scholarly journals Management of Vaginal Atrophy: Implications from the REVIVE Survey

2014 ◽  
Vol 8 ◽  
pp. CMRH.S14498 ◽  
Author(s):  
Susan Wysocki ◽  
Sheryl Kingsberg ◽  
Michael Krychman
Keyword(s):  
Unmet Needs ◽  
Medical Condition ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Treatment Preferences ◽  
Vaginal Atrophy ◽  
Vaginal Symptoms ◽  
Poor Understanding ◽  
Women’S Views

Vulvar and vaginal atrophy (VVA) is a chronic and progressive medical condition common in postmenopausal women. Symptoms of VVA such as dyspareunia, vaginal dryness, irritation, and itching can negatively impact sexual function and quality of life. The REVIVE (REal Women's Views of Treatment Options for Menopausal Vaginal ChangEs) survey assessed knowledge about VVA and recorded attitudes about interactions with healthcare providers (HCPs) and available treatment options for VVA. The REVIVE survey identified unmet needs of women with VVA symptoms such as poor understanding of the condition, poor communication with HCPs despite the presence of vaginal symptoms, and concerns about the safety, convenience, and efficacy of available VVA treatments. HCPs can address these unmet needs by proactively identifying patients with VVA and educating them about the condition as well as discussing treatment preferences and available therapies for VVA.

scholarly journals Update on Clinical Options for the Management of Allergic Rhinitis

2011 ◽  
Vol 3 ◽  
pp. CMT.S6375
Author(s):  
Mohsen Nasir ◽  
J. Andrew Grant
Keyword(s):  
Allergic Rhinitis ◽  
Medical Condition ◽  
Treatment Options ◽  
Chronic Medical Condition ◽  
Effective Treatment Option ◽  
Economic Productivity ◽  
First Line Therapy ◽  
Avoidance Measures ◽  
And Control

Allergic rhinitis is a common, chronic medical condition affecting millions of people worldwide. Uncontrolled disease has been associated with impairments in quality of life and decreased economic productivity. Proper identification and control of relevant co-morbid conditions is essential for optimal rhinitis control. Management of allergic rhinitis includes identification of relevant allergens, education on avoidance measures, medications and immunotherapy. First-line therapy includes the use on an intranasal steroid. Other treatment options include oral or intranasal antihistamines, decongestants, leukotriene receptor antagonists, mast cell stabilizers or anticholinergic agents. Immunotherapy is an effective treatment option for refractory disease.

scholarly journals How Well Do Documented Goals-of-Care Discussions for Patients with Stage IV Cancer Reflect Communication Best Practices?

2021 ◽  
Author(s):  
Natalie C. Ernecoff ◽  
Kathryn L. Wessell ◽  
William A. Wood ◽  
Gary S. Winzelberg ◽  
Frances A. Collichio ◽  
...  
Keyword(s):  
Best Practices ◽  
Cancer Progression ◽  
Treatment Options ◽  
Stage Iv ◽  
Treatment Recommendation ◽  
Treatment Preferences ◽  
Goals Of Care ◽  
Patient Goals ◽  
Stage Iv Cancer

Abstract Background: Written clinical communication regarding patients’ disease understanding and values may facilitate goal-concordant care, yet little is known about electronic health record (EHR) goals-of-care documentation. We sought to (1) describe frequency of communication best practices in EHR-documented goals-of-care discussions, and (2) assess whether templated notes improve quality of documentation.Methods: We abstracted all EHR-documented goals-of-care discussions for hospitalized patients with Stage IV cancer from admission to 60-days follow-up. Goals-of-care documentation was operationalized to include discussion of: (a) prognosis and/or illness understanding; and (b) goals and/or treatment options. Investigators qualitatively coded text based on conceptual frameworks for communication best practices, including decision making documentation, and noted if a health system template was used. Results: Among 206 of 492 (42%) patients with documented goals-of-care discussions, clinicians frequently communicated cancer progression or incurability (89%), but rarely addressed prognosis for life expectancy (22%). Goals and values were documented for 83%, and a treatment decision for 82% of patients. Treatment preferences were assessed for 98% of patients; options discussed included cancer treatment (62%), hospice (62%), resuscitation (51%), or intensive care (38%). Clinicians made a treatment recommendation for 40% of patients. Attention to emotional and spiritual concerns was uncommon (15%). Use of a template increased documentation of patient goals and values (80% vs. 61%, p<0.01), but did not enhance other communication best practices.Conclusion: Insights from the study can be used to guide future training and research to study and improve the quality of written communication about goal of care, and its impact on goal-concordant care.

Discovering the Unmet Needs of People With Difficulties Understanding Speech in Noise and a Normal or Near-Normal Audiogram

2020 ◽  
Vol 29 (3) ◽  
pp. 329-355
Author(s):  
Kiri Mealings ◽  
Ingrid Yeend ◽  
Joaquin T. Valderrama ◽  
Megan Gilliver ◽  
Jermy Pang ◽  
...  
Keyword(s):  
Help Seeking ◽  
Design Thinking ◽  
Unmet Needs ◽  
Treatment Options ◽  
Standard Test ◽  
Noisy Environments ◽  
Test Protocol ◽  
Help Seeking Behaviors ◽  
Speech In Noise

Purpose A proportion of people with a normal audiogram or mild hearing loss (NA-MHL) experience greater-than-expected difficulty hearing speech in noise. This preliminary exploratory study employed a design thinking approach to better understand the clinical pathway and treatment options experienced by this population. Method Exploratory survey data were analyzed from 233 people with NA-MHL who had consulted a clinician and 47 clinicians. Qualitative analysis was performed on interview data from 21 people with NA-MHL and seven clinicians. Results Results revealed that noisy environments, such as restaurants, were where many people experienced listening difficulties. Most people with NA-MHL were not offered a treatment option at their audiology appointment, and their satisfaction with the appointment was diverse. Many clients reported frustration at being told that their hearing was “normal.” Data from clinicians showed that there is no standard test protocol for this population, and most felt that they did not have adequate training or resources to help NA-MHL clients. Conclusion This study discusses the research needs regarding the experience of those with NA-MHL, their help-seeking behaviors, and treatment options. Understanding these needs is the first step to designing projects to improve the quality of life of this population.

Implementation of a new patient health questionnaire into standard practice in outpatient cancer clinics to improve patient care and quality of treatment.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 214-214
Author(s):  
Kathryn Estey ◽  
Catherine Brown ◽  
Andrea Perez-Cosio ◽  
Gursharan Gill ◽  
Mindy Liang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Patient Care ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Improve Patient Care ◽  
Electronic Version ◽  
Clinic Visit ◽  
Additional Information ◽  
Risk Factor Information

214 Background: Patient socio-demographic, lifestyle, and risk factor information at the Princess Margaret Cancer Centre (PM) is routinely collected for clinical purposes. The only standardized patient information presently being gathered in the outpatient cancer clinics at the PM is symptom management data, which is linked directly into the electronic medical records. Collecting and recording additional data can improve the quality of patient care, help identify risk factors, and guide treatment options. Our aim was to determine the feasibility of collecting this additional information in a clinical setting. Methods: This pilot cohort study was implemented in the thoracic outpatient oncology clinic at the PM. It involved developing a questionnaire utilizing literature sources, expert review, and pilot testing. Adult cancer patients completed the questionnaire and a complementary acceptability survey during their first clinic visit. Results: 170 patients with thoracic tumours, primarily lung cancer, took part in the feasibility study. Of these, 51% were female, 67% were Caucasian, and the median age was 65 (range 32 to 88) years old. The acceptability survey demonstrated that: 76% of respondents found that the questionnaire did not make their clinic visit more difficult, 68% found that it asked the right questions, 79% thought the questionnaire contained pertinent information for their doctor and other healthcare providers to know, and 51% found that it was time consuming to complete. Conclusions: This study determined that it is feasible to implement a standardized questionnaire that gathers patient socio-demographic, lifestyle, and risk factor information in routine clinical cancer care. Since half of the study population found the questionnaire time consuming to complete it should be administered prior to patient visits, in an electronic format, and with greater explanation/education. The next phase is converting the questionnaire into an electronic version, which aligns with the preferences of study participants and will allow the information to be more easily accessible by clinicians/researchers.

Assessing overall patient satisfaction among cancer patients: A radiotherapy survey.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19249-e19249
Author(s):  
JoAnne Meng ◽  
Elisabeth Cisa-Pare ◽  
Katelyn Balchin ◽  
Julie Renaud ◽  
Linda Bunch ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Cancer Patients ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Community Resources ◽  
Emotional Needs ◽  
Lung Cancers ◽  
Almost All ◽  
Radiation Medicine

e19249 Background: Healthcare providers (HCPs) strive to maximize the experience for cancer patients. Published reports suggest a variety of characteristics that are considered important. We decided to survey our patients undergoing radiotherapy to determine what they considered desirable traits and characteristics. Methods: An ethics approved 35-item patient satisfaction survey evaluating respondent experience was developed by an interdisciplinary team of HCPs working in the radiation medicine program. It was an anonymous, voluntary, paper-based survey for self-completion. It evaluated a variety of domains with respect to the quality of care patients received, and was administered to patients undergoing radiotherapy. Results: A total of 199 patients completed the survey. The median age was 68, with approximately 54% women and 45% men (1% unreported). Most patients (85%) had been diagnosed with their cancer within the previous year, and the commonly reported malignancies (61%) were breast, prostate and lung cancers. Almost all (95%) “agreed" or "strongly agreed" about the importance of physicians being sensitive and compassionate. Over 90% felt they received adequate explanations about their treatment, and had their questions answered. The vast majority (93%) felt included in the decision-making process. They reported the 5 most important qualities among the HCPs as follows (in descending order): knowledge, kindness, honesty (answering questions/giving information), good communicator and cheerful attitude. Most (>70%) reported feeling connected with their HCPs. Although overall satisfaction was high, there were areas for improvement identified. These included patients being offered future appointments to discuss their diagnosis and treatment, receiving information about clinical trials and other treatment options, and being given contact information for psychosocial and community resources. Also, HCPs tended to focus mainly on the physical needs of patients and to a lesser degree on their emotional needs, but spiritual and cultural needs were not routinely addressed (<10%). Conclusions: Reassuringly, cancer patients receiving radiation report high rates of satisfaction across many aspects of their care. The qualities most appreciated serve as a reminder to clinicians that their role is more than just that of a medical expert. These findings also reinforce the different aspects of holistic care that can be improved.

scholarly journals Muscle Invasive Bladder Cancer: From Diagnosis to Survivorship

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
N. E. Mohamed ◽  
M. A. Diefenbach ◽  
H. H. Goltz ◽  
C. T. Lee ◽  
D. Latini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
The Usa ◽  
Muscle Invasive ◽  
The Impact

Bladder cancer is the fifth most commonly diagnosed cancer and the most expensive adult cancer in average healthcare costs incurred per patient in the USA. However, little is known about factors influencing patients' treatment decisions, quality of life, and responses to treatment impairments. The main focus of this paper is to better understand the impact of muscle invasive bladder cancer on patient quality of life and its added implications for primary caregivers and healthcare providers. In this paper, we discuss treatment options, side effects, and challenges that patients and family caregivers face in different phases along the disease trajectory and further identify crucial areas of needed research.

scholarly journals Patient and provider differences in the treatment of opioid-induced constipation: a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Michelle S. Keller ◽  
Alma Jusufagic ◽  
Brennan M. R. Spiegel
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Pain ◽  
Treatment Options ◽  
Daily Basis ◽  
Lifestyle Changes ◽  
Treatment Preferences ◽  
Structured Interviews ◽  
Related Quality

Abstract Background Patients using opioids to treat chronic non-cancer pain often experience side effects that may affect health-related quality of life (HRQOL). These side effects include opioid-induced constipation (OIC), sedation, dizziness, and nausea. OIC can significantly affect HRQOL for patients on a daily basis. However, it is not well understood whether patients and clinicians view OIC management similarly. Aims In this study, we sought to elucidate the decision-making process around managing OIC by assessing patient and provider treatment preferences, experiences, and communication regarding this condition. Methods We conducted semi-structured interviews with 33 clinicians, and held three focus groups with patients who were currently using or had used opioids for chronic non-cancer pain. We then analyzed transcribed interviews using descriptive qualitative methods based on grounded theory methodology. Results Clinicians recognized OIC as a concern but prioritized pain management over constipation. They focused on medication-based treatments for OIC, but also recommended lifestyle changes (e.g., diet) and reducing opioids to relieve symptoms. Patients reported using over-the-counter treatments, but the majority focused on diet-related constipation management. Patients reported not receiving adequate information from clinicians about OIC and relevant treatments. Cost of treatment was a major concern for both patients and clinicians. Conclusions Assessing experiences with and preferences for OIC treatment, including cost, ease of access, and side effects, could improve patient-provider communication and HRQOL. Quality improvement efforts can target uncovered misalignments between patients and clinicians to improve communication about opioid medication adverse effects and relevant treatment options, which may help improve quality of life for patients with chronic pain.

scholarly journals Prioritizing the healthcare access concerns of Canadians with MS

2021 ◽  
Vol 7 (3) ◽  
pp. 205521732110296
Author(s):  
Julie Pétrin ◽  
Mary Ann McColl ◽  
Catherine Donnelly ◽  
Simon French ◽  
Marcia Finlayson
Keyword(s):  
Disease Burden ◽  
Online Survey ◽  
Unmet Needs ◽  
Healthcare Access ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Cross Sectional ◽  
Barriers To Healthcare ◽  
High Disease Burden

Background Canadians with MS are high users of healthcare services, yet they report multiple unmet needs, high disease burden, and low satisfaction with care. Engaging patients in healthcare planning can lead to improvements in access and care. There is currently limited evidence that has harnessed the perspectives of Canadians with MS. Objective To identify and prioritize the healthcare access concerns of Canadians with MS. Methods A cross-sectional online survey informed by the Concerns Report Methodology was used to address the objective. Participants were recruited through multiple methods. Descriptive statistics were used to identify the main barriers to healthcare providers, and concerns report methods were used to calculate needs indexes to prioritize concerns of participants. Results 324 Canadians with MS participated in the study between November 18, 2019 and March 27, 2020. The most pressing healthcare access concerns of Canadians with MS were related to availability of healthcare providers with MS knowledge and affordability of services that aim to improve wellness. Conclusion These findings provide healthcare planners with prioritized access concerns of Canadians with MS, which can be used to guide strategic planning to improve the quality of life of these individuals.

Alignment and discordances in perceptions and experiences of shared decision making (SDM) among bladder cancer (BC) patients and their care team.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 420-420
Author(s):  
Karim Chamie ◽  
Sarah P. Psutka ◽  
Taral Patel ◽  
Manojkumar Bupathi ◽  
Breanne Y Farris ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Bladder Cancer ◽  
Side Effects ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Shared Decision ◽  
Life Changes ◽  
Patient Goals

420 Background: To align BC treatment with patient goals, it is vital that healthcare providers (HCPs) engage their patients (pts) in SDM for treatment planning. We assessed alignment and discordances on aspects of SDM among BC pts and their urology and oncology teams. Methods: Between 05/2020 and 06/2020, surveys were administered to 53 pts with BC (48% female, mean age 68 years) and 23 HCPs, as part of in-clinic and virtual collaborative patient education sessions across 5 US-based practices. Surveys were designed to assess perceptions, preferences, and experiences with regard to SDM during BC care. Results: Survey findings indicated key alignments and discordances in pts’ reported experience and HCPs’ perceptions of the use of SDM in BC care. HCPs and pts identified the same top 2 patient goals for BC care: 1) preventing progression/recurrence (61% pts, 48% HCPs) and 2) maintaining quality of life (35% pts, 78% HCPs). When asked to identify patient’s top challenges for pts in BC care, both pts and HCPs indicated post-treatment aspects as the top challenge, though pts indicated managing side effects/serious worry about side effects from treatment as the top challenge (22%); whereas, HCPs were split evenly between managing side effects from treatment (26%) and managing life changes as a result of urinary diversion (26%). HCPs overestimated the effect that fatigue and worry had on pts capacity for SDM: only 9% of pts indicated worry or fatigue as a barrier to SDM, but 65% of HCPs indicated this as a likely barrier. Furthermore, the patient experience of SDM differed from HCP perception of SDM (Table); for some aspects of SDM, such as explaining different treatment options, explaining pros/cons of treatment options, and overall involvement in treatment decisions, fewer HCPs indicated that these aspects of SDM always or usually occurred as compared to pts. Conclusions: These findings reveal important alignments and discordances between pts and HCPs with regard to BC care and SDM, which may inform future bladder cancer and SDM initiatives. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document