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.

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