A prospective study of telephonic contact and subsequent physical follow-up of radically treated lung cancer patients

Addressing the Needs of Older Adults With Cancer in Low- and Middle-Income Settings

The number of older adults in the world is projected to increase steeply over the next 30 years; most older adults will live in low- and middle-income countries. This will have a direct impact on the global cancer burden, as cancer is largely a disease of aging. A revolution in the way we care for older adults in low- and middle-income settings is needed to meet rapidly rising demands. Regardless of a nation's relative wealth or resources, implementing the geriatric assessment in cancer care has presented a challenge because of omission of the principles of geriatric oncology from formal training and continuing education, lack of time, and a shortage of qualified personnel. To meet the challenge of caring for older adults globally, we must: (1) re-imagine aging-focused training for providers and nurses, (2) create and strengthen collaborations/partnerships between geriatric oncology teams and aging-service organizations, and (3) increase advocacy for age-friendly health care policy. By harnessing technology, the reach of specialized oncology education and care can be extended even-or especially-to low- and middle-income settings.

A systematic rapid review on quality of care among non-communicable diseases (NCDs) service delivery in South Asia

Background

At present, poor quality of care (QoC) surrounding non-communicable diseases (NCDs) service provision poses a threat to South Asia. This systematic rapid review aims to highlight the available approaches to improve QoC in NCD services in South Asian countries.

Methods

Three electronic databases (Medline, Embase, and the Cochrane Library) were used to identify relevant literature. Studies published from January 1, 1990 to December 31, 2020 were included. Studies published in English in the South Asian context following any research design about four major NCDs (cancer, diabetes, cardiovascular disease, chronic respiratory disease), and interventions to achieve QoC were included. Data extraction was done using a pre-specified form. A narrative synthesis was conducted for analyzing the extracted information. This systematic rapid review is registered in PROSPERO (International prospective register of systematic reviews) - CRD42020157401.

Results

Among 829 identified studies, 13 were included in the review for in-depth analysis. Most of the studies focused on cancer followed by diabetes and cardiovascular disease. Community and clinic-based screening, NCD care education, NCD specialized corner or hospital, and a follow-up system ensure patient satisfaction, accessibility, early detection, timely referral, and help to reduce disease severity, mortality rate, and incidence of the new disease.

Conclusions

Effective interventions for improving QoC surrounding NCD services can be scaled up in different settings in South Asia to reduce the burden of NCDs.

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There are knowledge gaps in quality of care among Non-Communicable Diseases (NCDs) service delivery.

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Community and clinic-based screening, NCD care education, and NCD specialized hospitals may improve the quality of care.

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More research on quality of care is required as there are limited number of experimental studies.

Triaging and adaptations of surveillance of cancer services in the COVID pandemic

Introduction:

Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer.

Methods:

Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients.

Conclusions:

We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

Progress in psycho-oncology with special reference to developing countries

PURPOSE OF REVIEW

Psycho-oncology has completed 25 years. There is growing recognition of the psychosocial needs of persons living with cancer and the role of sociocultural factors in addressing the needs. This review addresses the research in developing countries relating to distress associated with living with cancer and psychosocial care.

RECENT FINDINGS

There is growing recognition of the emotional needs, understanding of the sociocultural aspects of the emotional responses of persons, caregivers, role of resilience and posttraumatic growth and spirituality in cancer care. Psychosocial aspects of cancer are largely influenced by social, economic, cultural, religious and health systems. A number of innovative approaches to care like use of yoga, financial and material support and involvement of caregivers have been implemented. A positive development is the increasing professional attention to document and develop innovative care programmes.

SUMMARY

A significant proportion of the general population are living with cancer. There are significant psychosocial needs largely influenced by social, economic, cultural, religious aspects of the communities. There are a wide range of interventions from self-care to professional care to address the needs. In developing countries, there is need for longitudinal studies of psycho-social experiences, develop interventions that are culturally appropriate, along with enhanced use of information technology along with evaluation of interventions.

Cancer clinical trials - Survey evaluating patient participation and acceptance in a university-based Comprehensive Cancer Center (CCC)

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>50% of patients are willing to participate in clinical trials, only 18% are currently enrolled.

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The top reason to participate in trials was to serve medical progress and cancer research.

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Reasons for refusing were extensive travel time, no therapeutic advantage and too time-consuming.

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Good information strategies need to be implemented, and doctors need to be aware of running trials.

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Trial concepts must include patients’ needs, e.g. number of appointments, risk-benefit profile.

Introduction

Prospective clinical trials are essential to translate new therapy concepts or rather any scientific development into the medical routine. Besides a sophisticated trial protocol, the success of clinical trials depends on patient recruitment and participation. Patient recruitment remains a challenge and depends on several factors. To get a current picture of the patients’ attitude, we conducted the present survey.

Methods

We designed a survey with seven questions, which was given to all oncological patients treated within a timeframe of three months between Mai and July 2017. Participation was voluntary and anonymous. The questionnaire mainly inquires patients’ participation in clinical trials in a university-based setting, their attitude towards clinical trials regarding risks and benefits, and their source of information in this context.

Results

771 patients (1:1 male/female) participated with a median age of 61 years (range 18–91 years) with a response rate of 71.5%. Of all, 17.8% (137/771) were participating in a clinical trial. The most mentioned reason was to serve medical progress and cancer research. Out of the patients not currently participating in a trial, 79 (12.7%, 79/623) refusers named the following main reasons: extensive travel time to the clinic, no therapeutic advantage, and too time-consuming. Out of the patients not offered to take part in a trial, 265 (51.0%, 265/520) would participate if offered. Of all patients, 8.3% (64/771) used the clinics' homepage as a source of information, of those 79.7% (51/64) were satisfied with its content. To enhance patient recruitment strategies, we asked how patients wish to be informed about possible trials: More than half (52.0%) of the questioned patients preferred an individual medical consultation with their physician.

We further analyzed the trial participation depending on age, gender, unit, and tumor entity. We could show a significant influence of age (p < 0.001) but not for gender (p = 0.724). The trial participation was also significantly associated with the treating unit (p < 0.001) and tumor entity (p = 0.001).

Conclusion

Patients are willing to participate in clinical trials. Better information strategies need to be implemented. Physicians need to be aware of running trials within their department and must counseling counsel patients effectively to improve recruitment. Trial concepts should keep in mind patients’ needs including an adequate number of appointments, positive risk-benefit profiles, and information material.