Journal of Oncology Practice最新文献_第9页

Estimated Cost and Savings in a Patient Management Program for Oral Oncology Medications: Impact of a Split-Fill Component 口服肿瘤药物患者管理计划的估计成本和节省:分裂填充组件的影响

Journal of Oncology Practice Pub Date : 2019-08-29 DOI: 10.1200/JOP.19.00069

F. Staskon, H. Kirkham, Amy Pfeifer, Richard T. Miller

{"title":"Estimated Cost and Savings in a Patient Management Program for Oral Oncology Medications: Impact of a Split-Fill Component","authors":"F. Staskon, H. Kirkham, Amy Pfeifer, Richard T. Miller","doi":"10.1200/JOP.19.00069","DOIUrl":"https://doi.org/10.1200/JOP.19.00069","url":null,"abstract":"PURPOSE: A national specialty pharmacy implemented a split-fill option within an oral oncology patient management program to reduce pharmacy costs and medication wastage resulting from early discontinuations. Payers covered dispensed medications at half-quantity intervals for each dispense up to 3 months. Proactive outreach to patients before they had used up the initial dispensed medication quantity helped assess the patient’s tolerance to the new medication and adverse effects. This study compared costs for patients with a split-fill option to similar costs for patients without this option taking into account patient discontinuation rates, patient-reported adverse effects rates, estimated pharmacy costs, and potential wastage. METHODS: This retrospective cohort study included patients who were new to therapy on a split-fill medication between September 2015 and August 2017. A 1:1 greedy match algorithm was conducted using propensity variables to match patients from each cohort. Per-month discontinuation rates were determined for both split-fill and non–split-fill groups. The non–split-fill potential wastage was calculated as monthly costs for discontinuations in the following month and weighted by split-fill discontinuation rates. RESULTS: Of the 2,363 program patients who met selection criteria for the 11 medications, 671 patients from each group were matched. Payers with a split-fill program had significant medication savings per covered month ($2,147.60 at 1 month) and at a cumulative 6 months. Modeled wastage indicated that payers without a split-fill program could expect to save $2,646.74 monthly by using this option. Both cohorts had similar rates of adverse effects and time until first reported adverse effect. CONCLUSION: In the first 6 months, the split-fill patient managed program had lower discontinuation rates, significantly reduced pharmacy costs, and reduced potential wastage.","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"15 1","pages":"e856 - e862"},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44315918","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}

引用次数: 4

Has There Been a Shift in Use of Subacute Rehabilitation Instead of Hospice Referral Since Immunotherapy Has Become Available? 自从免疫疗法问世以来，在使用亚急性康复治疗而不是临终关怀转诊方面是否有转变?

Journal of Oncology Practice Pub Date : 2019-08-29 DOI: 10.1200/JOP.19.00044

J. Yeh, Louise S Knight, Joyce M. Kane, Danielle J. Doberman, Arjun Gupta, Thomas J. Smith

{"title":"Has There Been a Shift in Use of Subacute Rehabilitation Instead of Hospice Referral Since Immunotherapy Has Become Available?","authors":"J. Yeh, Louise S Knight, Joyce M. Kane, Danielle J. Doberman, Arjun Gupta, Thomas J. Smith","doi":"10.1200/JOP.19.00044","DOIUrl":"https://doi.org/10.1200/JOP.19.00044","url":null,"abstract":"PURPOSE\u0000Immunotherapy has rapidly become the mainstream treatment of multiple cancer types. Since the first drug approval in 2011, we have noted a decline in referrals from inpatient oncology to hospice and an increase in referrals to subacute rehabilitation (SAR) facilities, possibly with the aim of getting strong enough for immunotherapy and other promising drugs. This study explores outcomes after discharge to SAR, including rates of cancer-directed therapy after SAR, overall survival, and hospice use.\u0000\u0000\u0000METHODS\u0000We performed an electronic chart review of patients discharged from our inpatient oncology units to SAR facilities from 2009 to 2017. Demographics, admission statistics, and post-discharge outcomes were gathered from discharge summaries and targeted chart searches.\u0000\u0000\u0000RESULTS\u0000Three hundred fifty-eight patients were referred to SAR 413 times. One hundred seventy-four patients (49%) returned to the oncology clinic before readmission or death, and only 117 (33%) ever received additional cancer-directed treatment (chemotherapy, radiation, or immunotherapy). Among all discharges, 28% led to readmissions within 30 days. Seventy-four patients (21%) were deceased within 30 days, only 31% of whom were referred to hospice. Palliative care involvement resulted in more frequent do not resuscitate code status, documented goals of care discussions, and electronic advance directives.\u0000\u0000\u0000CONCLUSION\u0000A growing number of oncology inpatients are being discharged to SAR, but two thirds do not receive additional cancer therapy at any point, including a substantial fraction who are readmitted or deceased within 1 month. These data can help guide decision making and hospital discharge planning that aligns with patients' goals of care. More clinical data are needed to predict who is most likely to benefit from SAR and proceed to further cancer therapy.","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900044"},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41979809","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}

引用次数: 7

Journal of Oncology Practice Pub Date : 2019-08-26 DOI: 10.1200/JOP.19.00384

C. Shapiro, N. Yarom, D. Peterson, K. Bohlke, D. Saunders

{"title":"Medication-Related Osteonecrosis of the Jaw: MASCC/ISOO/ASCO Clinical Practice Guideline Summary.","authors":"C. Shapiro, N. Yarom, D. Peterson, K. Bohlke, D. Saunders","doi":"10.1200/JOP.19.00384","DOIUrl":"https://doi.org/10.1200/JOP.19.00384","url":null,"abstract":"Medication-related osteonecrosis of the jaw (MRONJ) is defined as exposed bone or bone that can be probed through an intraoral or extraoral fistula (or fistulae) in the maxillofacial region and that does not heal within 8 weeks, occurring in a patient who has received a bone-modifying agent (BMA) or an angiogenic inhibitor agent and with no history of head and neck radiation. The condition may involve the mandible or the maxilla. BMAs that have been linked with MRONJ principally include bisphosphonates and denosumab. BMAs are a key component of the management of patients with cancer with skeletal metastases or multiple myeloma. These medications provide a number of clinical benefits, including a reduced incidence of skeletal-related events (eg, pathologic fractures and spinal cord compression) and reduced need for radiation or surgery to bone. Use of BMAs is associated with MRONJ, which can be challenging to treat and can cause significant pain and reduced quality of life. Many studies have established that preventive oral care methods alongside effective oral health practices are associated with a lower rate of MRONJ.","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900384"},"PeriodicalIF":0.0,"publicationDate":"2019-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43033361","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}

引用次数: 2

Concordance of Patient and Caregiver Reports on the Quality of Colorectal Cancer Care. 癌症大肠癌患者和护理人员护理质量报告的一致性。

Journal of Oncology Practice Pub Date : 2019-08-20 DOI: 10.1200/JOP.19.00136

Rachel D. Havyer, M. van Ryn, Patrick M. Wilson, L. Bangerter, J. Griffin

{"title":"Concordance of Patient and Caregiver Reports on the Quality of Colorectal Cancer Care.","authors":"Rachel D. Havyer, M. van Ryn, Patrick M. Wilson, L. Bangerter, J. Griffin","doi":"10.1200/JOP.19.00136","DOIUrl":"https://doi.org/10.1200/JOP.19.00136","url":null,"abstract":"PURPOSE\u0000We aimed to better understand how similarly patients with colorectal cancer and caregivers view care quality and to assess factors that may influence concordance.\u0000\u0000\u0000MATERIALS AND METHODS\u0000We conducted a secondary analysis of paired patient and caregiver quality ratings of colorectal cancer care in three specific domains: surgery, chemotherapy overall, and chemotherapy nursing. Agreement was assessed with difference scores, concordance with Gwet second-order agreement statistics (AC2), and variation in agreement with stratified analyses. We examined whether the care experiences of patients and caregivers were associated with top-box (most-positive) ratings and examined variations in concordance on the basis of the presence of a top-box score.\u0000\u0000\u0000RESULTS\u0000Four hundred seventeen patient-caregiver dyads completed the surveys. Quality-of-care ratings were positively skewed, with most dyads indicating top-box ratings. Patient and caregiver care experiences were highly associated with top-box ratings. Overall patient-caregiver concordance was very high for all three care domains (surgery: AC2, 0.87 [95% CI, 0.83 to 0.90]; chemotherapy overall: AC2, 0.84 [95% CI, 0.79 to 0.88]; chemotherapy nursing: AC2, 0.91 [95% CI, 0.87 to 0.94]). Stratified analyses of patient and caregiver characteristics did not identify any patterns that consistently affected concordance. The concordance statistic significantly decreased for all three outcomes (P < .001), however, when the patient or caregiver assessed quality as anything other than top box.\u0000\u0000\u0000CONCLUSION\u0000Caregiver and patient reports on care quality were highly concordant for top-box care and did not vary with patient or caregiver factors. Additional exploration is needed to identify reasons for increased variability when the quality scores were less than a top-box response.","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900136"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46569812","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}

引用次数: 2

Progressive Multifocal Leukoencephalopathy After Carboplatin and Paclitaxel Chemotherapy for Ovarian Carcinoma. 卵巢癌卡铂和紫杉醇化疗后进行性多灶性白质脑病。

Journal of Oncology Practice Pub Date : 2019-08-19 DOI: 10.1200/JOP.19.00196

P. Menon, M. McKenna, S. Murphy

引用次数: 2

Development and Testing of the CAHPS Cancer Care Survey. CAHPS癌症护理调查的发展和测试。

Journal of Oncology Practice Pub Date : 2019-08-19 DOI: 10.1200/JOP.19.00039

C. Evensen, K. Yost, San D Keller, N. Arora, Elizabeth Frentzel, Tamika Cowans, S. Garfinkel

{"title":"Development and Testing of the CAHPS Cancer Care Survey.","authors":"C. Evensen, K. Yost, San D Keller, N. Arora, Elizabeth Frentzel, Tamika Cowans, S. Garfinkel","doi":"10.1200/JOP.19.00039","DOIUrl":"https://doi.org/10.1200/JOP.19.00039","url":null,"abstract":"PURPOSE\u0000The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Cancer Care Survey is a systematic assessment of health care experiences of patients with cancer. It supports comparisons among all cancer treatment settings and modalities.\u0000\u0000\u0000METHODS\u0000Formative research included 16 focus groups with patients receiving treatment and family members; advice from a panel of oncology and quality improvement experts; and interviews with stakeholders representing oncology associations, accredited cancer centers, and community oncology practices. We conducted cognitive tests of the instrument and field tests at six cancer centers and four community oncology practices, after which the survey was finalized and obtained the CAHPS trademark.\u0000\u0000\u0000RESULTS\u0000The survey includes 56 questions that form six core composite measures (Getting Timely Care; Supporting Patient Self-Management; Available to Provide Care and Information; Provider Communication; Care Coordination; and Courteous Office Staff); two single-item measures of family participation in care and interpreter services; and two global ratings of cancer care and the treatment team. Sixteen additional items form three supplemental composite measures: Shared Decision-Making, Keeping Patients Informed, and Access to Care.\u0000\u0000\u0000CONCLUSION\u0000Mail-only, mail-telephone mixed-mode, and Web-mail mixed-mode data collection methods are recommended. The questionnaires and instructions for use are free and available in English and Spanish on the CAHPS Website (www.ahrq.gov/cahps).","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900039"},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49225934","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}

引用次数: 23

Genomics and Therapeutic Decisions in Urothelial Malignancies. 尿路上皮恶性肿瘤的基因组学和治疗决策。

Journal of Oncology Practice Pub Date : 2019-08-12 DOI: 10.1200/JOP.19.00429

U. Vaishampayan

引用次数: 0

Magic Still Needed for Germ Cell Tumor Research, Especially in Adolescents and Young Adults. 生殖细胞肿瘤的研究仍然需要魔力，特别是在青少年和年轻人中。

Journal of Oncology Practice Pub Date : 2019-08-12 DOI: 10.1200/JOP.19.00431

A. Bleyer

引用次数: 3

Management of Urothelial Bladder Cancer in Clinical Practice: Real-World Answers to Difficult Questions. 尿路上皮性膀胱癌在临床实践中的管理:对困难问题的真实答案。

Journal of Oncology Practice Pub Date : 2019-08-12 DOI: 10.1200/JOP.19.00215

N. Mar, F. Dayyani