohort study.

BackgroundWhile national guidelines recommend Venous Thromboembolism (VTE) risk assessment in cancer outpatients and consideration of pharmacologic prophylaxis in high-risk patients, prophylaxis rates are low in community oncology practices. A successful model for guideline implementation (the Vermont Model, VM) is validated in an academic tertiary oncology setting. We undertook an implementation study to determine the success of this model in a multi-site community oncology practice. The study objectives were to: 1) adapt the VM to the community practice setting; 2) implement the adapted VM i

Association between palliative care and end-of-Life care for patients with hematological malignancies: A population-based study.

To date, few studies have examined the end-of-life (EOL) care for patients with hematological malignancies (HMs). We evaluated the effects of palliative care on the quality of EOL care and health care costs for adult patients with HMs in the final month of life.We conducted a population-based study and analyzed data from Taiwan's Longitudinal Health Insurance Database, which contains claims information for patient medical records, health care costs, and insurance system exit dates (our proxy for death) between 2000 and 2011.A total of 724 adult patients who died of HMs were investigated. Of th

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… oncologists. … J Palliat Med 2014 ; 17 : 195 – 9 . 24383458 10.1089/jpm.2013.0250 PMC3997144 [38] Kao SC Butow P Bray V Patient and oncologist estimates of survival in advanced cancer patients . …

Diagnostic and therapeutic approaches to multiple myeloma patients: 'Real-world' data from representative multicentre treatment surveys in Germany between 2008 and 2011.

A survey was conducted to investigate the standard of care for multiple myeloma in Germany, in order to clarify the status of implementation of international and national treatment guidelines. In addition, the changes in disease management over time were investigated by comparison with surveys conducted in 2008 and 2009. The survey captured a representative sample of 478 myeloma patients with a mean age of 67.9 years across various stages of the disease. Diagnostic approaches, prognostic aspects and treatment decisions were evaluated based on a survey conducted in 2011 in 58 representative cen

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… The patient population was very comparable between the surveys with regard to participating institutions, covering office-based haemato-oncologists, non-academic hospitals and university hospitals. … Hou J Jurczyszyn A Durie International myeloma working group recommendations for global myeloma care Leukemia 28 981 992 2014 10.1038/leu.2013.293 24177258 4 Pulte D Gondos A Brenner H Improvement in survival of older adults with multiple myeloma: Results of an updated period analysis of SEER data Oncologist …

The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges.

Cardiovascular multidisciplinary heart teams (MDHTs) have evolved significantly over the past decade. These teams play a central role in the treatment of a wide array of cardiovascular diseases affecting interventional cardiology, cardiac surgery, interventional imaging, advanced heart failure, adult congenital heart disease, cardio-oncology, and cardio-obstetrics. To meet the specific needs of both patients and heart programs, the composition and function of cardiovascular MDHTs have had to adapt and evolve. Although lessons have been learned from multidisciplinary cancer care, best practices

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… Surgical valve replacement (TV + PV) vs palliative/hospice care Card-Onc, HFC, CTS, IC, CA, oncologist, ACI PC, Neph 1. Assess frailty, physical and cognitive functioning, and nutritional status 2. Determine extent of extracardiac carcinoid 3. Assess severity of right HF 4. … Cardiologists, oncologists, and APCs form the primary core members of cardio-oncology MDHTs, and pharmacists play a key role in helping form cardiac and oncologic treatment plans with the aim of minimizing the risk of drug-drug interactions, QTc prolongation, bleeding, and thromboembolism. …

A Multi-step Approach to Adapting a Mind-Body Resiliency Intervention for Fear of Cancer Recurrence and Uncertainty in Survivorship (IN FOCUS).

BackgroundFor cancer survivors, there is a paucity of fear of recurrence (FOR) interventions that integrate empirically supported mind-body and psychological skills for managing FOR and are delivered in scalable formats.ObjectiveTo adapt an evidence-based resiliency intervention to address FOR among cancer survivors.MethodsA multidisciplinary team of researchers, clinicians, and patient stakeholders followed an iterative intervention adaptation process (ORBIT). In Step 1, we sought to define key FOR management skills through a literature review and feedback from stakeholders. In Step 2, we int

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… “ ) and their experiences engaging in healthcare (i.e., “After completing your treatment, what are reasons why you have contacted your oncologist? … Beth Israel Deaconess Medical Center oncologists and cancer clinicians confirmed that the study procedures were feasible and suggested an onsite location for holding the groups. …

Treatment of Severe Atopic Dermatitis with Dupilumab in Patients with Advanced Cancer.

Atopic dermatitis is a chronic inflammatory intensively pruritic skin disease. Patients with moderate-to-severe atopic dermatitis or with difficult-to-treat areas are candidates for systemic therapy, especially when topical therapy is inadequate. Currently, we have available not only conventional immunosuppressive systemic therapy, but also targeted biological therapy, which has shown a remarkable reduction in clinical severity with a good safety profile. Dupilumab has been approved to treat moderate-to-severe atopic dermatitis. Even though the therapy has been available for more than 3 years,

A structured group exercise program for patients with metastatic cancer receiving chemotherapy and CTNNB1 (β-catenin) as a biomarker of exercise efficacy.

IntroductionExercise can improve the symptoms of cancer. However, is it a cancer treatment? We tested the feasibility of group exercise for metastatic cancer patients while on chemotherapy. A biomarker for exercise efficacy in colorectal cancer (CRC), β-catenin, was tested.MethodsPatients undergoing palliative chemotherapy were eligible for a pre-post, single-arm study comprising an indefinite, weekly group exercise intervention using strength and aerobic training. The Functional Assessment of Chronic Illness Therapy (FACIT) and Piper Fatigue Scale (PFS) questionnaires were administered, and a

Clinical pharmacology of chemotherapy agents in older people with cancer.

Populations around the world are aging, and the associated increase in cancer incidence has led to the recognition of the importance of geriatric oncology. Chronological age is a poor determinant of pharmacological response to cancer chemotherapy agents. Age-associated changes in physiology and organ function have a significant impact on the clinical pharmacology of cancer chemotherapy agents used in cancer treatment. Altered response to medicines in older people is a consequence of changes in body composition, organ function, concomitant pathophysiology, multiple medications, genetic determin

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… Comprehensive Geriatric Assessment A comprehensive geriatric assessment (CGA) approach, including identification of frailty, can assist oncologists in identifying older patients who are more likely to develop severe toxicity during cancer treatment [ 44 ]. … Some clinical oncologists have used an abbreviated tool such as the VES-13 to screen patients who should go on to a full CGA [ 48 ]. …

Integrative oncology in Cancer Care Continuum

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… SIO has recently initiated an Ayurveda Interest Group, aiming to bring awareness of Ayurveda to the integrative oncologists and encourage collaborations for research in Ayurveda. … We welcome the critical comments, suggestions, and discussions from the learned TCIM scholars, readers, researchers, oncologists, and practitioners. …

Global Budget Revenue Model and Care for Patients Receiving Chemotherapy.

ImportanceMaryland's Global Budget Revenue (GBR) model provided fixed global payments to hospitals, aiming to control revenue growth while improving care quality. The implications of GBR implementation in 2014 for cancer care have not been robustly evaluated.ObjectiveTo examine the association between GBR implementation and subsequent changes in episode-based Medicare payments, hospital utilization, and quality of care among Medicare beneficiaries undergoing systemic therapy for cancer.Design, setting, and participantsThis cohort study used a difference-in-differences approach to compare chang

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… Each episode was assigned to a treating oncologist and oncology practice based on the plurality of office visits. Episodes attributed to out-of-state oncology practices were excluded. … We documented year-specific HSA-level variables, including number of billing oncologists per 10 000 elderly population, oncology practice–defined Herfindahl-Hirschman index, 28 number of hospital-owned oncology practices, total number of beds, percentage of 340B hospitals, and percentage of teaching …

Patient assessment and feasibility of treatment in older patients with cancer: results from the IN-GHO® Registry.

PurposePredicting feasibility of treatment in older patients with cancer is a major clinical task. The Initiative Geriatrische Hämatologie und Onkologie (IN-GHO®) registry prospectively collected data on the comprehensive geriatric assessment (CGA), physician's and patient's-self assessment of fitness for treatment, and the course of treatment in patients within a treatment decision aged ≥ 70 years.Patients and methodsThe registry included 3169 patients from 93 centres and evaluated clinical course and treatment outcomes 2-3 and 6 months after initial assessment. Fitness for treatment was clas

Precancer and cancer-associated depression and anxiety among older adults with blood cancers in the United States.

For patients with blood cancers, comorbid mental health disorders at diagnosis likely affect the entire disease trajectory, as they can interfere with disease information processing, lead to poor coping, and even cause delays in care. We aimed to characterize the prevalence of depression and anxiety in patients with blood cancers. Using the Surveillance, Epidemiology, and End Results-Medicare database, we identified patients ≥67 years old diagnosed with lymphoma, myeloma, leukemia, or myelodysplastic syndromes between 2000 and 2015. We determined the prevalence of precancer depression and anxi

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… Unfortunately, psychosocial care has mostly lagged behind biomedical care, with existing studies suggesting that a large proportion of oncologists do not routinely screen their patients for distress or mental health disorders. 28 In a national survey of 448 oncologists, only 14.3% reported screening … Screening for psychosocial distress: a national survey of oncologists . J Support Oncol. 2007 ; 5 ( 10 ): 499 - 504 . 18240673 29. Armenian SH , Lacchetti C , Lenihan D . …

Portable medical orders and end-of-life measures in acute myeloid leukemia and myelodysplastic syndromes.

Patients with acute myeloid leukemia (AML) or a myelodysplastic syndrome (MDS) experience high rates of hospitalization, intensive care unit (ICU) admission, and in-hospital death at the end of life. Early goals-of-care (GOC) discussions may reduce the intensity of end-of-life (EOL) care. Portable Medical Order forms, known as Medical Orders for Life-Sustaining Treatment (MOLST) forms in New York state, assist patients in translating GOC discussions into specific medical orders that communicate their wishes during a medical emergency. To determine whether the timing of completion of a MOLST fo

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… The primary oncologist completed the first MOLST form in 19.5% (58 of 297) of cases; the remaining MOLST forms were completed by other oncologists (25.6%; 76 of 297), hospitalist or other medicine providers (9.8%; 29 of 297), ICU providers (18.5%; 55 of 297), palliative care providers (8.1%; 24 of 297 … As a prior study suggested, 14 hematologic oncologist participation in GOC discussions/POLST completion may be important in guiding the use of intensive treatments and hospice care. Our study has limitations. …

Through the Eyes of Patients: The Effect of Training General Practitioners and Nurses on Perceived Shared Decision-Making Support.

PurposeTo examine the effects of training general practitioners and nurses in shared decision-making (SDM) support as perceived by cancer patients and survivors.DesignAn innovative, experimental design was adopted that included analogue patients (APs), that is, people who have or have had cancer and who imagine themselves in the position of the actor-patient presented in a video. Each AP assessed a video-recorded simulated consultation of a health care professional (HCP) conducted before or after an SDM support training program. The primary outcome was the APs' perceived SDM support with 13 se

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… The patient had had a conversation with the oncologist about starting palliative chemotherapy. … Effect of a skills training for oncologists and a patient communication aid on shared decision making about palliative systemic treatment: a randomized clinical trial. Oncologist. 2020;25:e578–88. 49. Wieldraaijer T, de Meij M, Zwaard S, van Weert H, Wind J. …

Artificial intelligence across the cancer care continuum.

Artificial intelligence (AI) holds significant potential to enhance various aspects of oncology, spanning the cancer care continuum. This review provides an overview of current and emerging AI applications, from risk assessment and early detection to treatment and supportive care. AI-driven tools are being developed to integrate diverse data sources, including multi-omics and electronic health records, to improve cancer risk stratification and personalize prevention strategies. In screening and diagnosis, AI algorithms show promise in augmenting the accuracy and efficiency of medical image ana

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… This process, which is traditionally done manually by radiation oncologists, can be time‐consuming and prone to variability. … AI algorithms can also analyze patient data to identify individuals who may be at risk for developing anxiety, depression, or other mental health conditions, allowing for early intervention and support. 46 The expertise of medical oncologists, radiation oncologists, surgeons, pathologists, radiologists …

Cannabis in Hematology Survey Study (CHESS): A Longitudinal Investigation on Uses, Attitudes, and Outcomes of Cannabis Among Hematology Patients Undergoing Hematopoietic Stem Cell Transplant.

Cancer patients use cannabis for medicinal purposes; however, few studies have examined hematology patients' use of cannabis and no research to our knowledge has investigated the use of cannabis amongst hematology patients before and after hematopoietic stem cell transplant (HCT). The purpose of this longitudinal survey study was to assess aspects of cannabis use in patients who underwent HCT. Eligible patients (N = 30) completed two surveys before and 90 days following their HCT. The surveys inquired about several aspects of cannabis (e.g., rate of use, beliefs and attitudes, access to inform

Отношение группы по гемато-онкологии к тому, чтобы направлять пациентов на паллиативный уход: качественное исследование.

ЦЕЛЬ: Согласно международной литературе, пациенты с гематологическими заболеваниями часто обращаются к паллиативному лечению (ПХ) на позднем этапе. Цель этого исследования заключается в изучении отношения группы по уходу за гемато-онкологами к направлению пациентов на ПК в больницу четвертого уровня в Боготе (Distrito Capital). МЕТОДЫ: Это аналитическое качественное исследование проводилось в рамках индивидуальных целевых групп в период с мая 2024 и октябрь 2024 в Университете Колумбии в Боготе, Колумбия. Данные анализировались на тематической основе с использованием рамочного анализа - аналит

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… Four in-person focus groups were conducted with members of the hemato-oncologist team at Clínica Universitaria Colombia in Bogotá, Distrito Capital, between July and December 2024. … How views of oncologists and haematologists impacts palliative care referral: A systematic review . BMC Palliat Care 2020 ; 19 ( 1 ): 175 ; doi: 10.1186/s12904-020-00671-5 33228651 PMC7686696 28. Sullivan LS , Adler M , Arenth J , et al. …

Интеграция паллиативного ухода в многообразное лечение миеломы: оптимизация качества жизни по всему спектру болезней.

Множественная миелома (ММ) создает значительные проблемы из-за ее сложного симптоматологического и изменяющегося ландшафта лечения. Несмотря на то, что терапевтический прогресс позволил улучшить показатели выживания, комплексное управление ММ требует удовлетворения многочисленных физических и психосоциальных потребностей пациентов. Паллиативный уход (ПХ) предлагает комплексный подход к лечению симптомов и поддержке ухода на физическом, психологическом и духовном уровнях; однако его роль в ММ по-прежнему недостаточно изучена. МЕТОДЫ: В этом ретроспективном исследовании с одним центром рассматри