Disparities in Time From First to Second Treatment in Breast Cancer Patients at a Diverse Academic Medical Center

2016 ◽  
Vol 96 (2) ◽  
pp. E32
Author(s):  
S. Khanna ◽  
M.M. Qureshi ◽  
N. Ko ◽  
A. Agarwal ◽  
A.E. Rand ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Medical Center ◽  
Academic Medical Center ◽  
Breast Cancer Patients ◽  
Academic Medical

scholarly journals Race/Ethnicity, Primary Language, and Income Are Not Demographic Drivers of Mortality in Breast Cancer Patients at a Diverse Safety Net Academic Medical Center

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Divya A. Parikh ◽  
Rani Chudasama ◽  
Ankit Agarwal ◽  
Alexandar Rand ◽  
Muhammad M. Qureshi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Medical Center ◽  
Academic Medical Center ◽  
Safety Net ◽  
Primary Language ◽  
Breast Cancer Patients ◽  
Patient Demographics ◽  
Academic Medical ◽  
Race Ethnicity

Objective. To examine the impact of patient demographics on mortality in breast cancer patients receiving care at a safety net academic medical center.Patients and Methods. 1128 patients were diagnosed with breast cancer at our institution between August 2004 and October 2011. Patient demographics were determined as follows: race/ethnicity, primary language, insurance type, age at diagnosis, marital status, income (determined by zip code), and AJCC tumor stage. Multivariate logistic regression analysis was performed to identify factors related to mortality at the end of follow-up in March 2012.Results. There was no significant difference in mortality by race/ethnicity, primary language, insurance type, or income in the multivariate adjusted model. An increased mortality was observed in patients who were single (OR = 2.36, CI = 1.28–4.37,p=0.006), age > 70 years (OR = 3.88, CI = 1.13–11.48,p=0.014), and AJCC stage IV (OR = 171.81, CI = 59.99–492.06,p<0.0001).Conclusions. In this retrospective study, breast cancer patients who were single, presented at a later stage, or were older had increased incidence of mortality. Unlike other large-scale studies, non-White race, non-English primary language, low income, or Medicaid insurance did not result in worse outcomes.

Prevalence of self-reported cognitive dysfunction in breast cancer patients.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 131-131
Author(s):  
Heidi Skirbe ◽  
Gabriela Hohn ◽  
Paula Klein ◽  
Mary Ann Juliano ◽  
Jeremy Winell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Cognitive Dysfunction ◽  
Medical Center ◽  
Academic Medical Center ◽  
Breast Cancer Patients ◽  
Cognitive Changes ◽  
Convenience Sample ◽  
Cognitive Difficulties ◽  
Emotional Dysfunction

131 Background: In 2011 a series of four time-limited, psycho-educational workshops was conducted by a neuropsychologist at a major urban academic medical center, providing information, coping strategies, and resources to women who had been treated for breast cancer (BrCa) and who then sought cognitive treatment. Based on positive evaluations of these workshops, we assessed the prevalence of self-reported cognitive dysfunction in BrCa patients with the goal of expanding cognitive services to all affected cancer patients. Methods: The study was IRB approved. We surveyed a convenience sample of 50 BrCa patients in a single medical oncology waiting room over several weeks. Subjects completed a 16 item questionnaire assessing potential cognitive problems on a 4 point-scale. Results: Fifty patients completed the survey, of whom 46% were currently employed. Sixty-eight percent of respondents were currently receiving cancer treatment and of those, 61.8% had also received prior treatment. Conclusions: An unexpectedly large proportion of BrCa patients perceived cognitive difficulties that may have been compounded by fatigue and emotional dysfunction. Others may have failed to report cognitive difficulties, unaware of their onset. Quality of life of cancer patients is diminished by cognitive decline. The current data indicate a need for formal assessment and intervention programs that will identify patients with cognitive and emotional dysfunction and remediate the difficulties via workshops and therapy. Formal neuropsychological assessment and treatment resourcestargeting cognitive changes associated with cancer should be expanded to meet documented need. Further research will optimize the scheduling and structure of therapeutic interventions. [Table: see text]

Feasibility of lay cancer patient navigation in an academic medical center on unmet needs of cancer patients.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 87-87 ◽  
Author(s):  
William Allen Wood ◽  
Jean B Sellers ◽  
Thomas C. Shea ◽  
Deborah Mayer
Keyword(s):  
Cancer Patient ◽  
Cancer Patients ◽  
Unmet Needs ◽  
Medical Center ◽  
Financial Burden ◽  
Academic Medical Center ◽  
Breast Cancer Patients ◽  
Patient Navigators ◽  
Academic Medical ◽  
Patient Resources

87 Background: Lay cancer patient navigators (LCPN) are volunteers from the community who assist cancer patients in overcoming barriers to receiving quality cancer care. LCPN can address issues such as. financial burden and psychosocial distress, and can reduce disparities in access to resources. There is little data regarding LCPN within academic medical centers. Methods: In 2013, 24 breast cancer patients at our center were surveyed to determine unmet needs. 82% reported feeling alone and 55% reported lack of awareness about available patient resources. These data supported the development of an LCPN program, in January 2015. Volunteers were provided with comprehensive training that focused on supportive communication, identification of barriers to care, and provision of available cancer resources to address unmet patient needs. Volunteers were integrated within clinical workflows to identify and interact with patients felt to potentially benefit from LCPN. Results: A total of 30 volunteer lay patient navigators were trained between January 2015 – June 2016. Of the 30, 14 elected to staff a weekly disease oriented clinic volunteering 3-4 hours per week. There have been 1,034 patient encounters with 484 encounters in new patients and 550 in repeat patients through June 2016. LCPN completed an encounter form after each patient visit. As a result of these encounters, referrals were provided to the following resources: patient and family resource center (74% ); community resource information (30%); financial counseling (27%); and social work (25%). LCPN report that they feel adequately trained to provide information and meet needs of cancer patients during these visits. Conclusions: We have developed an infrastructure to support an LCPN program within our academic medical center, and have found that this infrastructure facilitates provision of information to cancer patients that addresses their unmet needs. The model is cost-effective and requires few internal resources other than training and ongoing supervision. Future steps will include development of specific interventions to enhance the dissemination of this model throughout North Carolina.

scholarly journals Complementary and Alternative Medicine Use in Breast Cancer Patients at a Medical Center in Taiwan: A Cross-Sectional Study

2020 ◽  
Vol 19 ◽  
pp. 153473542098391
Author(s):  
Chieh-Ying Chin ◽  
Yung-Hsiang Chen ◽  
Shin-Chung Wu ◽  
Chien-Ting Liu ◽  
Yun-Fang Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Cancer Patients ◽  
Medical Center ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Cam Use ◽  
Complementary And Alternative

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.

scholarly journals Challenges of implementation and implementation research: Learning from an intervention study designed to improve tumor registry reporting

2016 ◽  
Vol 4 ◽  
pp. 205031211666621 ◽  
Author(s):  
Ann Scheck McAlearney ◽  
Daniel M Walker ◽  
Jennifer Livaudais-Toman ◽  
Michael Parides ◽  
Nina A Bickell
Keyword(s):  
Conceptual Framework ◽  
Implementation Research ◽  
Medical Center ◽  
Academic Medical Center ◽  
Breast Cancer Patients ◽  
Tumor Registry ◽  
Academic Medical ◽  
Study Team ◽  
Intervention Impact ◽  
Quality Of Medical Care

Objectives: Implementation of interventions designed to improve the quality of medical care often proceeds differently from what is planned. Improving existing conceptual models to better understand the sources of these differences can help future projects avoid these pitfalls and achieve desired effectiveness. To inform an adaptation of an existing theoretical model, we examined unanticipated changes that occurred in an intervention designed to improve reporting of adjuvant therapies for breast cancer patients at a large, urban academic medical center. Methods: Guided by the complex innovation implementation conceptual framework, our study team observed and evaluated the implementation of an intervention designed to improve reporting to a tumor registry. Findings were assessed against the conceptual framework to identify boundary conditions and modifications that could improve implementation effectiveness. Results: The intervention successfully increased identification of the managing medical oncologist and treatment reporting. During implementation, however, unexpected external challenges including hospital acquisitions of community practices and practices’ responses to government incentives to purchase electronic medical record systems led to unanticipated changes and associated threats to implementation. We present a revised conceptual model that incorporates the sources of these unanticipated challenges. Conclusion: This report of our experience highlights the importance of monitoring implementation over time and accounting for changes that affect both implementation and measurement of intervention impact. In this article, we use our study to examine the challenges of implementation research in health care, and our experience can help future implementation efforts.

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