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Kvale E, Phillips F, Ghosh S, Lea J, Hoppenot C, Costales A, Sunde J, Badr H, Nwogu-Onyemkpa E, Saleem N, Ward R, Balasubramanian B. Survivorship Care for Women Living With Ovarian Cancer: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e48069. [PMID: 38335019 PMCID: PMC10891493 DOI: 10.2196/48069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Ovarian cancer ranks 12th in cancer incidence among women in the United States and 5th among causes of cancer-related death. The typical treatment of ovarian cancer focuses on disease management, with little attention given to the survivorship needs of the patient. Qualitative work alludes to a gap in survivorship care; yet, evidence is lacking to support the delivery of survivorship care for individuals living with ovarian cancer. We developed the POSTCare survivorship platform with input from survivors of ovarian cancer and care partners as a means of delivering patient-centered survivorship care. This process is framed by the chronic care model and relevant behavioral theory. OBJECTIVE The overall goal of this study is to test processes of care that support quality of life (QOL) in survivorship. The specific aims are threefold: first, to test the efficacy of the POSTCare platform in supporting QOL, reducing depressive symptom burden, and reducing recurrence worry. In our second aim, we will examine factors that mediate the effect of the intervention. Our final aim focuses on understanding aspects of care platform design and delivery that may affect the potential for dissemination. METHODS We will enroll 120 survivors of ovarian cancer in a randomized controlled trial and collect data at 12 and 24 weeks. Each participant will be randomized to either the POSTCare platform or the standard of care process for survivorship. Our population will be derived from 3 clinics in Texas; each participant will have received some combination of treatment modalities; continued maintenance therapy is not exclusionary. RESULTS We will examine the impact of the POSTCare-O platform on QOL at 12 weeks after intervention as the primary end point. We will look at secondary outcomes, including depressive symptom burden, recurrence anxiety, and physical symptom burden. We will identify mediators important to the impact of the intervention to inform revisions of the intervention for subsequent studies. Data collection was initiated in November 2023 and will continue for approximately 2 years. We expect results from this study to be published in early 2026. CONCLUSIONS This study will contribute to the body of survivorship science by testing a flexible platform for survivorship care delivery adapted for the specific survivorship needs of patients with ovarian cancer. The completion of this project will contribute to the growing body of science to guide survivorship care for persons living with cancer. TRIAL REGISTRATION ClinicalTrials.gov NCT05752448; https://clinicaltrials.gov/study/NCT05752448. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48069.
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Affiliation(s)
- Elizabeth Kvale
- Section of Geriatrics and Palliative Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Farya Phillips
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, United States
| | - Samiran Ghosh
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center, Houston, TX, United States
| | - Jayanthi Lea
- Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Claire Hoppenot
- Department of Gynecologic Oncology, Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States
| | - Anthony Costales
- Department of Gynecologic Oncology, Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States
| | - Jan Sunde
- Department of Gynecologic Oncology, Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX, United States
| | - Hoda Badr
- Department of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Eberechi Nwogu-Onyemkpa
- Section of Geriatrics and Palliative Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Nimrah Saleem
- Section of Geriatrics and Palliative Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Rikki Ward
- University of Texas Health Houston School of Public Health - Dallas Campus, Dallas, TX, United States
| | - Bijal Balasubramanian
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center, Houston, TX, United States
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Bagheri I, Yousefi H, Bahrami M, Shafie D. Quality of Palliative Care Guidelines in Patients with Heart Failure: A Systematic Review of Quality Appraisal using AGREE II Instrument. Indian J Palliat Care 2023; 29:7-14. [PMID: 36846280 PMCID: PMC9943939 DOI: 10.25259/ijpc_46_2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/19/2022] [Indexed: 11/04/2022] Open
Abstract
Objectives While the principles for developing clinical practice guidelines (CPGs) are well established, the quality of published guidelines is very diverse. The present study was conducted to evaluate the quality of existing CPGs in palliative care for heart failure patients. Material and Methods The study was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses. A systematic search was conducted in the Excerpta Medica Database, MEDLINE/PubMed, CINAHL databases and Guideline internet sites: National Institute for Clinical Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, Guidelines International Network and National Health and Medical Research Council for CPGs published through April 2021. Criteria for including CPGs were: Containing palliative measures for patients with heart failure over 18 years old and preferably interprofessional guidelines that focus on only one dimension of palliative care or focus on diagnosis, definition and treatment were excluded from the study. After initial screening, five appraisers rated the quality of the final selection of CPGs using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II). Results From 1501 records, seven guidelines were selected for analysis. The 'scope and purpose' and 'clarity of presentation' domains obtained the highest mean and 'rigor of development' and 'applicability' domains obtained the lowest mean scores. Three categories of recommendations were: (1) Strongly recommended (guidelines 1, 3, 6 and 7); (2) recommended with modifications (guideline 2) and (3) not recommended (guidelines 4 and 5). Conclusion Clinical guidelines for palliative care in patients with heart failure were of moderate-to-high quality, with the main deficiencies occurring in the rigor of development and applicability domains. The results inform clinicians and guideline developers of the strengths and weaknesses of each CPG. To improve the quality of palliative care CPGs in the future, it is recommended that developers pay detailed attention to all domains of the AGREE II criteria. Funding agent: Isfahan University of Medical Sciences. (IR.MUI.NUREMA.REC.1400.123).
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Affiliation(s)
- Imane Bagheri
- Department of Adult Health Nursing, College of Nursing and Midwifery, Isfahan, Iran
| | - Hojatollah Yousefi
- Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, Isfahan, Iran
| | - Masoud Bahrami
- Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, Isfahan, Iran
| | - Davood Shafie
- Department of Cardiology, Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Seow SY, Kwok KFV, Tay KH, Chee WSA, Rawtaer I, Cheng Y, Tan QX, Tan SM. Systematic Review of Clinical Practice Guidelines for Insomnia Disorder. J Psychiatr Pract 2022; 28:465-477. [PMID: 36355585 DOI: 10.1097/pra.0000000000000670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This systematic review assessed the quality of clinical practice guidelines (CPGs) on the treatment of insomnia disorder and their reporting of recommendations, while summarizing the evidence and providing guidance on an algorithmic approach to appropriate pharmacological treatment. METHODS The PubMed and EMBASE databases, guideline repositories, and specialist association websites were searched. The quality of the CPGs was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument, complemented by the AGREE-REX (Appraisal of Guidelines REsearch and Evaluation-Recommendations EXcellence). A multidisciplinary team identified the key clinical questions that a clinician would consider when taking an algorithmic approach to the use of medication for patients with insomnia disorder. By using a meta-synthesis approach, recommendations from the CPGs were characterized and summarized via a recommendation matrix. RESULTS A total of 10 records that met the inclusion criteria were included and appraised. Four CPGs were rated as high and 3 CPGs were rated as moderate in overall quality. Most of the CPGs recommended pharmacotherapy only if cognitive behavioral therapy for insomnia or other nonpharmacological interventions were unavailable, unsuccessful, or declined by patients. Recommendations on types of medicines and dose and duration of treatment varied and were nonspecific. Few of the CPGs provided recommendations on pharmacotherapy in special populations. CONCLUSIONS Indications for starting medications are the only common thread in all of the reviewed CPGs. The CPGs diverged in the choice of first-line pharmacotherapy, and most of the CPGs did not provide recommendations on all subsequent clinical considerations.
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Affiliation(s)
- Su Yin Seow
- SEOW, KWOK, TAY, CHEE, RAWTAER, CHENG, QI XUAN TAN, and SHIAN MING TAN: Sengkang General Hospital, Singapore, Singapore
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Appraising the quality of guidelines for peripheral arterial catheters care: A systematic review of reviews. Aust Crit Care 2022:S1036-7314(22)00064-9. [PMID: 35787817 DOI: 10.1016/j.aucc.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 03/28/2022] [Accepted: 03/28/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Catheter-related bloodstream infections are among the most critical adverse events in critical patients with peripheral arterial catheters (ACs). Adherence to evidence-based guidelines can prevent and reduce arterial bloodstream infections. OBJECTIVE The objectives of this study were to assess clinical practice guidelines for AC care and analyse methodological factors related to their development for effective dissemination and implementation in clinical practice. REVIEW METHOD USED This was a systematic review of guidelines. DATA SOURCES We searched PubMed, CINAHL, EMBASE, CNKI, and WANFANG databases from inception until September 2021 and evaluated websites of organisations that complied or produced guidelines. REVIEW METHODS A comprehensive list of guidelines for ACs care was included. We excluded incomplete guidelines, guidelines translated in other languages, duplicate publications, and summaries of multiple guidelines. Two reviewers independently extracted and collected the data, and three authors conducted quality assessments independently using the Appraisal of Guidelines for Research and Evaluation, Second Edition (AGREE II) tool. The intraclass correlation coefficient (two-way random) with a 95% confidence interval was used to evaluate the concordance between reviewers. RESULTS Of the 738 total publications screened, seven were selected for evaluation. The concordance between observers was substantial (intraclass correlation coefficient >0.9, P < 0.001). Most guidelines (4/6) were developed in the United States and the United Kingdom. The median scores for the six domains were 89.0%, 65.5%, 58.0%, 86.0%, 65.0%, and 86.0%. The domains of stakeholder involvement, rigour of development, and applicability had the lowest scores. Guidelines by the United Kingdom's National Institute for Health and Care Excellence showed the highest quality. CONCLUSIONS The guidelines we included scored poorly on crucial domains (rigour of development, applicability, and stakeholder involvement). Most of the current recommendations on ACs were included in the guidelines for vascular catheter-related bloodstream infections. Therefore, targeted guidelines created specifically for ACs are warranted to reduce the incidence of catheter-related complications and ensure patient safety.
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Neher M, Landén Ludvigsson M, Enblom A. Preparedness to Implement Physical Activity and Rehabilitation Guidelines in Routine Primary Care Cancer Rehabilitation: Focus Group Interviews Exploring Rehabilitation Professionals' Perceptions. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:779-786. [PMID: 32062799 PMCID: PMC8328890 DOI: 10.1007/s13187-020-01704-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
To explore primary care professionals' perceptions of physical activity and other cancer rehabilitation practice in cancer survivors, investigating the preparedness to implement guidelines regarding cancer rehabilitation. We collected qualitative data through seven semi-structured focus group interviews with 48 rehabilitation professionals, with mean 9 years of experience in primary care rehabilitation (32 physiotherapists, 15 occupational therapists, and 1 rehabilitation assistant) in a primary care setting. Data was analyzed using content analysis. Primary care rehabilitation professionals expressed limited experience of cancer survivors, experienced lack of knowledge of cancer-related disability, and had doubts concerning how to treat cancer survivors. They also experienced uncertainty about where to find collaboration and support in the healthcare system outside their own rehabilitation clinic. There is a need to combine different implementation strategies to tackle multiple barriers for effective cancer survivor rehabilitation in primary care, to boost individual rehabilitation professionals' knowledge and self-efficacy, to clarify roles and responsibilities for cancer rehabilitation across levels of care, and to develop and strengthen organizational bridges to provide adequate access to rehabilitation for cancer survivors.
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Affiliation(s)
- Margit Neher
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Maria Landén Ludvigsson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Rehabilitation, and Department of Health, Medicine and Caring Sciences, Linköping University, Motala, Sweden
| | - Anna Enblom
- County Council of Östergötland, Linköping, Sweden
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Lanes TC, Ribeiro MAL, Oliveira DSD, Junior MGDN, Garcia FR, Melo JMFDO, Tiguman GMB. Guías de práctica clínica para el tratamiento de la enfermedad por Covid-19 en Brasil: revisión sistemática. REVISTA CUIDARTE 2021. [DOI: 10.15649/cuidarte.2025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: La enfermedad por coronavirus (Covid-19) es una patología infecciosa que afecta al sistema respiratorio, la cual se originó en China y se extendió rápidamente por todo el mundo. Objetivo: Evaluar la calidad metodológica y la transparencia de las guías de práctica clínica brasileñas para el tratamiento de la enfermedad por coronavirus (Covid-19). Materiales y métodos: Se realizó una revisión sistemática en 2020 en las bases de datos Medline (vía PubMed), Embase, Scopus, LILACS, National Guideline Clearinghouse y Guidelines International Network, además de consultas en los sitios web del Ministerio de Salud de Brasil, Asociación Médicas Brasileña, Consejo Federal de Medicina, Consejo Federal de Enfermería y Consejo Federal de Fisioterapia. La evaluación de la calidad metodológica y la transparencia de las guías se realizó con el instrumento Appraisal of Guidelines for Research and Evaluation (AGREE), segunda versión realizada por cuatro autores. Resultados: Se encontraron 33 guías, de las que se incluyeron 14 en el análisis. Hubo una sola guía que obtuvo una puntuación superior al 60% en todos los dominios. Entre los seis dominios, se presentaron puntuaciones más altas en los siguientes tres dominios: alcance y objetivo, participación de las partes interesadas y claridad de la presentación. Discusión: A pesar de la fragilidad metodológica, los autores se interesaron por presentar las recomendaciones de forma clara y concisa a través de información clave y opciones terapéuticas que faciliten la toma de decisiones. Conclusión: Las guías de práctica clínica brasileñas mostraron tener una baja calidad metodológica, de las que solamente una guía fue recomendada y clasificada como de alta calidad y transparencia metodológica.
Como citar este artículo: Lanes, Taís Carpes; Ribeiro, Mariane Albuquerque Lima; Oliveira, Daianny Seoni de; Junior, Marcos Gabriel do Nascimento; Garcia, Filipe Reis; Melo, Jéssyca Maria França de Oliveira; Tiguman, Gustavo Magno Baldin. Diretrizes de prática clínica para o tratamento da Covid-19 no Brasil: uma revisão sistemática. Revista Cuidarte. 2021;12(2):e2025 http://dx.doi.org/10.15649/cuidarte.2025
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Paniccia M, Provvidenza C, Kingsnorth S, Ippolito C, Zemek R, Reed N. Engaging target users to appraise and refine clinical practice guidelines in pediatric concussion: An integrated knowledge translation approach. JOURNAL OF CONCUSSION 2021. [DOI: 10.1177/20597002211017405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Clinical practice guidelines are systematically developed statements that assist clinicians in making evidence informed decisions regarding patient care. Within pediatric concussion, the Ontario Neurotrauma Foundation released the Guidelines for Diagnosing and Managing Pediatric Concussion in 2014. The purpose of this study was to evaluate the 2014 guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) evaluation tool, in addition to a brief knowledge translation survey, and to utilize the collected feedback from end users to inform improvements to support an updated version. An integrated knowledge translation approach was employed using clinical experts as guideline appraisers. Methods A purposive sample of researchers, physicians, allied health professionals, policy makers, educators and knowledge translation experts involved in updating the guidelines (N = 31) completed the AGREE II Likert scale survey regarding the 2014 guideline, and provided written justifications for their ratings. Domain and item AGREE II scaled scores were reported stratified by demographic factors, and written justifications were synthesized using content analysis to determine areas of improvement for the 2014 guideline. Results Appraisers scored the editorial independence (88.9%) and scope and purpose (80.8%) domains the highest, indicating high quality. The guidelines scored the lowest in the applicability domain (69.3%). Participants with less than 10 years of experience in their respective disciplines, as well as physicians and allied health professionals consistently provided higher ratings across domains compared to other professions. Conclusions The process of evaluating the 2014 guideline resulted in these important outcomes: (1) identified areas of the guideline that may have affected the lack of previous clinical uptake while abiding by a clinical practice guideline development framework; (2) shared and informed decision making regarding content and format of the revised clinical practice guideline; and (3) targeted content, clinical questions and dissemination strategies, which are key to clinical uptake.
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Affiliation(s)
- Melissa Paniccia
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Christine Provvidenza
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Shauna Kingsnorth
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Christina Ippolito
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Roger Zemek
- Department of Pediatrics and Emergency Medicine, University of Ottawa, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Nick Reed
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Kent K, Jessup B, Marsh P, Barnett T, Ball M. A systematic review and quality appraisal of bereavement care practice guidelines. J Eval Clin Pract 2020; 26:852-862. [PMID: 31287214 DOI: 10.1111/jep.13225] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/27/2019] [Accepted: 06/15/2019] [Indexed: 01/09/2023]
Abstract
Bereavement care practice guidelines assist in delivering high-quality bereavement care. However, the quality of published guidelines is unknown. A systematic review was conducted to identify and evaluate the quality of the process used to develop bereavement care practice guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. A keyword search was conducted in MEDLINE-Complete, CINAHL-Complete, Health-Source (Nursing/Academic Edition), Psychology and Behavioral Sciences Collection, and an internet search engine in October 2017. Sixteen guidelines with differing scope and purpose but similar core values were identified from the grey literature and then appraised at high quality (n = 1), moderate quality (n = 4), or low quality (n = 11). The domains "clarity of presentation" and "scope and purpose" achieved the highest scores (mean ± SD 71.0 ± 27.6% and 64.4 ± 37.5%, respectively), while "editorial independence" showed the lowest mean score (9.2 ± 13.3%). While few of the bereavement care practice guidelines met the AGREE II quality standards related to their development process, neither the quality of the content of each guideline nor the in-context application was assessed by the AGREE II instrument. Ongoing development of practice guidelines may benefit from consideration and application of the framework outlined in the AGREE II or similar appraisal instrument.
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Affiliation(s)
- Katherine Kent
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Belinda Jessup
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Pauline Marsh
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Tony Barnett
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Madeleine Ball
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
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Ren Y, Li H, Wang Y, Chen Y. Report of guidelines for diagnosis and treatment of common internal diseases in Chinese medicine: Headache. J Evid Based Med 2020; 13:70-80. [PMID: 32073239 DOI: 10.1111/jebm.12378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/04/2020] [Indexed: 11/27/2022]
Abstract
Headache is one of the most common clinical complaints and is listed as one of the top 10 disability disorders by the World Health Organization (WHO). For standardizing the diagnosis and treatment of headache and improve the level of clinical diagnosis and treatment of traditional Chinese medicine (TCM), on 30 January 2019, China Association of Chinese Medicine officially issued the Guidelines for Diagnosis and Treatment of Common Internal Diseases in Chinese Medicine-Headache (T/CACM 1271-2019). The Guidelines were developed following the method process recommended by Technical Requirements for the Revision of TCM Clinical Diagnosis and Treatment Guidelines (pilot edition), and also referring to WHO Handbook for Guideline Development. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was also followed. The protocol was formulated by the guideline project team, which comprised of specialists of TCM encephalopathy, guideline methodologist, patient representative, etc. Question regarding the treatment of headaches in TCM were formulated and 18 most important ones were chosen as PICOs (population, intervention, comparison, outcomes). Comprehensive search and review of the literature were performed and the quality of the evidence was assessed and rated based on certain criteria. Twenty-five recommendations were put forward in the Guidelines through three rounds of expert consensus based on their quality of evidence, in addition to the balance of pros and cons of these interventions, patient preferences and values, and economic factors. It is the first and the only clinical practice guide for Chinese medicine accepted by National Guidelines Clearinghouse in the world.
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Affiliation(s)
- Yongyan Ren
- The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui Li
- Guangdong Provincial Hospital of Chinese Medicine/Guangdong Provincial Engineering and Technology Research Center of Chinese Medicine Standardization, Guangzhou, China
| | - Yangyang Wang
- Guangdong Provincial Hospital of Chinese Medicine/Guangdong Provincial Engineering and Technology Research Center of Chinese Medicine Standardization, Guangzhou, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Chinese GRADE Center, Lanzhou, China
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Irajpour A, Hashemi M, Taleghani F. The quality of guidelines on the end-of-life care: a systematic quality appraisal using AGREE II instrument. Support Care Cancer 2019; 28:1555-1561. [PMID: 31834517 DOI: 10.1007/s00520-019-05220-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 11/28/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Guidelines are intended to facilitate knowledge translation and evidence-based clinical decision-making, but they vary in methodological rigor and quality. The present study was conducted to assess the quality of guidelines available on end-of-life care in patients with cancer using AGREE II. METHODS A comprehensive search was carried out in EMBASE (Excerpta Medica Database), MEDLINE/PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and gray literature sources until December 2016. The quality of the guidelines was assessed independently by five appraisers using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II). To promote consistency with available studies using AGREE II and identify high-quality guidelines, the AGREE II scores were also categorized as "Strongly recommended," "Recommended with modifications," or "Not recommended." RESULTS A total of 8 guidelines were included in this study. Five of the guidelines were developed based on evidence and two by consensus and one provided no information about its method of development. The highest mean score (82.77%) pertained to "Clarity of presentation" and the lowest to "Editorial independence" (44.80%). Based on the AGREE II results, three guidelines were "Strongly recommended," four were "Recommended with modifications," and one was "Not recommended." CONCLUSION Despite the variations in the quality and strength of the recommendations, a number of guidelines are currently available on end-of-life care. Health team members should be aware of this variability.
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Affiliation(s)
- Alireza Irajpour
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Hashemi
- Students Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Agbata EN, Padilla PF, Agbata IN, Armas LH, Solà I, Pottie K, Alonso-Coello P. Migrant Healthcare Guidelines: A Systematic Quality Assessment. J Immigr Minor Health 2019; 21:401-413. [PMID: 29785690 DOI: 10.1007/s10903-018-0759-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Significant international and cross-border migration has led to a growing availability of migrant healthcare guidelines (MHGs), which we systematically reviewed for quality. PubMed, MEDLINE, CINHAL, PsychINFO and guideline developer/guideline databases were searched for MHGs published 2006-2016. Three independent reviewers assessed eligible MHGs using the Appraisal of Guidelines, Research and Evaluation II instrument (AGREE II). MHGs were identified as high quality if they had a score of ≥ 60% in at least three of the six domains, including "rigour of development", and overall quality was assessed on a seven-point Likert scale. We included 32 MHGs. Overall agreement between reviewers was very good. Mean scores for each AGREE II domain were as follows: 85 ± 19.0% for "scope and purpose"; 51 ± 30.5% for "stakeholder involvement"; 34 ± 31.9% for "rigour of development"; 86 ± 7.3% for "clarity of presentation"; 40 ± 23.6% for "applicability"; and 27 ± 38.5% for "editorial independence". Nine and six MHGs were deemed "recommended" or "recommended with modifications", respectively, and 17 were "not recommended". Our review of MHGs has highlighted critical deficiencies in rigour of development, applicability, editorial independence and stakeholder involvement that point to the need for improvements in future MHGs.
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Affiliation(s)
- Eric Nwachukwu Agbata
- Faculty of Health and Psychology, Master of Public Health (MPH) programme, University of Roehampton, London, UK. .,Methodology of Biomedical Research and Public Health, Department of Paediatrics, Obstetrics, Gynaecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Paulina Fuentes Padilla
- Iberoamerican Cochrane Centre, Barcelona, Spain.,Faculty of Medicine and Dentistry, Universidad de Antofagasta, Antofagasta, Chile
| | - Ifeoma Nwando Agbata
- The Wicklow Mental Health Service, Newcastle Hospital, Greystones, Wicklow, Ireland
| | | | - Ivan Solà
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Kevin Pottie
- Centre for Global Health Institute of Population Health, University of Ottawa, Ottawa, ON, Canada.,C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Canada
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Biomedical Research Institute, Sant Pau (IIB Sant Pau), Barcelona, Spain
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Brauer ER, Pieters HC, Ganz PA, Landier W, Pavlish C, Heilemann MV. "Improving to where?": treatment-related health risks and perceptions of the future among adolescents and young adults after hematopoietic cell transplantation. Support Care Cancer 2019; 27:623-630. [PMID: 30043264 PMCID: PMC6326869 DOI: 10.1007/s00520-018-4350-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/09/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Despite the prevalence of hematological malignancies in early adulthood, very little is known about hematopoietic cell transplantation among adolescents and young adults, and even less is known about their transition from the completion of therapy to early survivorship. In this qualitative study, we investigated the impact of the cancer experience on sense of life potential and perception of the future from the perspectives of adolescents and young adults after hematopoietic cell transplantation. METHODS In-depth interviews were conducted with adolescents and young adults who underwent allogeneic or autologous hematopoietic cell transplantation between the ages of 15-29 years and were 6-60 months post-treatment. Interview transcripts were systematically coded based on constructivist grounded theory. RESULTS Eighteen adolescents and young adults participated and described how they came to understand the lifelong, chronic nature of cancer survivorship. "Improving to where?" was a question raised in the post-treatment period that reflected participants' confusion about the goals of treatment and expectations for survivorship. Participants reported bracing themselves for "something bad" to deal with the uncertainty of medical and psychosocial effects of treatment. They struggled to move forward with their lives given their substantial health risks and found it necessary to "roll with the punches" in order to adjust to this new reality. CONCLUSIONS Adolescents and young adults who undergo hematopoietic cell transplantation are at significant risk for long-term and late effects in survivorship. Age-appropriate interventions are needed to support these survivors as they manage their fears about the future while enhancing health and well-being.
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Affiliation(s)
- Eden R Brauer
- UCLA Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Huibrie C Pieters
- UCLA School of Nursing, 4-956 Factor Bldg, Box 956918, Los Angeles, CA, 90095-6918, USA
| | - Patricia A Ganz
- UCLA Fielding School of Public Health, UCLA David Geffen School of Medicine, UCLA Jonsson Comprehensive Cancer Center, 650 Charles Young Drive South, Room A2-125 CHS, Los Angeles, CA, 90095-6900, USA
| | - Wendy Landier
- University of Alabama at Birmingham Schools of Medicine and Nursing, 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA
| | - Carol Pavlish
- UCLA School of Nursing, 4-238 Factor Bldg, Box 956918, Los Angeles, CA, 90095-6918, USA
| | - MarySue V Heilemann
- UCLA School of Nursing, 5-252 Factor Bldg, Box 956919, Los Angeles, CA, 90095-6919, USA
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13
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Sterba KR, Armeson K, Zapka J, Scallion MA, Garris TK, Graboyes EM, Ruggiero K, Day TA. Evaluation of a survivorship needs assessment planning tool for head and neck cancer survivor-caregiver dyads. J Cancer Surviv 2019; 13:117-129. [PMID: 30645719 DOI: 10.1007/s11764-019-0732-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/03/2019] [Indexed: 01/01/2023]
Abstract
PURPOSE The objectives of this study were to test the acceptability and feasibility of a survivorship needs assessment planning (SNAP) tool for head and neck cancer (HNC) survivors and caregivers, evaluate short-term changes in psychosocial outcomes after completing the SNAP session, and develop strategies for system refinement. METHODS We used a prospective one-group design and mixed methods with HNC survivors and caregivers (N = 25 dyads). Participants completed baseline and 6-week surveys before and after completing a SNAP clinic visit to assess psychosocial outcomes and acceptability. Intervention sessions included tablet-based needs assessments driving tailored care plans. Dyads' open-ended feedback and clinician interviews (N = 12) evaluated acceptability and feasibility. RESULTS SNAP data collection time burden and technology challenges were minimal, and care plans included messages (M = 19), educational materials (M = 13), and referrals (M = 4.5; 86% behavioral medicine, 77% nutrition, 65% physical therapy). Participants reported high satisfaction with the session and care plan, highlighting the key strengths of pulling complex medical information together and the focus on caregiver well-being, with multiple suggestions to facilitate clinic workflow. Depression and unmet needs decreased and survivorship knowledge increased significantly in survivors and caregivers (p < .05) over the 6-week period. CONCLUSIONS The SNAP tool is an innovative technology-based survivor-centered strategy to assess and manage needs in HNC survivors and caregivers. Results support its acceptability and ability to address dyads' needs; the tool merits further testing in a clinical trial. IMPLICATIONS FOR CANCER SURVIVORS Technology-enabled care planning may be a productive way to assess and address HNC dyads' dynamic needs after treatment.
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Affiliation(s)
- Katherine R Sterba
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA.
| | - Kent Armeson
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Jane Zapka
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Megan A Scallion
- Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Tiffany K Garris
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Evan M Graboyes
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
| | - Kenneth Ruggiero
- Department of Psychiatry and Behavioral Sciences and College of Nursing, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC, 29425, USA
| | - Terry A Day
- Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, 87 Jonathan Lucas Street MSC 955, Charleston, SC, 29425, USA
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14
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Abstract
Survivorship has become a significant topic within oncologic care. The tools and means by which the provision of survivorship care can be implemented and delivered are in development and are the focus of significant research oncology-wide. These tools and methods include innovations of survivorship care delivery, survivorship care plans, and improving communication among all stakeholders in an individual patient's care as the means to elevate health-related quality of life. The merits of these survivorship care provisions in the field of neuro-oncology and its patients' exigent need for more patient-centric care focused on living with their illness are discussed. Since 2014 there has been a mandate within the United States for adult cancer patients treated with curative intent to receive survivorship care plans, comprising a treatment summary and a follow-up plan, intended to facilitate patients' care after initial diagnosis and upfront treatment. Several cancer-specific survivorship care plans have been developed and endorsed by health care professional organizations and patient advocacy groups. A survivorship care plan specific for neuro-oncology has been collaboratively developed by a multidisciplinary and interprofessional committee; it is endorsed by the Society for Neuro-Oncology Guidelines Committee. It is available as open access for download from the Society for Neuro-Oncology website under "Resources": https://www.soc-neuro-onc.org/SNO/Resources/Survivorship_Care_Plan.aspx. Survivorship care offers an opportunity to begin directly addressing the range of issues patients navigate throughout their illness trajectory, an oncology initiative to which neuro-oncology patients both need and deserve equitable access.
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Affiliation(s)
- Heather Leeper
- Department of Neurology, NorthShore University Health System, Evanston, Illinois
| | - Kathrin Milbury
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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15
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Salarvand S, Hemati S, Adibi P, Taleghani F. Appraising of the Clinical Practice Guidelines Quality in the Non-Pharmacological Management of Chemotherapy-Induced Febrile Neutropenia; A Review. Asian Pac J Cancer Prev 2018; 19:2701-2707. [PMID: 30360594 PMCID: PMC6291058 DOI: 10.22034/apjcp.2018.19.10.2701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Febrile neutropenia is a common and serious chemotherapy side effect, is associated with increased mortality, morbidity, and treatment expenditures. Several CPGs (Clinical practice guidelines) have been released for managing chemotherapy-induced febrile neutropenia. The aim of this study is Appraisal of the clinical practice Guidelines quality in the management of chemotherapy-induced febrile neutropenia. Methods: A review study with a systematic search of the present CPGs for the management of chemotherapy-induced febrile neutropenia. After screening the CPGs based on eligibility criteria, three CPGs were selected and 5 independent reviewers appraised them for methodological quality by using the AGREE II Instrument. Results: Three CPGs were included; all of them were evidence-based guidelines. The clarity of presentation domain scored the highest and the applicability domain has the lowest score among all domains of AGREE instrument and the rest of domains scored as descending respectively; Scope and purpose, stakeholder involvement, editorial independence, rigor of development. In general, the intra-class correlation coefficient (ICC) scores of all domains were very good according to the Landis and Koch’s scale, except the Applicability domain scored as substantial. Conclusions: This study showed the quality of appraised CPGs. Three domains of these CPGs based on the AGREE instrument scored less than other domains and were in relatively unfavorable status: applicability, rigor of development, editorial independence. Given the importance of these domains in guideline implementation, it is necessary to take actions for reducing these defects.
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Affiliation(s)
- Shahin Salarvand
- Social Determinant Health Research Center, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran. Taleghani@ nm.mui.ac.ir
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16
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Blanco-Mavillard I, Rodríguez-Calero MA, Castro-Sánchez E, Bennasar-Veny M, De Pedro-Gómez J. Appraising the quality standard underpinning international clinical practice guidelines for the selection and care of vascular access devices: a systematic review of reviews. BMJ Open 2018; 8:e021040. [PMID: 30344166 PMCID: PMC6196863 DOI: 10.1136/bmjopen-2017-021040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Catheter-related bloodstream infections are one of the most important adverse events for patients. Evidence-based practice embraces interventions to prevent and reduce catheter-related bloodstream infections in patients. At present, a growing number of guidelines exist worldwide. The purpose of the study was to assess clinical practice guidelines for peripheral and central venous access device care and prevention of related complications. DESIGN Systematic review of clinical practice guidelines: We conducted a search of the literature published from 2005 to 2018 using Medline/PubMed, Embase, CINAHL, Ovid, ScienceDirect, Scopus and Web of Science. We also evaluated grey literature sources and websites of organisations that compiled or produced guidelines. Guideline quality was assessed with the Appraisal of Guidelines for Research and Evaluation, Second Edition tool by three independent reviewers. Cohen's kappa coefficient was used to evaluate the concordance between reviewers. RESULTS We included seven guidelines in the evaluation. The concordance between observers was substantial, K=0.6364 (95% CI 0.0247 to 1.2259). We identified seven international guidelines, which scored poorly on crucial domains such as applicability (medium 39%), stakeholder involvement (medium 65%) and methodological rigour (medium 67%). Guidelines by Spanish Health Ministry and UK National Institute for Health and Care Excellence presented the highest quality. CONCLUSIONS It is crucial to critically evaluate the validity and reliability of clinical practice guidelines so the best, most context-specific document is selected. Such choice is a necessary prior step to encourage and support health organisations to transfer research results to clinical practice. The gaps identified in our study may explain the suboptimal clinical impact of guidelines. Such low adoption may be mitigated with the use of implementation guides accompanying clinical documents.
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Affiliation(s)
| | | | - Enrique Castro-Sánchez
- NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, UK
| | - Miquel Bennasar-Veny
- Department of Nursing and Physiotherapy, Universitat de les Illes Balears, Palma, Spain
| | - Joan De Pedro-Gómez
- Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Universitat de les Illes Balears, Palma, Spain
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17
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Tevaarwerk AJ, Klemp JR, van Londen GJ, Hesse BW, Sesto ME. Moving beyond static survivorship care plans: A systems engineering approach to population health management for cancer survivors. Cancer 2018; 124:4292-4300. [PMID: 30277575 DOI: 10.1002/cncr.31546] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/13/2018] [Accepted: 03/19/2018] [Indexed: 01/22/2023]
Abstract
The American cancer survivor population is ever-growing, with necessary follow-up primarily accomplished in a high-touch fashion-adding to unsustainability and fragmentation of care. Given the complexities of the health care system processes needed to support survivorship, engineering approaches may best address performance deficits and facilitate the provision of patient-centered care. Such collaboration between health care and engineering is recommended for redesigning health care delivery systems. By using Systems Engineering Initiative for Patient Safety (SEIPS), a systems engineering model widely used to improve health care quality and delivery, the authors examine the work system to identify the barriers and facilitators to necessary care in the presence of a survivorship care plan and visit. Recommendations for future improvement include ensuring that care-planning processes are dynamic, clearly assigned, resilient, and integrated with electronic health record systems.
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Affiliation(s)
- Amye J Tevaarwerk
- Department of Medicine, University of Wisconsin, Madison and Carbone Cancer Center, Madison, Wisconsin
| | - Jennifer R Klemp
- Department of Medicine, University of Kansas Medical Center and University of Kansas Cancer Center, Kansas City, Kansas
| | - Gijsberta J van Londen
- University of Pittsburgh Cancer Institute and School/Department of Medicine, Pittsburgh, Pennsylvania
| | - Bradford W Hesse
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
| | - Mary E Sesto
- Department of Medicine, University of Wisconsin, Madison and Carbone Cancer Center, Madison, Wisconsin
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18
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Blanco-Mavillard I, Bennasar-Veny M, De Pedro-Gómez JE, Moya-Suarez AB, Parra-Garcia G, Rodríguez-Calero MÁ, Castro-Sánchez E. Implementation of a knowledge mobilization model to prevent peripheral venous catheter-related adverse events: PREBACP study-a multicenter cluster-randomized trial protocol. Implement Sci 2018; 13:100. [PMID: 30045737 PMCID: PMC6060537 DOI: 10.1186/s13012-018-0792-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/03/2018] [Indexed: 11/17/2022] Open
Abstract
Background Peripheral venous catheters are the most commonly used invasive devices in hospitals worldwide. Patients can experience multiple adverse events during the insertion, maintenance, and management of these devices. Health professionals aim to resolve the challenges of care variability in the use of peripheral venous catheter through adherence to clinical practice guidelines. The aim of this cluster-randomized controlled trial is to determine the efficacy of a multimodal intervention on incidence of adverse events associated with the use of peripheral venous catheters in adult hospital patients. Additional aims are to analyze the fidelity of nurses and the relationship between contextual factors on the use of best available and the outcomes of the intervention. Methods Five public hospitals in the Spanish National Health System, with diverse profiles, including one university hospital and four second-level hospitals, will be included. In total, 20 hospitalization wards will be randomized for this study by ward to one of two groups. Those in the first group receive an intervention that lasts 12 months implementing evidence-based practice in healthcare related to peripheral catheters through a multimodal strategy, which will contain updated and poster protocols insertion, maintenance and removal of peripheral venous catheters, technologies applied to e-learning, feedback on the results, user and family information related to peripheral catheter, and facilitation of the best evidence by face-to-face training session. Primary outcome measures: Incidence of adverse events associated with the use of peripheral venous catheters is measured by assessing hospital records. Secondary outcome measures: Nurses’ adherence to clinical practice guidelines, clinical outcomes, and the cost of implementing the multimodal intervention. Discussion Clinical implementation is a complex, multifaceted phenomenon which requires a deep understanding of decision-making, knowledge mobilization, and sense making in routine clinical practice. Likewise, the inclusion of strategies that promote fidelity to recommendations through multicomponent and multimodal intervention must be encouraged. The use of a transfer model could counterbalance one of the greatest challenges for organizations, the evaluation of the impact of the implementation of evidence in the professional context through quality indicators associated with prevention and control of infections. Trial registration Current Controlled Trials ISRCTN10438530. Registered 20 March 2018.
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Affiliation(s)
| | - Miquel Bennasar-Veny
- Evidence, Lifestyles and Health Research Group, Research Institute of Health Sciences, Universitat de les Illes Balears, Palma, Spain
| | | | | | | | | | - Enrique Castro-Sánchez
- NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, UK
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19
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Salarvand S, Hemati S, Adibi P, Taleghani F. The quality of guidelines in non-pharmacological prevention and management of chemotherapy-induced neuropathy: A review. Oncol Rev 2018; 12:359. [PMID: 30464808 PMCID: PMC6207849 DOI: 10.4081/oncol.2018.359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/07/2018] [Indexed: 12/16/2022] Open
Abstract
Chemotherapy-induced peripheral neuropathy is a common adverse effect occurring in patients undergoing neurotoxic chemotherapy. However, there is no FDA-approved treatment option for it. Given the importance of clinical practice guidelines in this area, this study aimed to determine the methodological quality of extant CIPN guidelines. The study was done as part of the adaptation process of CIPN related CPGs at Isfahan University of Medical Sciences, Iran. A systematic search of published CPGs about chemotherapy-induced CIPN in which the AGREE II instrument was applied for appraising CPGs of CIPN was performed. In general, amongst all of the AGREE II Instrument’s domains in the evaluated CPGs, the clarity of presentation and stakeholder involvement domains took favorable scores; and other domains obtained unfavorable and relatively favorable scores. The quality of cancer therapy-induced neuropathy CPGs needs to be improved and designing high-quality CPGs must be considered.
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Affiliation(s)
- Shahin Salarvand
- Social Determinant Health Research Center, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad
| | - Simin Hemati
- Radiation oncology department, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan
| | - Payman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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20
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Wellmann R, Borden BA, Danahey K, Nanda R, Polite BN, Stadler WM, Ratain MJ, O'Donnell PH. Analyzing the clinical actionability of germline pharmacogenomic findings in oncology. Cancer 2018; 124:3052-3065. [PMID: 29742281 DOI: 10.1002/cncr.31382] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/07/2018] [Accepted: 03/09/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Germline and tumor pharmacogenomics impact drug responses, but germline markers less commonly guide oncology prescribing. The authors hypothesized that a critical number of clinically actionable germline pharmacogenomic associations exist, representing clinical implementation opportunities. METHODS In total, 125 oncology drugs were analyzed for positive germline pharmacogenomic associations in journals with impact factors ≥5. Studies were assessed for design and genotyping quality, clinically relevant outcomes, statistical rigor, and evidence of drug-gene effects. Associations from studies of high methodologic quality were deemed potentially clinically actionable, and translational summaries were written as point-of-care clinical decision support (CDS) tools and formally evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. RESULTS The authors identified germline pharmacogenomic results for 56 of 125 oncology drugs (45%) across 173 publications. Actionable associations were detected for 12 drugs, including 6 that had germline pharmacogenomic information within US Food and Drug Administration labels or published guidelines (capecitabine/fluorouracil/dihydropyrimidine dehydrogenase [DPYD], irinotecan/uridine diphosphate glucuronosyltransferase family 1 member A1 [UGT1A1], mercaptopurine/thioguanine/thiopurine S-methyltransferase [TPMT], tamoxifen/cytochrome P450 [CYP] family 2 subfamily D member 6 [CYP2D6]), and 6 others were novel (asparaginase/nuclear factor of activated T-cells 2 [NFATC2]/human leukocyte antigen D-related β1 [HLA-DRB1], cisplatin/acylphosphatase 2 [ACYP2], doxorubicin/adenosine triphosphate-binding cassette subfamily C member 2/Rac family small guanosine triphosphatase 2/neutrophil cytosolic factor 4 [ABCC2/RAC2/NCF4], lapatinib/human leukocyte antigen DQ α1 [HLA-DQA1], sunitinib/cytochrome P450 family 3 subfamily A member 5 [CYP3A5], vincristine/centrosomal protein 72 [CEP72]). By using AGREE II, the developed CDS summaries had high mean ± standard deviation scores (maximum score, 100) for scope and purpose (92.7 ± 5.1) and rigour of development (87.6 ± 7.4) and moderate yet robust scores for clarity of presentation (58.6 ± 25.1) and applicability (55.9 ± 24.6). The overall mean guideline quality score was 5.2 ± 1.0 (maximum score, 7). Germline pharmacogenomic CDS summaries for these 12 drugs were recommended for implementation. CONCLUSIONS Several oncology drugs have actionable germline pharmacogenomic information, justifying their delivery through institutional pharmacogenomic implementations to determine clinical utility. Cancer 2018;124:3052-65. © 2018 American Cancer Society.
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Affiliation(s)
- Rebecca Wellmann
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois
| | - Brittany A Borden
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois
| | - Keith Danahey
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois.,Center for Research Informatics, The University of Chicago, Chicago, Illinois
| | - Rita Nanda
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois.,Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Blase N Polite
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois.,Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Walter M Stadler
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois.,Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Mark J Ratain
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois.,Department of Medicine, The University of Chicago, Chicago, Illinois.,Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois
| | - Peter H O'Donnell
- Center for Personalized Therapeutics, The University of Chicago, Chicago, Illinois.,Department of Medicine, The University of Chicago, Chicago, Illinois.,Committee on Clinical Pharmacology and Pharmacogenomics, The University of Chicago, Chicago, Illinois
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21
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Fang Y, Yao L, Sun J, Zhang J, Li Y, Yang R, Yang K, Tian L. Appraisal of clinical practice guidelines on the management of hypothyroidism in pregnancy using the Appraisal of Guidelines for Research and Evaluation II instrument. Endocrine 2018; 60:4-14. [PMID: 29445919 DOI: 10.1007/s12020-018-1535-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 01/15/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE This study aimed to systematically evaluate the quality of guidelines for the management of hypothyroidism in pregnancy. METHOD Systematic searches were conducted to identify hypothyroidism in pregnancy guidelines published in electronic databases and developers' websites. Four reviewers independently evaluated eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Agreement among reviewers was measured using the intraclass correlation coefficient (ICC). The number of recommendations, strength of recommendations, and levels of evidence were determined. The software used for analysis was SPSS version 12.0. RESULTS Nine guidelines met the inclusion criteria and were appraised. The scope and purpose (65%) and clarity of presentation (70%) domains achieved relatively high scores, whereas the stakeholder involvement (41%), rigor of development (33%), applicability (36%), and editorial independence (31%) domains yielded low scores. The American Thyroid Association (ATA) guideline ranked the highest, whereas the 2012 Chinese Society of Endocrinology (CSE) guideline ranked the lowest among all the guidelines. The British Thyroid Association (BTA) and ATA guidelines were strongly recommended as dependable and helpful references to aid clinical decisions for medical providers, whereas the CSE guideline was not recommended. Most recommendations of the guidelines were relatively consistent. However, the nine guidelines varied with respect to their recommendations on thyroid scanning, dose of levothyroxine (L-T4) treatment, and target thyroid-stimulating hormone(TSH) level of L-T4 therapy. CONCLUSIONS The quality of the guidelines on the management of hypothyroidism in pregnancy is highly variable. Additionally, these guidelines need significant improvement, especially in the rigor of development and applicability domains. Some improvements should be made to promote the development and implementation of guidelines, for example, conducting a comprehensive search strategy to include more potential evidence and establishing a standard grading system to evaluate the quality of evidence.
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Affiliation(s)
- Yuan Fang
- Department of Endocrinology, Gansu Provincial Hospital, Dong gang West Road, Lanzhou, 730000, Gansu, People's Republic of China
| | - Liang Yao
- Clinical Evidence based medicine center, Gansu Provincial Hospital, Dong gang West Road, Lanzhou, 730000, Gansu, People's Republic of China
| | - Jing Sun
- Department of Clinical Medicine, Ningxia Medical University, Yinchuan, 750004, Ningxia, People's Republic of China
| | - Jian Zhang
- Department of Clinical Medicine, Ningxia Medical University, Yinchuan, 750004, Ningxia, People's Republic of China
| | - Yanxia Li
- Department of Ultrasonography, Hebei Province Veterans Hospital, Lianchi South Street, Baoding, 071000, Hebei, People's Republic of China
| | - Ruifei Yang
- Department of Endocrinology, Gansu Provincial Hospital, Dong gang West Road, Lanzhou, 730000, Gansu, People's Republic of China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Limin Tian
- Department of Endocrinology, Gansu Provincial Hospital, Dong gang West Road, Lanzhou, 730000, Gansu, People's Republic of China.
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22
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Giese-Davis J, Sisler J, Zhong L, Brandelli Y, McCormick JL, Railton C, Shirt L, Lau H, Hao D, Chobanuk J, Walley B, Joy AA, Taylor A, Carlson L. Alberta CancerBridges development of a care plan evaluation measure. ACTA ACUST UNITED AC 2018; 25:e59-e72. [PMID: 29507497 DOI: 10.3747/co.25.3766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background No standardized measures specifically assess cancer survivors' and healthcare providers' experience of Survivor Care Plans (scps). We sought to develop two care plan evaluation (cpe) measures, one for survivors (cpe-s) and one for healthcare providers (cpe-p), examine initial psychometric qualities in Alberta, and assess generalizability in Manitoba, Canada. Methods We developed the initial measures using convenience samples of breast (n = 35) and head and neck (n = 18) survivors who received scps at the end of active cancer-centre treatment. After assessing Alberta's scp concordance with Institute of Medicine (iom) recommendations using a published coding scheme, we examined psychometric qualities for the cpe-s and cpe-p. We examined generalizability in Manitoba, Canada, with colorectal survivors discharged to primary care providers for follow-up (n = 75). Results We demonstrated acceptable internal consistency for the cpe-s and cpe-p subscales and total score after eliminating one item per subscale for cpe-s, two for cpe-p, resulting in revised scales with four 7-item and 6-item subscales, respectively. Subscale scores correlated highly indicating that for each measure the total score may be the most reliable and valid. We provide initial cpe-s discriminant, convergent, and predictive validity using the total score. Using the Manitoba sample, initial psychometrics similarly indicated good generalizability across differences in tumour groups, scp, and location. Conclusions We recommend the revised cpe-s and cpe-p for further use and development. Studies documenting the creation and standardization of scp evaluations are few, and we recommend further development of patient experience measures to improve both clinical practice and the specificity of research questions.
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Affiliation(s)
- J Giese-Davis
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - J Sisler
- Department of Family Medicine, University of Manitoba, Winnipeg, Manitoba
| | - L Zhong
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - Y Brandelli
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - J L McCormick
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
| | - C Railton
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta
| | - L Shirt
- Palliative Consult Service-Calgary Zone Urban, Alberta Health Services, Calgary, Alberta
| | - H Lau
- Department of Radiation Oncology, Head and Neck Tumour Group, Tom Baker Cancer Center, Calgary
| | - D Hao
- Department of Radiation Oncology, Head and Neck Tumour Group, Tom Baker Cancer Center, Calgary
| | - J Chobanuk
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta
| | - B Walley
- Comprehensive Breast Care Program (cbcp), Community Oncology, Alberta Health Services-Cancer Care, Edmonton, Alberta
| | - A A Joy
- Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta; and
| | - A Taylor
- Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alberta.,Division of Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta; and
| | - L Carlson
- Department of Oncology, Division of Psychosocial Oncology, University of Calgary, Calgary, Alberta.,Psychosocial Resources, Tom Baker Cancer Center, Alberta Health Services, Calgary, Alberta
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Hoffmann-Eßer W, Siering U, Neugebauer EA, Lampert U, Eikermann M. Systematic review of current guideline appraisals performed with the Appraisal of Guidelines for Research & Evaluation II instrument—a third of AGREE II users apply a cut-off for guideline quality. J Clin Epidemiol 2018; 95:120-127. [DOI: 10.1016/j.jclinepi.2017.12.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 11/29/2017] [Accepted: 12/20/2017] [Indexed: 12/20/2022]
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24
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Leeper HE, Acquaye AA, Bell S, Clarke JL, Forst D, Laack NN, Link MJ, Taylor JW, Armstrong TS. Survivorship care planning in neuro-oncology. Neurooncol Pract 2018; 5:3-9. [PMID: 31386011 DOI: 10.1093/nop/npx034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Cancer patient survivorship has become a significant topic within oncology care for both adult and pediatric patients. Starting in 2005, the Institute of Medicine recommended the use of survivorship care plans to assist patients transitioning from active treatment to the posttreatment phase of their cancer care, a critical time for many patients. Since 2014 there has been a mandate within the United States for adult cancer patients treated with curative intent to receive survivorship care plans comprised of a treatment summary and a follow-up plan to facilitate a better understanding among patients of what to expect after treatment. In addition to a general oncology survivorship care plan, specific care plans have been created for breast, lung, prostate, and colon cancers, as well as lymphoma. A survivorship care plan specific to adult neuro-oncology has been developed by a multidisciplinary and interprofessional committee, with approval from the Society for Neuro-Oncology Guidelines Committee. It has been published in compendium with this review of survivorship care planning and available as a fillable PDF on the Society of Neuro-Oncology Guidelines Endorsement web page (https://www.soc-neuro-onc.org/SNO/Resources/Survivorship_Care_Plan.aspx). Implementation of this survivorship care plan provides a unique opportunity to begin addressing the range of survivorship issues our neuro-oncology patients navigate from diagnosis to end of life.
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Affiliation(s)
- Heather E Leeper
- Department of Neurology, NorthShore University Health System, Evanston, IL
| | | | - Susan Bell
- The Ohio State University Werner Medical Center, Department of Neurological Surgery, Columbus, OH
| | - Jennifer L Clarke
- Departments of Neurology and Neurological Surgery, University of California (UCSF), San Francisco, CA
| | - Deborah Forst
- Massachusetts General Hospital Cancer Center, Boston, MA
| | - Nadia N Laack
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - Michael J Link
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN
| | - Jennie W Taylor
- Departments of Neurology and Neurological Surgery, University of California (UCSF), San Francisco, CA
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25
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A Review of the Quality of Extant Clinical Practice Guidelines in Cancer Therapy-Induced Mucositis. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2017. [DOI: 10.5812/ijcm.11553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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The Impact of Survivorship Care Planning on Patients, General Practitioners, and Hospital-Based Staff. Cancer Nurs 2017; 39:E26-E35. [PMID: 26720214 DOI: 10.1097/ncc.0000000000000329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND In 2005, the Institute of Medicine recommended that all cancer patients receive a survivorship care plan (SCP). Despite widespread support, few centers have routinely implemented them. Understanding of their impact is limited. OBJECTIVES The aims of this study were to examine the impact of SCP delivery on patients and healthcare professionals at an Australian comprehensive cancer center and determine enablers and barriers to implementation. METHODS Six groups were surveyed: (1) patients who had received SCPs; (2) nurse coordinators using SCPs, (3) general practitioners (primary care, GPs) of patients who had received SCPs, (4) clinical service chairs, (5) heads of allied health, and (6) nurse coordinators not using SCPs (nonengaged nurse coordinators). Groups 1 to 3 completed written questionnaires. Groups 4 to 6 participated in semistructured interviews. RESULTS Fifty patients, 7 nurse coordinators, 18 GPs, 7 clinical service chairs, 4 heads of allied health, and 8 nonengaged nurse coordinators participated. Eighty-seven percent of patients considered the SCP to be very or somewhat useful; 50% felt it helped them understand their cancer experience. All engaged nurse coordinators reported SCPs to be very or somewhat useful, and 86% believed SCPs improved communication with GPs. General practitioners felt SCPs were very or somewhat useful (67%) and wished to receive SCPs for future patients (83%). Organizational and clinical leadership, multidisciplinary engagement, resourcing, and timing of SCP delivery were considered critical enablers. CONCLUSION Patients and healthcare professionals support the use of SCPs; however, they are resource intensive and require significant organizational support. IMPLICATIONS FOR PRACTICE Nurses are instrumental to SCP implementation. Attention to enablers and barriers is important for successful implementation.
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27
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28
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Beehler GP, Novi J, Kiviniemi MT, Steinbrenner L. Military veteran cancer survivors' preferences for a program to address lifestyle change and psychosocial wellness following treatment. J Psychosoc Oncol 2016; 35:111-127. [PMID: 27901404 DOI: 10.1080/07347332.2016.1265623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aimed to understand military veteran cancer survivors' preferences regarding the delivery of post-treatment wellness services. Thirty-three military veteran cancer survivors were interviewed about their perceptions of three models of health service delivery (home-, primary care-, and oncology-based services). Conventional qualitative content analysis revealed strengths and weaknesses of each service delivery model's content and structure (e.g., program location, inclusion of emotional support, access to clinical experts). All service delivery programs had strengths, with clinic-based programs offering the greatest breadth of services deemed important for wellness by cancer survivors.
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Affiliation(s)
- Gregory P Beehler
- a VA Center for Integrated Healthcare , VA Western New York Healthcare System , Buffalo , NY , USA.,b School of Nursing , University at Buffalo, The State University of New York , Buffalo , NY , USA.,c School of Public Health and Health Profession , University at Buffalo, The State University of New York , Buffalo , NY , USA
| | - Jonathan Novi
- d Behavioral Health Careline , New Mexico VA Health Care System , Albuquerque , NM , USA
| | - Marc T Kiviniemi
- c School of Public Health and Health Profession , University at Buffalo, The State University of New York , Buffalo , NY , USA
| | - Lynn Steinbrenner
- e Medical VA Careline, VA Western New York Healthcare System , Buffalo , NY , USA
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29
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Cassis L, Cortès-Saladelafont E, Molero-Luis M, Yubero D, González MJ, Herrero AO, Fons C, Jou C, Sierra C, Castejon Ponce E, Ramos F, Armstrong J, O’Callaghan MM, Casado M, Montero R, Olivas SMM, Artuch R, Barić I, Bartoloni F, Bellettato CM, Bonifazi F, Ceci A, Cvitanović-Šojat L, Dali CI, D’Avanzo F, Fumic K, Giannuzzi V, Lampe C, Scarpa M, Cazorla ÁG. Review and evaluation of the methodological quality of the existing guidelines and recommendations for inherited neurometabolic disorders. Orphanet J Rare Dis 2015; 10:164. [PMID: 26714856 PMCID: PMC4696316 DOI: 10.1186/s13023-015-0376-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 12/10/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Inherited neurometabolic disorders (iNMDs) represent a group of almost seven hundred rare diseases whose common manifestations are clinical neurologic or cognitive symptoms that can appear at any time, in the first months/years of age or even later in adulthood. Early diagnosis and timely treatments are often pivotal for the favorable course of the disease. Thus, the elaboration of new evidence-based recommendations for iNMD diagnosis and management is increasingly requested by health care professionals and patients, even though the methodological quality of existing guidelines is largely unclear. InNerMeD-I-Network is the first European network on iNMDs that was created with the aim of sharing and increasing validated information about diagnosis and management of neurometabolic disorders. One of the goals of the project was to determine the number and the methodological quality of existing guidelines and recommendations for iNMDs. METHODS We performed a systematic search on PubMed, the National Guideline Clearinghouse (NGC), the Guidelines International Network (G-I-N), the Scottish Intercollegiate Guideline Network (SIGN) and the National Institute for Health and Care Excellence (NICE) to identify all the published guidelines and recommendations for iNMDs from January 2000 to June 2015. The methodological quality of the selected documents was determined using the AGREE II instrument, an appraisal tool composed of 6 domains covering 23 key items. RESULTS A total of 55 records met the inclusion criteria, 11 % were about groups of disorders, whereas the majority encompassed only one disorder. Lysosomal disorders, and in particular Fabry, Gaucher disease and mucopolysaccharidoses where the most studied. The overall methodological quality of the recommendation was acceptable and increased over time, with 25 % of the identified guidelines strongly recommended by the appraisers, 64 % recommended, and 11 % not recommended. However, heterogeneity in the obtained scores for each domain was observed among documents covering different groups of disorders and some domains like 'stakeholder involvement' and 'applicability' were generally scarcely addressed. CONCLUSIONS Greater efforts should be devoted to improve the methodological quality of guidelines and recommendations for iNMDs and AGREE II instrument seems advisable for new guideline development. The elaboration of new guidelines encompassing still uncovered disorders is badly needed.
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Affiliation(s)
- Linda Cassis
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Elisenda Cortès-Saladelafont
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Marta Molero-Luis
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Delia Yubero
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Maria Julieta González
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Aida Ormazabal Herrero
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Carme Fons
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Cristina Jou
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Cristina Sierra
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Esperanza Castejon Ponce
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Federico Ramos
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Judith Armstrong
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - M. Mar O’Callaghan
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Mercedes Casado
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Raquel Montero
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Silvia Maria Meavilla Olivas
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Rafael Artuch
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
| | - Ivo Barić
- />Department of Pediatrics, University Hospital Center Zagreb, Zagreb & University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Franco Bartoloni
- />Gianni Benzi Pharmacological Research Foundation, Valenzano, BA Italy
| | | | - Fedele Bonifazi
- />Gianni Benzi Pharmacological Research Foundation, Valenzano, BA Italy
| | - Adriana Ceci
- />Gianni Benzi Pharmacological Research Foundation, Valenzano, BA Italy
| | - Ljerka Cvitanović-Šojat
- />Department of Pediatrics, University Hospital Center Zagreb, Zagreb & University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Christine I Dali
- />Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Francesca D’Avanzo
- />Department of Women and Children Health, Brains for Brain Foundation, Padova, Italy
| | - Ksenija Fumic
- />Department of Pediatrics, University Hospital Center Zagreb, Zagreb & University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Viviana Giannuzzi
- />Gianni Benzi Pharmacological Research Foundation, Valenzano, BA Italy
| | - Christina Lampe
- />Department of Women and Children Health, Brains for Brain Foundation, Padova, Italy
- />Department of Pediatric and Adolescent Medicine, Centre for Rare Diseases, Horst Schmidt Klinik Wiesbaden, Wiesbaden, Germany
| | - Maurizio Scarpa
- />Department of Women and Children Health, Brains for Brain Foundation, Padova, Italy
- />Department of Pediatric and Adolescent Medicine, Centre for Rare Diseases, Horst Schmidt Klinik Wiesbaden, Wiesbaden, Germany
- />Department of Women’s and Children’s Health, University of Padova, Padova, Italy
| | - Ángels Garcia- Cazorla
- />Neurology, gastroenterology pathology and clinical biochemistry Departments, IRP-HSJD and CIBERER, Barcelona, Spain
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