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Mavragani A, Duncan PW, Thakur E, Puccinelli-Ortega N, Salsman JM, Russell G, Pasche BC, Wentworth S, Miller DP, Wagner LI, Topaloglu U. Adaptation of a Personalized Electronic Care Planning Tool for Cancer Follow-up Care: Formative Study. JMIR Form Res 2023; 7:e41354. [PMID: 36626203 PMCID: PMC9893883 DOI: 10.2196/41354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Most patients diagnosed with colorectal cancer will survive for at least 5 years; thus, engaging patients to optimize their health will likely improve outcomes. Clinical guidelines recommend patients receive a comprehensive care plan (CP) when transitioning from active treatment to survivorship, which includes support for ongoing symptoms and recommended healthy behaviors. Yet, cancer care providers find this guideline difficult to implement. Future directions for survivorship care planning include enhancing information technology support for developing personalized CPs, using CPs to facilitate self-management, and assessing CPs in clinical settings. OBJECTIVE We aimed to develop an electronic tool for colorectal cancer follow-up care (CFC) planning. METHODS Incorporating inputs from health care professionals and patient stakeholders is fundamental to the successful integration of any tool into the clinical workflow. Thus, we followed the Integrate, Design, Assess, and Share (IDEAS) framework to adapt an existing application for stroke care planning (COMPASS-CP) to meet the needs of colorectal cancer survivors (COMPASS-CP CFC). Constructs from the Consolidated Framework for Implementation Research (CFIR) guided our approach. We completed this work in 3 phases: (1) gathering qualitative feedback from stakeholders about the follow-up CP generation design and workflow; (2) adapting algorithms and resource data sources needed to generate a follow-up CP; and (3) optimizing the usability of the adapted prototype of COMPASS-CP CFC. We also quantitatively measured usability (target average score ≥70; range 0-100), acceptability, appropriateness, and feasibility. RESULTS In the first phase, health care professionals (n=7), and patients and caregivers (n=7) provided qualitative feedback on COMPASS-CP CFC that informed design elements such as selection, interpretation, and clinical usefulness of patient-reported measures. In phase 2, we built a minimal viable product of COMPASS-CP CFC. This tool generated CPs based on the needs identified by patient-completed measures (including validated patient-reported outcomes) and electronic health record data, which were then matched with resources by zip code and preference to support patients' self-management. Elements of the CFIR assessed revealed that most health care professionals believed the tool would serve patients' needs and had advantages. In phase 3, the average System Usability Scale score was above our target score for health care professionals (n=5; mean 71.0, SD 15.2) and patients (n=5; mean 95.5, SD 2.1). Participants also reported high levels of acceptability, appropriateness, and feasibility. Additional CFIR-informed feedback, such as desired format for training, will inform future studies. CONCLUSIONS The data collected in this study support the initial usability of COMPASS-CP CFC and will inform the next steps for implementation in clinical care. COMPASS-CP CFC has the potential to streamline the implementation of personalized CFC planning to enable systematic access to resources that will support self-management. Future research is needed to test the impact of COMPASS-CP CFC on patient health outcomes.
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Affiliation(s)
| | - Pamela W Duncan
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | | | | | - John M Salsman
- Wake Forest University School of Medicine, Winston-Salem, NC, United States.,Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
| | - Greg Russell
- Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Boris C Pasche
- Wake Forest University School of Medicine, Winston-Salem, NC, United States.,Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
| | - Stacy Wentworth
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
| | - David P Miller
- Wake Forest University School of Medicine, Winston-Salem, NC, United States.,Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
| | - Lynne I Wagner
- Wake Forest University School of Medicine, Winston-Salem, NC, United States.,Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
| | - Umit Topaloglu
- Wake Forest University School of Medicine, Winston-Salem, NC, United States.,Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, United States
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Shukla R, Thakur E, Bradford A, Hou JK. Caregiver Burden in Adults With Inflammatory Bowel Disease. Clin Gastroenterol Hepatol 2018; 16:7-15. [PMID: 28529169 DOI: 10.1016/j.cgh.2017.05.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/01/2017] [Accepted: 05/09/2017] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel disease (IBD) is a chronic condition that has a relapsing and remitting disease course. There is high degree of inpatient and outpatient health care utilization by IBD patients along with a great deal of psychosocial stress associated with the condition. Patients frequently rely on family, friends, and other informal caregivers to provide medical, instrumental, and emotional support. The role of caregiving for adult IBD patients can lead to significant caregiver burden. At present, there are limited data on the existence of caregiver burden in adult IBD patients. Moreover, there are no specific measures for evaluating caregiver burden and there are no interventions targeting caregiver burden in adults with IBD. This review outlines the limited available data on caregiver burden in IBD, explores caregiver burden in other chronic conditions, and proposes applications of these data for creating screening and assessment tools and interventions for caregiver burden in IBD.
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Affiliation(s)
- Richa Shukla
- Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas
| | - Elyse Thakur
- Menninger Department of Psychiatry and Behavioral Sciences, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; Houston VA Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas
| | - Andrea Bradford
- Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; Menninger Department of Psychiatry and Behavioral Sciences, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas
| | - Jason K Hou
- Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; Houston VA Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas.
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Hou JK, Vanga RR, Thakur E, Gonzalez I, Willis D, Dindo L. One-Day Behavioral Intervention for Patients With Inflammatory Bowel Disease and Co-Occurring Psychological Distress. Clin Gastroenterol Hepatol 2017; 15:1633-1634. [PMID: 28532699 DOI: 10.1016/j.cgh.2017.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 05/11/2017] [Accepted: 05/16/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Jason K Hou
- Houston VA HSR&D Center of Excellence, Baylor College of Medicine, Houston, Texas; Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
| | - Rohini R Vanga
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Elyse Thakur
- Department of Psychiatry, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas; VA South Central Mental Illness, Research and Education Clinical Center, Houston, Texas
| | - Iliana Gonzalez
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Diana Willis
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Lilian Dindo
- Department of Psychiatry, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas
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