Objectives: To determine whether implementation of patient-centered oncology standards in 5 medical oncology practices improved patient experiences and quality and reduced emergency department (ED) and hospital use.
Study Design: Retrospective, pre-post study design with a concurrent nonrandomized control group.
Methods: We used insurance claims to calculate all-cause hospitalizations and ED visits and primary care and specialist office visits (n = 28,826 eligible patients during baseline and 30,843 during follow-up) and identify patients for a care experiences survey (n = 715 preintervention and 437 postintervention respondents). For utilization and patient experience outcomes, we compared pilot practices' performance with 18 comparison practices using difference-in-differences (DID) regression models accounting for practice-level clustering. We assessed pilot practice performance on 31 quality measures from the American Society of Clinical Oncology Quality Oncology Practice Initiative program.
Results: There were no statistically significant differences in hospital, ED, or primary care visits between the pilot and comparison groups over time, but there was a significant increase in specialty visits for the pilot group (adjusted DID of 0.07; 95% CI, 0.01-0.13; P = .03). For care experiences, pilot practices improved more on shared decision-making (4.03 DID composite score; P = .013), whereas the comparison group improved more on access (-6.36 DID composite score; P < .001) and exchanging information (-4.25 DID composite score; P = .013). On average, pilot practices improved performance on 65% of core quality measures from baseline to follow-up.
Conclusions: This pilot of patient-centered oncology care showed improved quality but no impact on hospitalizations/ED use and mixed results for patient experiences. Findings are consistent with early evaluations of primary care patient-centered medical homes.
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http://dx.doi.org/10.37765/ajmc.2020.88487 | DOI Listing |
Brain Behav Immun Health
February 2025
General Direction, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi 53, Rome, 00144, Rome, Italy.
Background: This article analyzes the main coordination needs linked to the diagnosis and treatment of oncological diseases, presenting the various integration tools that our healthcare organization adopted to guarantee continuity of care at the IRCCS IFO (Istituto di Ricovero e Cura a Carattere Scientifico Istituti Fisioterapici Ospitalieri) in Rome. The object of investigation is the disease management team (DMT) organization for the diagnosis and treatment of people suffering from oncological disease and the consequences in terms of improving their management.
Methods: The study focuses, in particular, on the analysis of the different organizational methods chosen for the management of activities related to diagnosis and treatment paths.
Cancer Med
January 2025
Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Objective: Cancer-related fatigue is one of the most common burdens of cancer patients. To date, most studies focused on fatigue during or after treatment. However, investigation of pretreatment fatigue is crucial to identify causal or risk factors other than cancer therapy and to enable timely fatigue management.
View Article and Find Full Text PDFBefore October 2024, the Advisory Committee on Immunization Practices (ACIP) recommended use of a pneumococcal conjugate vaccine (PCV) for all adults aged ≥65 years, as well as for those aged 19-64 years with risk conditions for pneumococcal disease who have not received a PCV or whose vaccination history is unknown. Options included either 20-valent PCV (PCV20; Prevnar20; Wyeth Pharmaceuticals) or 21-valent PCV (PCV21; CAPVAXIVE; Merck Sharp & Dohme) alone or 15-valent PCV (PCV15; VAXNEUVANCE; Merck Sharp & Dohme) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax23; Merck Sharp & Dohme). There are additional recommendations for use of PCV20 or PCV21 for adults who started their pneumococcal vaccination series with 13-valent PCV (PCV13; Prevnar13; Wyeth Pharmaceuticals).
View Article and Find Full Text PDFBMC Med Inform Decis Mak
January 2025
Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China.
Background: Medical decision-making is a complex multi-stage process. Chinese cancer patients' preference for participation in decision-making stages, family involvement and influencing factors remain unclear.
Methods: A total of 1,422 cancer patients from four tertiary hospitals in China were included in the cross-sectional survey.
Semin Oncol Nurs
January 2025
Nursing Department, Cyprus University of Technology, Limassol, Cyprus.
Objectives: Cancer-related cachexia affects approximately 50% to 80% of cancer patients and contributes significantly to cancer-related mortality, accounting for 20% of deaths. This multifactorial syndrome is characterized by systemic inflammation, anorexia, and elevated energy expenditure, leading to severe weight loss and muscle wasting. Understanding the underlying mechanisms is critical for developing effective interventions.
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