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Nohová I, Andrews J, Votan B, Miller A, Sehouli J, Berger R. Patient involvement in research within the Gynecological Cancer InterGroup: A call to action for a systematic approach: Results from a survey. Health Sci Rep 2023; 6:e1735. [PMID: 38045625 PMCID: PMC10691166 DOI: 10.1002/hsr2.1735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/24/2023] [Accepted: 11/05/2023] [Indexed: 12/05/2023] Open
Abstract
Background and Aims Involving patients in research, not only as trial subjects, is not a newly established practice. Over the last two decades, patient roles have gradually expanded to become active research contributors, creating a more patient-centered research landscape. Our survey has explored the scope of patient involvement within the Gynecologic Cancer InterGroup (GCIG), an International Gynecologic Cancer Research Consortium, and identified challenges in developing a systematic, meaningful and sustainable level of patient involvement. Methods In late 2019, the GCIG Harmonisation Operations Committee conducted an online survey across 26 national and/or international research cooperative groups, aiming to identify current patient involvement practices implemented by each group. Twelve questions were asked. The results have been generated to support a systematic strategic planning process to increase patient involvement into clinical research projects. Results More than half of the 26 participating groups have either already involved (15, [58%]) or are planning (6, [23%]) to involve patients in their research activities. Gaining patient support in raising public awareness around clinical trials appears to be one of the most desired benefits (21, [81%]). Ten respondents managed to integrate patient involvement into their standard practice. When involving patients in research the groups mostly consider that patients bring added value to the study (19, [73%]), although only eight groups (40%) have a well-organized process in doing so. Conclusion Even though patient involvement is considered a significant added value to clinical research, its application within GCIG groups is not considered on a regular basis and is predominantly limited to operational aspects of research activities. The lack of resources and expertize, as well as the missing well-organized and structured process of some groups, combined with their ability to ensure process sustainability, are among the main factors affecting implementation and adoption of patient involvement within GCIG research activities.
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Affiliation(s)
- Ivana Nohová
- Department of Gynaecology, Obstetrics and Neonatology First Faculty of MedicineCharles University and General University Hospital in Prague, Central and Eastern European Gynecologic Oncology Group (CEEGOG)PragueCzech Republic
| | - John Andrews
- Australia New Zealand Gynaecological Oncology Group (ANZGOG)CamperdownAustralia
| | - Bénédicte Votan
- Association de Recherche dans les CAncers Gynécologiques–Groupe d'Investigateurs National pour l'Etude des Cancers de l'Ovaire et du sein (ARCAGY‐GINECO)ParisFrance
| | - Austin Miller
- Department of Biostatistics and BioinformaticsRoswell Park Comprehensive Cancer Center, GOG FoundationBuffaloNew YorkUSA
| | - Jalid Sehouli
- Department of Gynecology with Center for Oncological SurgeryCharité ‐ Universitätsmedizin Berlin, Nord‐Ostdeutsche Gesellschaft für Gynäkologische Onkologie (NOGGO e.V.)BerlinGermany
| | - Regina Berger
- Department for Gynecology and Obstetrics, Medical University of InnsbruckArbeitsgemeinschaft Gynäkologische Onkologie Österreich (AGO Austria)InnsbruckAustria
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GCIG-Consensus guideline for Long-term survivorship in gynecologic Cancer: A position paper from the gynecologic cancer Intergroup (GCIG) symptom benefit committee. Cancer Treat Rev 2022; 107:102396. [PMID: 35525106 DOI: 10.1016/j.ctrv.2022.102396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Long-term survivors of gynecological cancers may be cured but still have ongoing health concerns and long-term side effects following cancer treatment. The aim of this brainstorming meeting was to develop recommendations for long-term follow-up for survivors from gynecologic cancer. METHODS International experts, representing each member group within the Gynecologic Cancer InterGroup (GCIG), met to define long-term survival, propose guidelines for long term follow-up and propose ways to implement long term survivorship follow-up in clinical trials involving gynecological cancers. RESULTS Long-term survival with/from gynecological cancers was defined as survival of at least five years from diagnosis, irrespective of disease recurrences. Review of the literature showed that more than 50% of cancer survivors with gynecological cancer still experienced health concerns/long-term side effects. Main side effects included neurologic symptoms, sleep disturbance, fatigue, sexual dysfunction, bowel and urinary problems and lymphedema. In this article, long-term side effects are discussed in detail and treatment options are proposed. Screening for second primary cancers and lifestyle counselling (nutrition, physical activity, mental health) may improve quality of life and overall health status, as well as prevent cardiovascular events. Clinical trials should address cancer survivorship and report patient reported outcome measures (PROMs) for cancer survivors. CONCLUSION Long-term survivors after gynecological cancer have unique longer term challenges that need to be addressed systematically by care givers. Follow-up after completing treatment for primary gynecological cancer should be offered lifelong. Survivorship care plans may help to summarize cancer history, long-term side effects and to give information on health promotion and prevention.
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Stover AM, Kurtzman R, Walker Bissram J, Jansen J, Carr P, Atkinson T, Ellis CT, Freeman AT, Turner K, Basch EM. Stakeholder Perceptions of Key Aspects of High-Quality Cancer Care to Assess with Patient Reported Outcome Measures: A Systematic Review. Cancers (Basel) 2021; 13:cancers13143628. [PMID: 34298841 PMCID: PMC8306432 DOI: 10.3390/cancers13143628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/02/2021] [Accepted: 07/14/2021] [Indexed: 01/10/2023] Open
Abstract
Simple Summary We conducted a review to identify important symptoms reported by patients on questionnaires (e.g., pain) that can be used to compare cancer centers on how well they provide care. For example, cancer centers could be compared on the percentage of patients with controlled pain after adjusting for demographic and clinical characteristics. Standard review methods were used to identify studies through August 2020. Searches generated 1813 articles and 1779 were coded as not relevant. The remaining 34 studies showed that patients, caregivers, clinicians, and healthcare administrators identify psychosocial care (e.g., distress) and symptom management as critical parts of high-quality care. Patients and caregivers also perceive that maintaining physical function and daily activities are important. Clinicians and healthcare administrators perceive control of specific symptoms to be important (e.g., pain, poor sleep, diarrhea). Results were used to inform testing of symptom questionnaires to compare the quality of care provided by six cancer centers. Abstract Performance measurement is the process of collecting, analyzing, and reporting standardized measures of clinical performance that can be compared across practices to evaluate how well care was provided. We conducted a systematic review to identify stakeholder perceptions of key symptoms and health domains to test as patient-reported performance measures in oncology. Stakeholders included cancer patients, caregivers, clinicians, and healthcare administrators. Standard review methodology was used, consistent with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). MEDLINE/PubMed, EMBASE, and the Cochrane Library were searched to identify relevant studies through August 2020. Four coders independently reviewed entries and conflicts were resolved by a fifth coder. Efficacy and effectiveness studies, and studies focused exclusively on patient experiences of care (e.g., communication skills of providers) were excluded. Searches generated 1813 articles and 1779 were coded as not relevant, leaving 34 international articles for extraction. Patients, caregivers, clinicians, and healthcare administrators prioritize psychosocial care (e.g., distress) and symptom management for patient-reported performance measures. Patients and caregivers also perceive that maintaining physical function and daily activities are critical. Clinicians and administrators perceive control of specific symptoms to be critical (gastrointestinal symptoms, pain, poor sleep). Results were used to inform testing at six US cancer centers.
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Affiliation(s)
- Angela M. Stover
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC 27599, USA;
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA; (J.J.); (P.C.)
- Correspondence:
| | - Rachel Kurtzman
- Department of Health Behavior, University of North Carolina, Chapel Hill, NC 27599, USA;
| | | | - Jennifer Jansen
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA; (J.J.); (P.C.)
| | - Philip Carr
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA; (J.J.); (P.C.)
| | - Thomas Atkinson
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - C. Tyler Ellis
- Department of Surgery, University of Louisville Health, Louisville, KY 40202, USA;
| | | | - Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Ethan M. Basch
- Department of Health Policy and Management, University of North Carolina, Chapel Hill, NC 27599, USA;
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA; (J.J.); (P.C.)
- Department of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA;
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Kpoghomou MA, Geneau M, Menard J, Stiti M, Almont T, Ghose B, Attal J, Delannes M, Huyghe E, Ducassou A. Assessment of an onco-sexology support and follow-up program in cervical or vaginal cancer patients undergoing brachytherapy. Support Care Cancer 2021; 29:4311-4318. [PMID: 33411047 DOI: 10.1007/s00520-020-05898-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 11/16/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Women's sexual health and wellbeing with cervical or vaginal cancer may be largely affected by complications from external beam radiotherapy (EBRT) and utero-vaginal brachytherapy (BT), of which vaginal stenosis is the main complication. The objective of this study was to assess the impact of support by a nurse sexologist on sexuality, vaginal side-effects, and the quality of clinical follow-up in patients treated with brachytherapy for cervical or vaginal cancer. METHODS We performed a retrospective study of the sexuality of women treated for cervical or vaginal cancer. Data from patients with cervical or vaginal cancer who underwent brachytherapy between 2013 and 2017 were collected at Institut Universitaire de Cancer de Toulouse-Oncopôle (IUCT-Oncopôle). Patients were divided into two groups: group A (intervention group) received support from a nurse sexologist and group B (control group) did not. The chi-square test and a logistic multivariate model were used for data analysis. RESULTS A total of 156 patients were included in this study, including 57.7% who were followed by a nurse sexologist. We observed low compliance in using vaginal dilators after brachytherapy and/or radiotherapy over time regardless of the group, and patients' sexual activity was inadequately addressed. Information regarding the resumption of sexuality 2 months after treatment was missing in 1.1% of patients in group A and in 36.4% of patients in group B. Multivariate analysis showed that patients in group A had a lower risk of developing vaginal stenosis with OR crude = 0.5 (95% CI = 0.25-0.92) and OR adj. = 0.5 (95% CI = 0.26-1.09) compared with those in group B. CONCLUSION This retrospective study highlights the lack of information collected by physicians during follow-up concerning the sexuality of patients with cervical or vaginal cancer treated by EBRT and BT. The support offered by nurse sexologists in improving patients' sexual activity and reducing their physical side-effects such as vaginal stenosis is likely to be beneficial. A prospective study is currently being conducted to validate the present findings.
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Affiliation(s)
- Marce-Amara Kpoghomou
- Pôle Centre de Psychiatrie générale, Unité d'hospitalisation Adulte "L'Odyssée", Centre Hospitalier Henri Guérin Pierrefeu-du-var, Toulon, France.
| | - Marion Geneau
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Josiane Menard
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Moufid Stiti
- Pôle Centre de Psychiatrie générale, Unité d'hospitalisation Adulte "L'Odyssée", Centre Hospitalier Henri Guérin Pierrefeu-du-var, Toulon, France
| | - Thierry Almont
- EA 3694 Human Fertility Research Group, Paule de Viguier, Reproductive Medicine Department, Toulouse University Hospital, Toulouse, France.,French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Reproductive Medicine Department, Paule de Viguier University Hospital, Toulouse, France
| | - Bishwajit Ghose
- School of Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Justine Attal
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Martine Delannes
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
| | - Eric Huyghe
- EA 3694 Human Fertility Research Group, Paule de Viguier, Reproductive Medicine Department, Toulouse University Hospital, Toulouse, France.,French Education and Research Group in Andrology, Urology and Sexology (GEFRAUS), Reproductive Medicine Department, Paule de Viguier University Hospital, Toulouse, France
| | - Anne Ducassou
- Radiotherapy Department, Institut Claudius Regaud, Toulouse University Institute for Cancer (IUCT-Oncopole), Toulouse, France
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