scholarly journals Driving Distance and Patient-Reported Outcomes in Hematopoietic Cell Transplantation Survivors

2020 ◽  
Vol 26 (11) ◽  
pp. 2132-2138
Author(s):  
Rahul Banerjee ◽  
Jean C. Yi ◽  
Navneet S. Majhail ◽  
Heather S.L. Jim ◽  
Joseph Uberti ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Patient Reported Outcomes ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Patient Reported

scholarly journals Novel Health Information Technology Tool Use by Adult Patients Undergoing Allogeneic Hematopoietic Cell Transplantation: Longitudinal Quantitative and Qualitative Patient-Reported Outcomes

2018 ◽  
pp. 1-12 ◽  
Author(s):  
Lyndsey Runaas ◽  
Flora Hoodin ◽  
Anna Munaco ◽  
Alex Fauer ◽  
Roshun Sankaran ◽  
...  
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Cell Transplantation ◽  
Patient Engagement ◽  
Patient Reported Outcomes ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Health It ◽  
Patient Reported

Purpose Health information technology (IT) is an ideal medium to improve the delivery of patient-centered care and increase patient engagement. Health IT interventions should be designed with the end user in mind and be specific to the needs of a given population. Hematopoietic cell transplantation (HCT), commonly referred to as blood and marrow transplantation (BMT), is a prime example of a complex medical procedure where patient-caregiver-provider engagement is central to a safe and successful outcome. We have previously reported on the design and development of an HCT-specific health IT tool, BMT Roadmap. Methods This study highlights longitudinal quantitative and qualitative patient-reported outcomes (PROs) in 20 adult patients undergoing allogeneic HCT. Patients completed PROs at three time points (baseline, day 30 post-HTC, and day 100 post-HCT) and provided weekly qualitative data through semistructured interviews while using BMT Roadmap. Results The mean hospital stay was 23.3 days (range, 17 to 37 days), and patients had access to BMT Roadmap for a mean of 21.3 days (range, 15 to 37 days). The total time spent on BMT Roadmap ranged from 0 to 139 minutes per patient, with a mean of 55 minutes (standard deviation, 47.6 minutes). We found that patients readily engaged with the tool and completed qualitative interviews and quantitative PROs. The Patient Activation Measure, a validated measure of patient engagement, increased for patients from baseline to discharge and day 100. Activation was significantly and negatively correlated with depression and anxiety PROs at discharge, suggesting that this may be an important time point for intervention. Conclusion Given the feasibility and promising results reported in this study, next steps include expanding our current health IT platform and implementing a randomized trial to assess the impact of BMT Roadmap on critical PROs.

scholarly journals Patients as experts: characterizing the most relevant patient-reported outcomes after hematopoietic cell transplantation

2019 ◽  
Vol 55 (1) ◽  
pp. 242-244 ◽  
Author(s):  
Justin C. Solle ◽  
Alexis Steinberg ◽  
Priya Marathe ◽  
Tamryn F. Gray ◽  
Amy Emmert ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Patient Reported Outcomes ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Patient Reported

scholarly journals Financial Hardship and Patient-Reported Outcomes after Hematopoietic Cell Transplantation

2016 ◽  
Vol 22 (8) ◽  
pp. 1504-1510 ◽  
Author(s):  
Gregory A. Abel ◽  
Randy Albelda ◽  
Nandita Khera ◽  
Theresa Hahn ◽  
Diana Y. Salas Coronado ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Patient Reported Outcomes ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Financial Hardship ◽  
Patient Reported

scholarly journals Modified Delphi Panel to Prioritize Patient-Reported Outcomes Following Hematopoietic Cell Transplantation

2018 ◽  
Vol 24 (3) ◽  
pp. S492-S493
Author(s):  
Alexis Steinberg ◽  
Joseph H. Antin ◽  
Sara Close ◽  
Amy Emmert ◽  
Brett Glotzbecker ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Patient Reported Outcomes ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Delphi Panel ◽  
Modified Delphi ◽  
Patient Reported

Financial Burden and Patient-Reported Outcomes after Hematopoietic Cell Transplantation: Impact of Pre-Treatment Awareness of Transplant-Associated Costs

Blood ◽  
2017 ◽  
Vol 130 (Suppl_1) ◽  
pp. 684-684
Author(s):  
Diana Y Salas Coronado ◽  
Theresa Hahn ◽  
Randy Albelda ◽  
Nandita Khera ◽  
Oreofe O. Odejide ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Perceived Stress ◽  
Patient Reported Outcomes ◽  
Hematopoietic Cell Transplantation ◽  
Financial Burden ◽  
Hematopoietic Cell ◽  
Financial Hardship ◽  
Patient Reported ◽  
Pre Treatment ◽  
The Impact

Abstract Background: Financial burden during cancer treatment is associated with compromised patient-reported outcomes (PROs). Being aware of impending costs may help preserve affected PROs during treatment, as patients can adjust their financial expectations. We aimed to determine if the relationship between financial burden and PROs differs among those who were aware versus unaware of transplant-related costs before hematopoietic cell transplantation (HCT) for hematologic malignancy. Methods: In 2015, we administered a mailed survey to adult patients at least 150 days after autologous or allogeneic HCT at three centers: Dana-Farber Cancer Institute, Roswell Park Cancer Institute, and Mayo Clinic Arizona. We assessed pre-treatment awareness of transplant-related costs, decreased household income after HCT, and financial hardship (defined as any one or two of the following: reporting being either unsatisfied with present finances, having difficulty meeting monthly bill payments, or not having enough money at the end of the month; given that experiencing all three would represent extreme hardship likely to impact PROs regardless of awareness, we excluded this group). A seven-point scale was provided for perceptions of overall quality of life (QOL, and patient-reported stress was measured with the Perceived Stress Scale (PSS-4). We fit regression models-stratified by awareness-to assess for the association of income decline and financial hardship with QOL below the median and perceived stress above the median (adjusting for transplant type, sex, age, race, marital status, income, distance to transplant center, and time since diagnosis). Results:In the overall survey cohort (n=325; response rate = 65.1%), 21.6% reported being unaware of HCT-related costs, with no differences due to age, race, income, or education as compared to those who were aware. Patients who reported being aware prior to transplant most often reported being informed of costs by a social worker (40.6%) and least often by a physician (23.4%; sources not mutually exclusive). Among aware patients, income decline after HCT was not associated with QOL below the median (AOR 1.4 [0.8, 2.5]; p=0.24); in contrast, among the unaware, income decline increased the odds of reporting worse QOL (AOR 4.3 [1.1, 16.7]; p=0.04). Among the aware, self-reported financial hardship was associated with worse QOL after HCT (AOR 2.7 [1.5, 4.8]; p=<.001), but the odds were even higher among the unaware (AOR 4.7 [1.2, 19.4]; p=0.03). Similar increases were observed among the unaware for the association of decline in income and financial hardship with increased perceived stress. Conclusions: In this large multi-institutional cohort of patients post-HCT, more than one-fifth reported being unaware of transplant-related costs before the procedure. Moreover, this analysis suggests that pre-treatment awareness of transplant-related costs may ameliorate the impact of post-HCT financial burden on patient-reported outcomes. Figure Figure. Disclosures Khera: Novartis: Consultancy. Zafar: Novartis: Other: Spouse's Employment.

scholarly journals Patient-reported physical functioning predicts the success of hematopoietic cell transplantation (BMT CTN 0902)

Cancer ◽  
2015 ◽  
Vol 122 (1) ◽  
pp. 91-98 ◽  
Author(s):  
William A. Wood ◽  
Jennifer Le-Rademacher ◽  
Karen L. Syrjala ◽  
Heather Jim ◽  
Paul B. Jacobsen ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Physical Functioning ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Patient Reported

scholarly journals Patient-Reported Quality of Life Is an Independent Predictor of Survival after Allogeneic Hematopoietic Cell Transplantation: A Secondary Analysis from the Blood and Marrow Transplant Clinical Trials Network (BMT CTN) 0902

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 206-206 ◽  
Author(s):  
William A. Wood ◽  
Jennifer Le-Rademacher ◽  
Mingwei Fei ◽  
Brent R. Logan ◽  
Karen L Syrjala ◽  
...  
Keyword(s):  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Management Training ◽  
Change Score ◽  
Hematopoietic Cell ◽  
Morbidity And Mortality ◽  
Stress Management Training ◽  
Sf 36 ◽  
Patient Reported ◽  
Physical Hrqol

Abstract INTRODUCTION: Patient reported outcomes (PROs) including symptoms and health related quality of life (HRQOL) predict mortality in multiple cancers, such as myeloma, head and neck, lung and prostate cancer. The relationship of PROs with survival is not clear in hematopoietic cell transplantation (HCT). We tested three hypotheses about the relationship between HRQOL and survival after HCT: (1) Pre-HCT HRQOL (particularly physical HRQOL) reflects functional status and predicts survival after allogeneic (allo) HCT independently of traditional risk factors and indices; (2) Post-HCT change in physical HRQOL reflects the “toll” of the HCT and predicts subsequent outcomes, including survival, among early survivors; (3) Since autologous (auto) HCT is associated with lower risks for treatment-related morbidity and mortality, PROs may not be as predictive for this group. METHODS: We tested these hypotheses using data from the 711 participants in BMT CTN 0902 (sponsored by NHLBI and NCI, NCT 01278927), a randomized study of pre-transplant exercise and stress management training for patients undergoing auto or allo HCT. Because the primary analysis for BMT CTN 0902 did not show a significant effect for exercise or stress management training, intervention groups were combined for these analyses. However, auto and allo recipients were analyzed separately because of the expected substantial differences in the subsequent risks for morbidity and mortality in the two populations. The HRQOL measures used were the physical component score (PCS) and mental component score (MCS) from the SF-36, measured pre-HCT and at day 100. RESULTS: Among 310 alloHCT recipients with a median follow-up of 23 months, while there were no pre-HCT clinical covariates (including age, conditioning intensity, donor type, graft source, disease, disease stage) that predicted survival, pre-HCT physical HRQOL (PCS on the SF-36) was strongly prognostic for survival (HR for death of 0.72 per 10 points increase, 95% CI 0.60-0.85, p<0.001) while pre-HCT MCS was not (HR 0.99, 95% CI 0.84-1.16, p=0.29). Survival estimates for the first, second, third, and fourth quartiles of baseline PCS were, respectively, 67%, 72%, 81%, and 91% at 6 months and 50%, 65%, 75%, and 83% at one year (Figure 1). Among the eight SF-36 subscales, higher pre-HCT Physical Functioning and General Health scores were strongly associated with better survival. Among day 100 survivors, the PCS change score from baseline to Day 100 was also strongly prognostic for subsequent survival after adjusting for pre-HCT PCS (HR 0.55 per 10 points improvement, 95% CI 0.42-0.72, p<0.001) as was the MCS change score after adjusting for pre-HCT MCS (HR 0.70, 95% CI 0.56-0.89, p=0.003). In models that included patient age and the Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI), the EBMT Score, or the Disease Risk Index (DRI), the findings for both pre-HCT values and change scores remained statistically significant with similar hazard ratios, suggesting that PROs convey independent prognostic information for survival despite inclusion of traditional risk factors. Analyses of transplant-related mortality (TRM) in alloHCT recipients showed similar patterns. Higher pre-HCT PCS was predictive of lower TRM. Among patients alive and disease-free at day 100, PCS change score was also associated with lower TRM after adjusting for pre-HCT PCS (HR 0.28, 95% CI 0.17-0.47, p<0.001) and the HCT-CI, EBMT and DRI; pre-HCT MCS and change in MCS did not predict TRM. Among autoHCT recipients (n=337), there were no pre-HCT clinical covariates that predicted survival. Pre-HCT HRQOL also was not prognostic of survival in autoHCT (physical PCS from the SF-36 p=0.82, mental MCS from the SF-36, p=0.56), nor were early changes in either the PCS or the MCS. CONCLUSION: In summary, among alloHCT recipients who participated in BMT CTN 0902, lower pre-HCT physical HRQOL and early decline in physical HRQOL were strongly predictive for worse overall survival and higher transplant-related mortality. These results suggest that patient-reported data are an important component of risk assessment and could assist in clinical decision-making. High-risk individuals could be targeted for different management strategies or more aggressive supportive care interventions to reduce treatment-related morbidity and mortality in this population. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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