The association of distress and depression screening measures and other electronic health record information with adjuvant endocrine therapy persistence.

Purpose: Few risk factors for early adjuvant endocrine discontinuation have been identified, but clinical trials suggest pre-AET symptom burden might be important. We sought to assess this in an academic practice.

Methods: We examined baseline and up to five years of follow-up information for postmenopausal women with stage I-III hormone-receptor positive breast cancer 2014-2019 receiving oncologist prescriptions for AET.

Developing a urinary incontinence primary care pathway: a mixed methods study.

Background: While nearly 50% of adult women report at least one episode of urinary incontinence (UI), most never receive treatment.

Objective: To better integrate primary and specialty UI care, we conducted (i) an environmental scan to assess the availability of key pathway resources in primary care, (ii) interviews with primary care providers to understand barriers to care, and (iii) a pilot UI care pathway intervention.

Methods: Environmental scan: Clinic managers from all primary care clinics within a Midwestern healthcare system were invited to participate in an interview covering the availability of clinic resources.

Urinary Incontinence Medications: Patient-Initiated Concerns in Primary Care.

Importance: Guideline-recommended medications for overactive bladder and urge urinary incontinence (OAB/UUI) are effective but have high costs and side effects. Little is known about patient concerns regarding these medications when prescribed by their primary care providers (PCPs).

Objective: The aim of the study was to describe PCP-patient interactions when prescribing medications for OAB/UUI, specifically clinical concerns, cost and authorization issues, and mode of communication for these interactions.

Adherence to adjuvant endocrine therapy for breast cancer: a qualitative exploration of attribution of symptoms among post-menopausal women.

Purpose: Oral adjuvant endocrine therapy (AET) is an effective treatment for hormone receptor positive breast cancer to decrease recurrence and mortality, but adherence is poor. This study explored post-menopausal women's experiences with AET, with a particular focus on adherence to AET as well as distress and symptoms experienced prior to and during AET treatment.

Methods: Participants were recruited from a hospital registry, stratified by adherence to/discontinuation of AET.

The unique risk factor profile of triple-negative breast cancer: a comprehensive meta-analysis.

Background: Triple-negative breast cancer (TNBC) has a poor prognosis compared with other breast cancer subtypes. This systematic review and meta-analysis examines whether known risk factors for breast cancer are also associated with TNBC in adult women.

Methods: EMBASE, Medline, SCOPUS, and gray literature were queried with no limit on the date or language of publication.

Referral and Prescription Patterns for Female Patients With Urinary Incontinence.

Importance: Although behavioral modifications, medications, and other interventions can improve urinary incontinence (UI), many women never receive them.

Objectives: To better characterize UI treatment patterns in primary care, we examined prescriptions and referrals to pelvic floor physical therapy (PFPT) and specialist physicians within a large Midwestern academic health system.

Study Design: Electronic health records were queried to identify a cohort of adult female patients receiving a new UI diagnosis during outpatient primary care visits from 2016 to 2020.

Electrochemically enabled oxidative aromatization of pyrazolines.

Pyrazoles are a very important structural motif widely found in pharmaceuticals and agrochemicals. An electrochemically enabled approach for the sustainable synthesis of pyrazoles oxidative aromatization of pyrazolines is presented. Inexpensive sodium chloride is employed in a dual role as a redox mediator and supporting electrolyte in a biphasic system (aqueous/organic).

Implementation-effectiveness trial of systematic family health history based risk assessment and impact on clinical disease prevention and surveillance activities.

Background: Systematically assessing disease risk can improve population health by identifying those eligible for enhanced prevention/screening strategies. This study aims to determine the clinical impact of a systematic risk assessment in diverse primary care populations.

Methods: Hybrid implementation-effectiveness trial of a family health history-based health risk assessment (HRA) tied to risk-based guideline recommendations enrolling from 2014-2017 with 12 months of post-intervention survey data and 24 months of electronic medical record (EMR) data capture.

Medication delivery factors and adjuvant endocrine therapy adherence in breast cancer.

Purpose: Over 50% of breast cancer patients prescribed a 5-year course of daily oral adjuvant endocrine therapy (ET) are nonadherent. We investigated the role of costs and cancer medication delivery mode and other medication delivery factors on adherence.

Methods: We conducted a retrospective cohort study of commercially insured and Medicare advantage patients with newly diagnosed breast cancer in 2007-2015 who initiated ET.

Feasibility of a pharmacist-led symptom monitoring and management intervention to improve breast cancer endocrine therapy adherence.

Background: Adjuvant endocrine therapy (AET) for breast cancer reduces mortality, but one-third to one-half of patients discontinue it early or are nonadherent.

Objective: We developed a pilot single-site study of patients with evidence of early nonadherence to AET to assess the feasibility of a novel, clinical pharmacist-led intervention targeting symptom and medication management.

Methods: Patients with prescription fill records showing nonadherence were enrolled in a single-arm feasibility study.

Pharmacy deserts and patients with breast cancer receipt of influenza vaccines.

Background: Yearly influenza vaccination is strongly recommended at age 65 and reimbursed by Medicare without copays or deductibles at pharmacies and clinical settings. Uptake is low among patients with a high risk for influenza complications and good access to specialist care, such as recent cancer survivors. We hypothesized that more accessible pharmacies could be associated with higher immunization uptake in such patients.

Neighborhood Characteristics and Cancer Survivorship: An Overview of the Current Literature on Neighborhood Landscapes and Cancer Care.

There is a growing literature on the association between neighborhood contexts and cancer survivorship. To understand the current trends and the gaps in the literature, we aimed to answer the following questions: To what degree, and how, has cancer survivorship research accounted for neighborhood-level effects? What neighborhood metrics have been used to operationalize neighborhood factors? To what degree do the neighborhood level metrics considered in cancer research reflect neighborhood development as identified in the Leadership for Energy and Environmental Design for Neighborhood Development (LEED-ND) guidelines? We first conducted a review guided by PRISMA extension for scoping review of the extant literature on neighborhood effects and cancer survivorship outcomes from January 2000 to January 2021. Second, we categorized the studied neighborhood metrics under six main themes.

Patient-Physician Concordance for Quantitative Formats and Treatment Options and the Relationship with State Anxiety.

Patient-physician concordance about topics discussed in a clinic visit is essential for effective communication but may be difficult to achieve in cancer care. We conducted a multicenter, observational study at two Midwestern oncology clinics. A sample of 48 English-speaking or Spanish-speaking women with newly diagnosed stage 0-3 breast cancer completed surveys before and after a visit with an oncologist.

The Role of Physician Professional Networks in Physicians' Receipt of Pharmaceutical and Medical Device Industries' Payments.

Background: Financial relationships between physicians and the pharmaceutical and medical device industries are common, but the factors associated with physicians receiving payments are unknown.

Objective: The objective of this study is to evaluate the influence of physicians' professional networks' characteristics on the receipt of payments among physicians.

Design: Network analysis of cross-sectional data PARTICIPANTS: US physicians who shared Medicare patients with other physicians in 2015 (N=357,813).

An adapted two-step floating catchment area method accounting for urban-rural differences in spatial access to pharmacies.

Objective: To adapt the two-step floating catchment area approach to account for urban-rural differences in pharmacy access in the United States.

Methods: The urban-rural two-step floating catchment area method was described mathematically. To calculate urban-rural-two-step floating catchment area measure, census tracts and pharmacies within the study area (Southeastern Wisconsin) were classified as urban, suburban or rural, and then different catchment area sizes (2, 5 and 15 miles) were applied, based on the Centers for Medicare & Medicaid Services (CMS)' criteria for Medicare Part D service access within urban, suburban and rural areas.

Differences in length of stay by teaching team status in an academic medical center in the Midwestern United States.

: Given the high cost of inpatient stays, hospital systems are investigating ways to decrease lengths of stay while ensuring high-quality care. The goal of this study was to determine if patients in teaching teams (hospitalist teams with residents and interns) had a higher length of stay after adjusting for relevant confounders compared to hospitalist-only teams (staffed only by attending physicians).: Using a retrospective design, we investigated differences in length of stay for 17,577 inpatient encounters over a 2-year period.

The role of residential history in cancer research: A scoping review.

The role of residential history in cancer prevention, diagnosis, treatment, and survivorship is garnering increasing attention in cancer research. To our knowledge, there is no comprehensive synthesis of the current state of knowledge in the field. We reviewed the extant literature on this topic and conducted a scoping analysis to examine two main research questions: (a) To what degree, and how, have researchers accounted for residential history/mobility in cancer research? and (b) What are the gaps in the literature based on a knowledge synthesis using scoping review and concept mapping? To answer these questions, this scoping analysis focuses on how researchers compile, analyze and discuss residential history/mobility in studies on cancer.

Aromatase Inhibitor Symptom Management Practices: A Retrospective Study.

Purpose: Aromatase inhibitor (AI)-associated symptoms contribute to early therapy discontinuation. Although guidelines exist for management of these symptoms, little is known about the degree to which physicians address symptoms and adhere to the guidelines for treatment.

Patients And Methods: In this retrospective chart review, women with hormone receptor-positive breast cancer who were prescribed an AI between October 15, 2012, and September 14, 2017, were randomly selected from the institution's cancer registry.

At the intersection of precision medicine and population health: an implementation-effectiveness study of family health history based systematic risk assessment in primary care.

Background: Risk assessment is a precision medicine technique that can be used to enhance population health when applied to prevention. Several barriers limit the uptake of risk assessment in health care systems; and little is known about the potential impact that adoption of systematic risk assessment for screening and prevention in the primary care population might have. Here we present results of a first of its kind multi-institutional study of a precision medicine tool for systematic risk assessment.

The Use and Concurrent Use of Side Effect Controlling Medications Among Women on Aromatase Inhibitors.

Women on aromatase inhibitors (AIs) as part of their breast cancer treatment often experience difficult to control side effects. Although there are several medications to manage the side effects of AI therapy, many of them are associated with their own risk, particularly sedation. The objective of this study was to describe the prescribing practices for side effect managing (SE) medications among women with breast cancer on AI therapy and to assess for combinations of medications that may present a clinical risk to patients.

A dependent Dirichlet process model for survival data with competing risks.

In this paper, we first propose a dependent Dirichlet process (DDP) model using a mixture of Weibull models with each mixture component resembling a Cox model for survival data. We then build a Dirichlet process mixture model for competing risks data without regression covariates. Next we extend this model to a DDP model for competing risks regression data by using a multiplicative covariate effect on subdistribution hazards in the mixture components.