Journal of Oncology Practice最新文献

{"title":"Effect of Medical Scribes on Outpatient Oncology Visits at a Multidisciplinary Cancer Center.","authors":"Rebecca W. Gao, Anisia Dugala, J. Maxwell, P. Falconer, A. Birkeland, V. Divi, E. Rosenthal","doi":"10.1200/JOP.19.00307","DOIUrl":"https://doi.org/10.1200/JOP.19.00307","url":null,"abstract":"PURPOSE\u0000The use of medical scribes has emerged as a strategy to increase clinic workflow efficiency and reduce physician burnout. While oncology clinics may be ideally suited to scribe integration because of the high burden of documentation, oncology-specific scribe research has been limited. The objective of this study was to determine the effect of scribe integration on clinic workflow efficiency and physician satisfaction and quality of life in outpatient oncology clinics.\u0000\u0000\u0000METHODS\u0000We conducted a retrospective, concurrent qualitative and quantitative analysis of patient visit durations and survey data for 129 attending physicians affiliated with an academic hospital's cancer center between January 2017 and January 2019. Thirty-three physicians were paired with scribes in each physician's individual clinic or clinics.\u0000\u0000\u0000RESULTS\u0000In terms of clinic efficiency, physicians with scribes had a 12.1% decrease in their overall average patient visit duration compared with their own time before receiving a scribe (P < .0001) and spent significantly less time completing charts at the end of the day (P = .04). Compared with their peers, oncologists with scribes showed a 10%-20% decrease in the duration of all patient visits. Scribes also contributed to patient care, as shown by 90% of physicians surveyed who strongly agreed that they spent less time at the computer and more time with patients; 100% of physicians surveyed strongly agreed that scribes improved their quality of life.\u0000\u0000\u0000CONCLUSION\u0000The integration of medical scribes into oncology clinics across several oncologic disciplines has the potential to reduce burnout through increasing physician satisfaction and quality of life, improving patient care, and streamlining clinic workflow.","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900307"},"PeriodicalIF":0.0,"publicationDate":"2019-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00307","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44975064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Addition of Carboplatin AUC ≥ 4 to Antiemetic Guidelines for Triple Antiemetic Prophylaxis: A Gap in Quality of Care, Guideline Adoption, and Avoiding Acute Care.","authors":"R. Navari, K. Ruddy, T. Leblanc, R. Clark-Snow, R. Wickham, G. Binder, T. Coberly, R. Potluri, L. Schmerold, E. Roeland","doi":"10.1200/JOP.19.00457","DOIUrl":"https://doi.org/10.1200/JOP.19.00457","url":null,"abstract":"PURPOSE\u0000After ASCO and National Comprehensive Cancer Network guideline recommendations for triple antiemetic prophylaxis for carboplatin area under the curve (AUC) ≥ 4, and the publication of studies documenting avoidable acute care after chemotherapy involving nausea and vomiting (NV) and other toxicities, we studied clinician adherence to the guideline change and assessed avoidable acute-care use.\u0000\u0000\u0000METHODS\u0000Using a large electronic health record database, we evaluated antiemetic prophylaxis as recommended in the guidelines and post-chemotherapy avoidable acute-care use (defined as involving any of NV or 8 other toxicities) for patients initiating carboplatin or other chemotherapy from October 2012 to August 2018.\u0000\u0000\u0000RESULTS\u0000We identified 11,554 carboplatin courses. After the guideline change adding neurokinin-1 receptor antagonists (RAs) for carboplatin AUC ≥ 4, its use rose to 20% of courses from the prior average of 16%; virtually all courses also included a 5-HT3 RA plus dexamethasone. We found avoidable acute care in 23% of courses; one quarter of these events were associated with NV. Acute care rates after carboplatin mirrored those after other highly emetogenic chemotherapy or oxaliplatin and exceeded those after other chemotherapy regimens. The > 80% shortfall in adherence may have been caused by low awareness or acceptance of the guideline change and/or by poor awareness of avoidable acute-care use after carboplatin.\u0000\u0000\u0000CONCLUSION\u0000Neurokinin-1 RA prophylaxis for carboplatin AUC ≥ 4 remains low and largely unchanged despite National Comprehensive Cancer Network and ASCO 2017 recommendations for inclusion. NV and avoidable acute care involving NV seen after carboplatin were consistent with other highly emetogenic chemotherapy. Clinician action is required to remediate incomplete prophylaxis and to no longer place patient outcomes, resources for cancer treatment, and clinician reimbursement at risk.","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900457"},"PeriodicalIF":0.0,"publicationDate":"2019-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00457","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42306631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shocking Finding on Head Computed Tomography.","authors":"S. McClelland, T. Mitin","doi":"10.1200/jop.19.00275","DOIUrl":"https://doi.org/10.1200/jop.19.00275","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900275"},"PeriodicalIF":0.0,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/jop.19.00275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47204437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leukemic Infiltration of the Optic Nerve.","authors":"R. MacDonell-Yilmaz, Brittney Statler, P. Channa, R. Janigian, J. Welch","doi":"10.1200/JOP.19.00311","DOIUrl":"https://doi.org/10.1200/JOP.19.00311","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900311"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00311","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43090305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Raynaud's Phenomenon From PD-1 Immune Checkpoint Inhibition.","authors":"Haesoo Kim, A. J. Jones, Artak Labadzhyan, Veronica R. Placencio-Hickok, D. Wallace, J. Gong, A. Hendifar","doi":"10.1200/JOP.19.00333","DOIUrl":"https://doi.org/10.1200/JOP.19.00333","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900333"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41624452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreign Body Mimicking Lung Cancer Recurrence.","authors":"E. M. Minerva, M. Patella, S. Di Lascio, R. Inderbitzi, S. Cafarotti","doi":"10.1200/JOP.19.00394","DOIUrl":"https://doi.org/10.1200/JOP.19.00394","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900394"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45197585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraneoplastic Glomerulonephropathy Associated With Renal Cell Carcinoma.","authors":"A. Khurana, V. Robila, H. D. Massey, A. Paul","doi":"10.1200/JOP.19.00464","DOIUrl":"https://doi.org/10.1200/JOP.19.00464","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900464"},"PeriodicalIF":0.0,"publicationDate":"2019-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00464","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45090414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Fibrillation and Stroke Risk in Patients With Cancer: A Primer for Oncologists.","authors":"Marc Sorigue,&nbsp;Milos D Miljkovic","doi":"10.1200/JOP.18.00592","DOIUrl":"https://doi.org/10.1200/JOP.18.00592","url":null,"abstract":"<p><p>Cancer and atrial fibrillation (AF) are common conditions, but for patients affected with both, there is a lack of data about management of anticoagulation and cerebrovascular outcomes. In the first section of this review, we summarize the most relevant studies on stroke risk and management of AF in patients with active cancer, attempting to answer questions of whether to anticoagulate, whom to anticoagulate, and what agents to use. In the second section of the review, we suggest a decision algorithm on the basis of the available evidence and provide practical recommendations for each of the anticoagulant options. In the third section, we discuss the limitations of the available evidence. On the basis of low-quality evidence, we find that patients with cancer and AF have a risk of stroke similar to that of the general population but a substantially higher risk of bleeding regardless of the anticoagulant agent used; this makes anticoagulation-related decisions complex and evidence from the general population not immediately applicable. In general, we suggest stopping anticoagulation in patients with high risk of bleeding and in those with a moderate bleeding risk without a high thromboembolic risk and recommend anticoagulation as in the general population for patients at a low risk for bleeding. However, regardless of initial therapy, we recommend reassessing whether anticoagulation should be given at each point in the clinical course of the disease. High-quality evidence to guide anticoagulation for AF in patients with cancer is needed.</p>","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":" ","pages":"641-650"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.18.00592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37447513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Promise of Direct-Acting Antiviral Therapies to Improve Care and Outcomes in Patients With Cancer Who Have Chronic Hepatitis C Infection.","authors":"Yiannis Koullias,&nbsp;Sarah P Hammond","doi":"10.1200/JOP.19.00664","DOIUrl":"https://doi.org/10.1200/JOP.19.00664","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":" ","pages":"639-640"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37447516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncologic Implications of Chronic Hepatitis C Virus Infection.","authors":"Jessica P Hwang,&nbsp;Noelle K LoConte,&nbsp;John P Rice,&nbsp;Lewis E Foxhall,&nbsp;Erich M Sturgis,&nbsp;Janette K Merrill,&nbsp;Harrys A Torres,&nbsp;Howard H Bailey","doi":"10.1200/JOP.19.00370","DOIUrl":"https://doi.org/10.1200/JOP.19.00370","url":null,"abstract":"<p><p>Chronic hepatitis C virus (HCV) infection increases the risk for several types of cancer, including hepatocellular carcinoma (HCC) and B-cell non-Hodgkin lymphoma, as primary and second primary malignancies. HCV-infected patients with cancer, particularly those undergoing anticancer therapy, are at risk for development of enhanced HCV replication, which can lead to hepatitis flare and progression of liver fibrosis or cirrhosis. Risk factors for HCV infection include injection drug use, blood transfusion, or solid organ transplantation before 1992, receipt of clotting factor concentrates before 1987, long-term hemodialysis, chronic liver disease, HIV positivity, and occupational exposure. Widely available direct-acting antivirals are highly effective against HCV and well tolerated. Identification of HCV-infected individuals is the essential first step in treatment and eradication of the infection. One-time screening is recommended for persons born from 1945 to 1965; screening is also recommended for persons with risk factors. Recently, a public health recommendation has been drafted to screen all adults age 18 to 79 years. Two oncology organizations recommend screening all patients with hematologic malignancies and hematopoietic cell transplant recipients, and a recently published multicenter prospective study supports universal HCV screening for all patients with cancer. HCV screening entails testing for anti-HCV antibodies in serum and, when results are positive, HCV RNA quantitation to confirm infection. Direct-acting antiviral therapy eradicates HCV in almost all cases. Virologic cure of HCV prevents chronic hepatitis and progression to liver fibrosis or cirrhosis. HCV eradication also decreases the risk of developing HCV-associated primary and second primary malignancies, and it may allow HCV-infected patients access to important cancer clinical trials. Patients with HCV-related cirrhosis require lifelong surveillance for HCC, even after viral eradication.</p>","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":" ","pages":"629-637"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37447515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}