scholarly journals Clinical and economic effect of administration of red blood product transfusions in an outpatient supportive care cancer service

2020 ◽  
Author(s):  
Andrea Sbrana ◽  
Federico Paolieri ◽  
Francesco Bloise ◽  
Marco Danova ◽  
Luca Galli ◽  
...  
Keyword(s):  
Supportive Care ◽  
Blood Product ◽  
Economic Effect ◽  
Cancer Service ◽  
Outpatient Supportive Care

A Supportive Care in Cancer Unit Reduces Costs and Hospitalizations for Transfusions in a Comprehensive Cancer Center

2017 ◽  
Vol 103 (5) ◽  
pp. 449-456 ◽  
Author(s):  
Carla Ida Ripamonti ◽  
Pietro Molani ◽  
Cinzia Desti ◽  
Giacomo Boscagli ◽  
Fernando Ravagnani ◽  
...  
Keyword(s):  
Supportive Care ◽  
Blood Product ◽  
Hematologic Malignancies ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Daily Cost ◽  
Previous Hospitalization ◽  
Unplanned Hospitalizations ◽  
Outpatient Supportive Care ◽  
Average Daily Cost

Purpose Among patients with solid or hematologic malignancies undergoing oncologic therapies, blood product transfusions (BPT) are a relevant reason for planned/unplanned hospitalizations, as well as a possible cause of delay in administration of the oncologic therapies. Furthermore, they create additional costs for the healthcare system (HCS). The aim of this study was to compare the costs of performing BPT (erythrocytes and platelets) in medical units/wards to the costs derived from the administration of BPT in a dedicated outpatient supportive care in cancer unit (SCCU). Methods Costs were analyzed from June 3, 2009 (when the SCCU started), until December 2013. Four inpatient oncologic units (bone marrow transplantation, radiotherapy, medical oncology I and II) were compared to the SCCU. Data regarding the transfusions performed by the SCCU of the patients who were previously hospitalized for transfusions were extracted, checked, and analyzed through a cross-check on the tax codes. Therefore, patients were considered suitable for the analysis if they had received BPT in the SCCU after a previous hospitalization for transfusion in one of the 4 units/wards. The average daily cost deriving from blood product units and from the hospitalization in each ward (irrespective of pharmaceutical expenses) was compared with the average daily cost deriving from blood product units and from the management of patients in the SCCU. Results We analyzed 227 patients (112 female) with a mean age of 60 years (range 20-90) with hematologic malignancies in 79% of cases. The number of transfusions performed by the SCCU has grown constantly and consistently over the years, reaching 1,402 transfusions in 2013, thus exceeding the other considered units. The total savings for the HCS was €282.204.71, €151.182.85 in 2013 only. We saved €124.319,26 for each patient transfused at the SCCU. Conclusions A dedicated outpatient SCCU, aimed at monitoring and treating cancer therapy-related toxicities and comorbidities and in which it is also possible to perform BPT promptly and effectively, reduces the number of hospitalizations and provides an economical benefit for HCS.

Frequency, predictors, and outcomes of urine drug test among patients with advanced cancer on chronic opioid therapy at an outpatient supportive care clinic.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 94-94
Author(s):  
Joseph Anthony Arthur ◽  
Tonya Edwards ◽  
David Hui ◽  
Jessica Marie Waletich-Flemming ◽  
Suresh K. Reddy ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Opioid Therapy ◽  
Cancer Stage ◽  
Chronic Opioid Therapy ◽  
Advanced Cancer Patients ◽  
Care Clinic ◽  
Urine Drug ◽  
Outpatient Supportive Care

94 Background: Data on the utilization and outcomes of urine drug tests (UDT) among advanced cancer patients is limited. The main objective of this study was to determine the factors associated with UDT ordering and results in advanced cancer outpatients. Methods: A retrospective chart review of 1058 patients seen from March 2014 to November 2015 at an outpatient supportive care clinic was conducted. Sixty-one patients on chronic opioid therapy who underwent UDT were identified. A control group of 120 patients who did not undergo UDT was selected for comparison of information on demographic and clinical characteristics. Results: 61/1058 patients (6%) underwent UDT. 33/61 patients (54%) had abnormal results. Multivariate analysis found that the odds ratio for UDT ordering was 3.9 in CAGE positive patients (p = 0.002), 4.41 in patients less than 45years (p < 0.001), 5.58 in patients with moderate to severe pain (ESAS pain score ≥ 4) (p < 0.001), 0.27 in patients with advanced cancer stage, (p = 0.008), and 0.25 in patients with moderate to severe fatigue (p = 0.001). Among 52 abnormal UDT results in 33 patients, the most common opioid findings were: prescribed opioids absent in urine (14/52, 27%) and un-prescribed opioids in urine (13/52, 25%). Conclusions: UDT was used infrequently among advanced cancer patients receiving outpatient chronic opioid therapy. Younger age, CAGE positivity, early cancer stage or NED status, higher pain intensity, and lower fatigue were significant predictors of UDT ordering. More than 50% of UDTs were abnormal. More research is necessary to better characterize aberrant opioid use in advanced cancer patients.

Advanced cancer patients' (CP) attitudes and perceptions regarding reasons for outpatient supportive care (SC) referral at a comprehensive cancer center: A randomized controlled study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e24135-e24135
Author(s):  
Angelique Wong ◽  
Frank V. Fossella ◽  
George R. Simon ◽  
Rama Maddi ◽  
Zhanni Lu ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Care ◽  
Comprehensive Cancer Center ◽  
Controlled Study ◽  
Cancer Center ◽  
Cancer Type ◽  
Attitudes And Perceptions ◽  
Outpatient Supportive Care

e24135 Background: Current ASCO guidelines propose early access to SC in all CP to improve quality of care, quality of life, and symptoms. Very few studies have evaluated patients’ perceived criteria for referral to outpatient SC and perceptions of patients who are referred early in their disease trajectory. Methods: In this study we evaluated CP attitudes and perceptions regarding the role of and access to outpatient Supportive Care clinic (SCC) at a comprehensive cancer center. CP with life expectancy of greater than 6 months (as determined by the oncologist) and who are newly registered at MD Anderson Cancer Center were randomized to either obtain an educational brochure that explained the role of the SCC or no brochure. Both groups then completed a survey regarding the role and access to of outpatient SCC. After completion of the survey, patients were asked if they would like to be seen by the SC team. If so, they were scheduled by their oncologist for a SC consult. Results: 288 patients were evaluable: median age was 63, 43% were female, 84% were Caucasian, and the most common cancer type was lung cancer (39%). Median survival was 15 months. Patients who received a brochure reported more understanding of the role of SC vs those who did not receive a brochure (63% vs 37%, p = 0.04). Both groups felt that SC could help to address physical (47% vs 54%) and psychosocial (50% vs 50%) symptoms. Both groups felt SC could help to address questions regarding prognosis (50% vs 50%) and future care (53% vs 47%). Both groups did not feel that time (50% vs 50%) nor financial concerns (49% vs 51%) would be barriers to access SC. Both groups did not feel that receiving SC would impede their cancer care (60% vs 40%) nor change their oncologists’ perspective of them (25% vs 75%). Both groups felt they could receive SC and cancer care simultaneously (50% vs 50%). Approximately half of the patients in both groups perceived it was not too early for a referral to SC. There were no statistical differences in these groups for these findings. Conclusions: Patients who received a brochure had a better understanding of the role of SC. A very significant proportion in both groups had limited awareness of the value of SC. Oncologist driven referral and education of SC may facilitate better understanding of the value of SC. Further studies are needed.

scholarly journals Factors Associated With Survival After Opioid Rotation in Cancer Patients Presenting to an Outpatient Supportive Care Center

2014 ◽  
Vol 48 (1) ◽  
pp. 92-98 ◽  
Author(s):  
Akhila Reddy ◽  
Sriram Yennurajalingam ◽  
Maxine de la Cruz ◽  
Shana L. Palla ◽  
Xuan Wang ◽  
...  
Keyword(s):  
Supportive Care ◽  
Cancer Patients ◽  
Care Center ◽  
Opioid Rotation ◽  
Factors Associated ◽  
Outpatient Supportive Care
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