The Medium Is the Message: How Do Canadian University Students Want Digital Medication Information?

(1) Background: To facilitate optimal prescription medication benefits and safety, it is important that people are informed about their prescription medications. As we shift towards using the digital medium to communicate medication information, it is important to address the needs and preferences of different user groups so that they are more likely to read and use this information. In this study, we examined what digital medication information (DMI) format Canadian University students want and why.

We Built It, But They Are Not Coming: Exploring Deterrents to Consumer Medication Information Use.

Given the prevalence of prescription medication use, it is important that consumers are aware of the benefits and risks of taking their prescribed medications. One approach to informing consumers in North America is to provide them with Consumer Medication Information (CMI), the paper leaflets given to consumers when they fill a prescription for the first time. Unfortunately, reported use rates of written medication information are quite low.

Are Health Literacy and eHealth Literacy the Same or Different?

Many researchers assume that there is a relationship between health literacy and eHealth literacy, yet it is not clear whether the literature supports this assumption. The purpose of this study was to determine if there was a relationship between health and eHealth literacy. To this end, participants' (n = 36) scores on the Newest Vital Sign (NVS, a health literacy measure) were correlated with the eHealth Literacy Scale (eHEALS, an eHealth literacy measure).

Deriving a Set of Privacy Specific Heuristics for the Assessment of PHRs (Personal Health Records).

With the emergence of personal health record (PHR) platforms becoming more widely available, this research focused on the development of privacy heuristics to assess PHRs regarding privacy. Existing sets of heuristics are typically not application specific and do not address patient-centric privacy as a main concern prior to undergoing PHR procurement. A set of privacy specific heuristics were developed based on a scoping review of the literature.

Mining Association Rules in the BCCA Liver Cancer Data Set.

The objective of this study is to apply data mining techniques to determine factors that are commonly associated with liver cancer incidence, using an anonymized data set of 6064 patients from the British Columbia Cancer Agency (BCCA). The association rules indicate that in BC the patient demographic factors associated with increased liver cancer include: age ranges 60-69, male gender, and geographic location in the Greater Vancouver area. The main factors associated with decreased survivability in BC were being male and in the age range 70-79.

Toward a population-based approach to end-of-life care surveillance in Canada: initial efforts and lessons.

This paper describes a project undertaken by the Hospice Palliative End-of-Life Care Surveillance Team Network--one of four Cancer Surveillance and Epidemiology Networks established by the Canadian Partnership Against Cancer in 2009 to create information products that can be used to inform cancer control. The project was designed to improve the quality and use of existing electronic patient databases in its member organizations. The project's intent was to better understand terminally ill cancer patients in their final year of life, with noncancer as comparison.

The introduction and evaluation of mobile devices to improve access to patient records: a catalyst for innovation and collaboration at BCCA.

Prompt and efficient access to patient records is vital in providing optimal patient care. The Cancer Agency Information System (CAIS) is the primary patient record repository for the British Columbia Cancer Agency (BCCA) but is only accessible on traditional computer workstations. The BCCA clinics have significant space limitations resulting in multiple health care professionals sharing each workstation.

Assessing the feasibility of data mining techniques for early liver cancer detection.

The objective of this study is to assess the feasibility of a data mining association analysis technique, the FP Growth algorithm, for the detection of associations of liver cancer, geographic location and demographic of patients. For the research, we are planning to use data extracted from electronic health record systems of three healthcare organizations in different geographic locations (Canada, Taiwan and Mongolia). The data are arranged into 'transactions' which contain a set of data items focused around cancer diseases, geographic locations and patient demographics.

Characteristics of patients at risk for adverse drug events: designing for patient safety and decision support.

Adverse drug events are a significant global health issue. In this paper we describe our research work to date in identifying the characteristics of patients who are at risk for adverse drug events. We conducted a focus group study with health professionals to identify those characteristics of patients that health professionals attend to if they believe a patient is at risk for an adverse drug event.

Telehealth--a change in a practice model in oncology.

Background: A clinical study to examine the barriers to using telehealth for oncologic visits was performed by the British Columbia Cancer Agency's Vancouver Island Centre (BCCAVIC) and the Vancouver Island Health Authority in 2006-2007. One of the major barriers encountered was physician engagement. The current observational study was to determine whether patients' enthusiasm and the introduction of telehealth in a study resulted in telehealth becoming integrated within BCCAVIC.

Teleoncology uptake in British Columbia.

Telehealth enables the delivery of specialized health care to patients living in isolated and remote regions. The purpose of this analysis is to determine the current uptake of teleoncology in mainland British Columbia. Patient appointment data was extracted from the Cancer Agency Information System (CAIS) for the 2009 calendar year.

Sociotechnical evaluation of a clinical transformation project in a specialized cancer care centre.

The radiation therapy (RT) department at the British Columbia Cancer Agency - Vancouver Island Centre (VIC) is responsible for delivering radiation treatments to cancer patients from Vancouver Island, which has a population base of approximately 750,000. The purpose of this analysis is to examine a process transformation project undertaken by a VIC clinical champion using a sociotechnical approach and identify factors that influenced the project outcome. Beginning in January 2009, a radiation oncologist at VIC initiated a project to transform the clinical process of generating prescriptions for radiation therapy.

Impact of irinotecan and oxaliplatin on overall survival in patients with metastatic colorectal cancer: a population-based study.

A look at the temporal impact of advancements in therapeutic options in the last 10 years-from fluorouracil to irinotecan and oxaliplatin-on overall survival in a population-based cohort.

Use of combined androgen blockade for advanced prostate cancer in British Columbia.

Objectives: Initial androgen deprivation therapy (ADT) for metastatic prostate cancer with combined androgen blockade (luteinizing-hormone releasing hormone agonist [LHRH agonist] plus antiandrogen) is not recommended in British Columbia (BC). However, this is difficult to monitor since ADT includes concurrent antiandrogen for the first month of LHRH agonist to prevent disease flare. We describe the prevalence of CAB use in BC and its financial impact.

Adopting and introducing new technology to improve patient care: a wedding of clinicians and informatics specialists.

The BC Cancer Agency sees 128,172 patients per year, of which 2,186 are referred to the Patient Symptom Management/Palliative Care (PSMPC) clinics for tertiary symptom management. Other than at the PSMPC clinics, screening for symptom distress is extremely variable because there is no systematic assessment protocol. In a recent audit of patients coming to the Cancer Agency, approximately 64% of patients reported experiencing a moderate to severe level of symptom distress.

Pharmacy information systems in Canada.

The goal of Canada Health Infoway is to provide at least 50% of all Canadians with an electronic health record (EHR) by 2010. The goal of the Infoway Drug Information Systems Program is to develop an interoperable drug information system that will keep each patient's medication history: prescribed and dispensed drugs, allergies, ongoing drug treatment, etc. Drug and drug-interaction checks will be performed automatically and added to the patients' drug profiles.

Risk of early recurrence among postmenopausal women with estrogen receptor-positive early breast cancer treated with adjuvant tamoxifen.

Background: Adjuvant aromatase inhibitors (AIs), instead of or after tamoxifen, are effective in decreasing recurrence in postmenopausal women with estrogen receptor (ER)-positive breast cancer. An understanding of which patients are at risk of early recurrence while they are receiving tamoxifen may improve clinical decision making.

Methods: The patients who were included in this study were women aged >or= 50 years with early-stage, ER-positive breast cancer diagnosed between 1986 and 1999 and had been treated with tamoxifen.

Adjuvant therapy with raltitrexed in patients with colorectal cancer intolerant of 5-fluorouracil: British Columbia Cancer Agency experience.

Background: Severe 5-FU toxicity in adjuvant therapy of colorectal cancer may require change of therapy. We retrospectively explored the safety and efficacy of adjuvant raltitrexed in patients intolerant of 5-FU.

Methods: Over a 5 year period, patients who received 5-FU and subsequent raltitrexed therapy were identified.

The impact of new chemotherapeutic and hormone agents on survival in a population-based cohort of women with metastatic breast cancer.

Background: Over the past decade, a number of new therapeutic agents have become available in the treatment of metastatic breast cancer (MBC). This study characterized the use and assessed the impact on survival of population-based access to new agents for the treatment of MBC.

Methods: The dates of release in British Columbia of 7 new systemic agents for MBC during the 1990s were used to construct 4 time cohorts.

Renal safety of 1-hour pamidronate infusion for breast cancer and multiple myeloma patients: comparison between clinical trials and population-based database.

Purpose: The American Society of Clinical Oncology recommends infusion of pamidronate over 2 hours to avoid renal deterioration, although there are data to suggest that 1-hour infusions may be safe.

Methods: Prevalence of renal deterioration with 1-hour pamidronate infusions from a population database was compared to renal deterioration with 2-hour pamidronate infusions, in randomised, controlled, trials. A cost-minimisation analysis, comparing the 1- and 2-hour pamidronate infusions, and the 15-minute infusion of zoledronic acid, was performed with a sensitivity analysis that varied the opportunity cost of time in the treatment room.

Impact on survival of time from definitive surgery to initiation of adjuvant chemotherapy for early-stage breast cancer.

Purpose: To determine if time to start of adjuvant chemotherapy after curative surgery influences survival in early-stage breast cancer.

Patients And Methods: A retrospective review was conducted of 2,594 patients receiving adjuvant chemotherapy for stage I and II breast cancer between 1989 and 1998 at the British Columbia Cancer Agency. Relapse-free survival (RFS) and overall survival (OS) were compared among patients grouped by time from definitive curative surgery to start of adjuvant chemotherapy (< or = 4 weeks, > 4 to 8 weeks, > 8 to 12 weeks, and >12 to 24 weeks).