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Eng L, Brual J, Nagee A, Mok S, Fazelzad R, Chaiton M, Saunders D, Mittmann N, Truscott R, Liu G, Bradbury P, Evans W, Papadakos J, Giuliani M. Reporting of tobacco use and tobacco-related analyses in cancer cooperative group clinical trials: a systematic scoping review. ESMO Open 2022; 7:100605. [PMID: 36356412 PMCID: PMC9646674 DOI: 10.1016/j.esmoop.2022.100605] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/21/2022] [Accepted: 09/23/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Continued smoking after a diagnosis of cancer negatively impacts cancer outcomes, but the impact of tobacco on newer treatments options is not well established. Collecting and evaluating tobacco use in clinical trials may advance understanding of the consequences of tobacco use on treatment modalities, but little is known about the frequency of reporting and analysis of tobacco use in cancer cooperative clinical trial groups. PATIENTS AND METHODS A comprehensive literature search was conducted to identify cancer cooperative group clinical trials published from January 2017-October 2019. Eligible studies evaluated either systemic and/or radiation therapies, included ≥100 adult patients, and reported on at least one of: overall survival, disease/progression-free survival, response rates, toxicities/adverse events, or quality-of-life. RESULTS A total of 91 studies representing 90 trials met inclusion criteria with trial start dates ranging from 1995 to 2015 with 14% involving lung and 5% head and neck cancer patients. A total of 19 studies reported baseline tobacco use; 2 reported collecting follow-up tobacco use. Seven studies reported analysis of the impact of baseline tobacco use on clinical outcomes. There was significant heterogeneity in the reporting of baseline tobacco use: 7 reported never/ever status, 10 reported never/ex-smoker/current smoker status, and 4 reported measuring smoking intensity. None reported verifying smoking status or second-hand smoke exposure. Trials of lung and head and neck cancers were more likely to report baseline tobacco use than other disease sites (83% versus 6%, P < 0.001). CONCLUSIONS Few cancer cooperative group clinical trials report and analyze trial participants' tobacco use. Significant heterogeneity exists in reporting tobacco use. Routine standardized collection and reporting of tobacco use at baseline and follow-up in clinical trials should be implemented to enable investigators to evaluate the impact of tobacco use on new cancer therapies.
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Affiliation(s)
- L. Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Canada,Prof L. Eng, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada. Tel: +1-416-946-2953; Fax: +1-416-946-6546 @Lawson_Eng@MeredithGiulia1@PMcancercentre
| | - J. Brual
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - A. Nagee
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - S. Mok
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - R. Fazelzad
- Library and Information Services, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - M. Chaiton
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - D.P. Saunders
- Northeast Cancer Centre of Health Sciences North, Northern Ontario School of Medicine, Sudbury, Canada
| | - N. Mittmann
- Canadian Agency for Drugs and Technologies in Health, Toronto, Canada
| | - R. Truscott
- Division of Prevention Policy and Stakeholder Engagement, Ontario Health (Cancer Care Ontario), Toronto, Canada
| | - G. Liu
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Canada
| | - P.A. Bradbury
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Canada
| | - W.K. Evans
- Department of Oncology, McMaster University, Hamilton, Canada
| | - J. Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada,Patient Education, Ontario Health (Cancer Care Ontario), Toronto, Canada
| | - M.E. Giuliani
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada,Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Canada,Correspondence to: Prof M. Giuliani, Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada. Tel: +1-416-946-2983; Fax: +1-416-946-6546
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Barry A, Elliott M, Loewen S, Alfieri J, Bowes D, Stuckless T, Keyes M, Debenham B, Croke J, Quartey N, Papadakos J, Giuliani M. Exploring Caregiver and Parental Roles as Radiation Oncologists in Canada. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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3
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Busca I, Giuliani M, Weiss J, Jones J, Quartey N, Huang S, Toulany A, Papadakos J, Ringash J. Long Term Results of a Longitudinal Study of Unmet Survivorship Needs in Patients with Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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4
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Perlis N, Finelli A, Lovas M, Lund A, Di Meo A, Lajkosz K, Berlin A, Papadakos J, Ghai S, Deniffel D, Meng E, Wiljer D, Alibhai S, Bakas V, Badzynski A, Lee O, Cafazzo J, Haider M. Exploring the value of using patient-oriented mri reports in clinical practice. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00558-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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5
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Jennifer C, Julius A, Manhertz J, Heck C, Chan K, Lawrie K, Quartey N, Papadakos J. PO-1120: Exploring Brachytherapy Educational Needs of Cervical Cancer Patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Giuliani M, Brual J, Cameron E, Chaiton M, Eng L, Haque M, Liu G, Mittmann N, Papadakos J, Saunders D, Truscott R, Evans W. Smoking Cessation in Cancer Care: Myths, Presumptions and Implications for Practice. Clin Oncol (R Coll Radiol) 2020; 32:400-406. [PMID: 32029357 DOI: 10.1016/j.clon.2020.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
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Giuliani M, Martimianakis MA, Broadhurst M, Papadakos J, Fazelad R, Driessen E, Frambach J. Humanism in global oncology curricula: an emerging priority. ACTA ACUST UNITED AC 2020; 27:46-51. [PMID: 32218660 DOI: 10.3747/co.27.5461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Training in humanism provides skills important for improving the quality of care received by patients, achieving shared decision-making with patients, and navigating systems-level challenges. However, because of the dominance of the biomedical model, there is potentially a lack of attention to humanistic competencies in global oncology curricula. In the present study, we aimed to explore the incorporation of humanistic competencies into global oncology curricula. Methods This analysis considered 17 global oncology curricula. A curricular item was coded as either humanistic (as defined by the iecares framework) or non-humanistic. If identified as humanistic, the item was coded using an aspect of humanism, such as Altruism, from the iecares framework. All items, humanistic and not, were coded under the canmeds framework using 1 of the 7 canmeds competency domains: Medical Expert, Communicator, Collaborator, Leader, Scholar, Professional, or Health Advocate. Results Of 7792 identified curricular items in 17 curricula, 780 (10%) aligned with the iecares humanism framework. The proportion of humanistic items in individual curricula ranged from 2% to 26%, and the proportion increased from 3% in the oldest curricula to 11% in the most recent curricula. Of the humanistic items, 35% were coded under Respect, 31% under Compassion, 24% under Empathy, 5% under Integrity, 2% under Excellence, 1% under Altruism, and 1% under Service. Within the canmeds domains, the humanistic items aligned mostly with Professional (35%), Medical Expert (31%), or Communicator (25%). Conclusions The proportion of humanistic competencies has been increasing in global oncology curricula over time, but the overall proportion remains low and represents a largely Western perspective on what constitutes humanism in health care. The representation of humanism focuses primarily on the iecares attributes of Respect, Compassion, and Empathy.
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Affiliation(s)
- M Giuliani
- Radiation Medicine Program, Princess Margret Cancer Centre, and Department of Radiation Oncology, University of Toronto
| | | | - M Broadhurst
- Cancer Education, Princess Margret Cancer Centre
| | - J Papadakos
- Cancer Education, Princess Margret Cancer Centre
| | - R Fazelad
- Information Sciences, Princess Margret Cancer Centre, Toronto, ON
| | - E Driessen
- Department of Educational Development and Research, Faculty of Health Medicine and Life Sciences
| | - J Frambach
- School of Health Professions Education, Maastricht University, Maastricht, Netherlands
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Abdelmutti N, Brual J, Papadakos J, Fathima S, Goldstein D, Eng L, Papadakos T, Liu G, Jones J, Giuliani M. Implementation of a comprehensive smoking cessation program in cancer care. ACTA ACUST UNITED AC 2019; 26:361-368. [PMID: 31896934 DOI: 10.3747/co.26.5201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Quitting smoking after a cancer diagnosis maximizes treatment-related effects, improves prognosis, and enhances quality of life. However, smoking cessation (sc) services are not routinely integrated into cancer care. The Princess Margaret Cancer Centre implemented a digitally-based sc program in oncology, leveraging an e-referral system (cease) to screen all new ambulatory patients, provide tailored education and advice on quitting, and facilitate referrals. Methods We adopted the Framework for Managing eHealth Change to guide implementation of the sc program by integrating 6 key elements: governance and leadership, stakeholder engagement, communication, workflow analysis and integration, monitoring and evaluation, and training and education. Results Incorporating elements of the Framework, we used extensive stakeholder engagement and strategic partnerships to establish a sc program with organizational and provincial accountability. Existing electronic patient-reported assessments were changed to integrate cease. Clinic audits and staff engagement allowed for analysis of workflow, ongoing monitoring and evaluation that aided in establishing a communication strategy, and development of cancer-specific education for patients and health care providers. From April 2016 to March 2018, 22,137 new patients were eligible for screening. Among those new patients, 13,617 (62%) were screened, with 1382 (10%) being current smokers and 532 (4%) having recently quit (within 6 months). Of the current smokers and those who had recently quit, all were advised to quit or to stay smoke-free, and 380 (20%) accepted referral to a sc counselling service. Conclusions Here, we provide a comprehensive practice blueprint for the implementation of digitally based sc programs as a standard of care within comprehensive cancer centres with high patient volumes.
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Affiliation(s)
- N Abdelmutti
- Cancer Strategy Stewardship Program, Princess Margaret Cancer Centre, Toronto, ON
| | - J Brual
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, ON
| | - J Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, ON.,Patient Education, Cancer Care Ontario, Toronto, ON
| | - S Fathima
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, ON
| | - D Goldstein
- Otolaryngology, Head and Neck Surgery Clinic, Princess Margaret Cancer Centre, Toronto, ON
| | - L Eng
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON
| | - T Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, ON.,Patient Education, Cancer Care Ontario, Toronto, ON
| | - G Liu
- Otolaryngology, Head and Neck Surgery Clinic, Princess Margaret Cancer Centre, Toronto, ON.,Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON
| | - J Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, Toronto, ON
| | - M Giuliani
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, ON.,Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON.,Department of Radiation Oncology, University of Toronto, Toronto, ON
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9
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Puts M, Strohschein F, Mclean B, Alqurini N, Syed A, Amir E, Béland F, Berger A, Bergman S, Vanderbyl B, Breunis H, Elser C, Emmenegger U, Fung S, Hsu T, Jang R, Krahn M, Koneru R, Kozlowski N, Krzyzanowska M, Lemonde M, Li A, Mariano C, Mehta R, Monette J, Papadakos J, Pitters E, Prica A, Ray J, Romanofsky L, Szumacher E, Wan-Chow-Wah D, Langleben A, Alibhai S. CLINICAL AND COST-EFFECTIVENESS OF COMPREHENSIVE GERIATRIC ASSESSMENT AND MANAGEMENT FOR CANADIAN ELDERS WITH CANCER: THE 5C STUDY – INITIAL RECRUITMENT AND IMPLEMENTATION RESULTS. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Oar A, Yap M, Rodin D, McNiven A, Papadakos J, Giuliani M. Postgraduate Global Health Competency Profile for Radiation Oncology. Clin Oncol (R Coll Radiol) 2018; 30:810-816. [DOI: 10.1016/j.clon.2018.08.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/22/2018] [Accepted: 07/25/2018] [Indexed: 12/19/2022]
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11
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Gillan C, Papadakos J, Brual J, Harnett N, Hogan A, Milne E, Giuliani ME. Impact of high-fidelity e-learning on knowledge acquisition and satisfaction in radiation oncology trainees. ACTA ACUST UNITED AC 2018; 25:e533-e538. [PMID: 30607120 DOI: 10.3747/co.25.4090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background e-Learning is an underutilized tool in education for the health professions, and radiation medicine, given its reliance on technology for clinical practice, is well-suited to training simulation in online environments. The purpose of the present study was to evaluate the knowledge impact and user interface satisfaction of high-(hf) compared with low-fidelity (lf) e-learning modules (e-modules) in radiation oncology training. Methods Two versions of an e-module on lung radiotherapy (lf and hf) were developed. Radiation oncology residents and fellows were invited to be randomized to complete either the lf or the hf module through individual online accounts over a 2-week period. A 25-item multiple-choice knowledge assessment was administered before and after module completion, and user interface satisfaction was measured using the Questionnaire for User Interaction Satisfaction (quis) tool. Results Of 18 trainees, 8 were randomized to the lf module, and 10, to the hf module. Overall, knowledge assessment performance increased (11%, p < 0.05), with hf-group participants reporting a 13% improvement (p = 0.02), and senior participants reporting an almost 15% improvement (p < 0.01). Scores on the quis indicated that participants were satisfied with various aspects of the user interface. Conclusions The hf e-module had a greater impact on knowledge acquisition, and users expressed satisfaction with the interface in both the hf and lf situations. The use of e-learning in a competency-based curriculum could have educational advantages; participants expressed benefits and drawbacks. Preferences for e-learning integration in education for the health professions should be explored further.
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Affiliation(s)
- C Gillan
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - J Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, ON
| | - J Brual
- Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - N Harnett
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - A Hogan
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON
| | - E Milne
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON
| | - M E Giuliani
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON.,Department of Radiation Oncology, University of Toronto, Toronto, ON
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12
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Giuliani M, Quartey N, Catton C, D’souza A, Kucharski E, Maganti M, Matthew A, Papadakos J. Exploring the Role of Prostate Cancer Survivors in Managing Survivorship Care. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Moraes F, Giuliani M, Quartey N, Cardozo J, Icliates N, Tittenbrun Z, Papadakos J, Brierley J. Closing the Gap on the Availability of Cancer Staging Information for Healthcare Providers in the Global Cancer Community: Development of a Multilingual Cancer Staging Video Series. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.59600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background and context: Tumor, Node, Metastases (TNM) classification system provide valuable measures to researchers in facilitating the understanding of disparities in outcomes and allowing for the comparison of these outcomes over time. There is a lack of multimodal formats for disseminating comprehensive information and education about cancer stage to the global cancer community. To address this gap, the Departments of Radiation Oncology and Cancer Education at the Princess Margaret Cancer Centre (PM) (Toronto, Canada) in collaboration with The Union for International Cancer Control (UICC) envisioned the development of a cancer staging video series. Aim: To provide current and accurate information on cancer staging to healthcare professionals and stakeholders for global cancer control. Strategy/Tactics: The Cancer Education program worked with experts in the field of cancer staging to develop 8 videos (average length 4 min) to provide information to the global cancer community about existing information on key issues with cancer staging and how to properly stage patients using the TNM classification. Videos include references to current research and examples of staging across various cancers to illustrate and reinforce the importance of cancer staging. Script development involved defining key messages, refining learning objectives and breaking up information to ensure the content is digestible and easy to understand. Prior to video production, draft scripts were reviewed by international collaborators for completeness of information and accuracy of content. Videos contain appropriate text on screen to reinforce key messages and include a narrated voiceover to orient the learner. To expand the global reach, trained faculties translated the English videos and scripts, into the 5 official United Nations languages: Arabic, Chinese, French, Russian and Spanish. Program/Policy process: Videos in the cancer staging series include: The Importance of Cancer Staging; What is Cancer Stage; General Rules for Cancer Staging; Cancer Staging Examples; Staging Terminology; Importance of a Common Stage Language; Why Stage Language Changes; Essential TNM. Videos will be made available on UICC and PM Web sites (free of charge and globally advertised). Outcomes: The video series will increase education and awareness on the importance of a unified approach to cancer staging among the larger community and have the aim to empower the community on how to access cancer and define prognosis, treatment and or trial eligibility. What was learned: The development and promotion of the cancer staging video series was a meaningful, collaborative and challenging activity. It was learned that educational videos need to be well-designed and simple to provide axiomatic information on cancer stating to the global cancer control community.
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Affiliation(s)
- F.Y. Moraes
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- University of Toronto, Department of Radiation Oncology, Toronto, Canada
| | - M. Giuliani
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- University of Toronto, Department of Radiation Oncology, Toronto, Canada
| | - N.K. Quartey
- Princess Margaret Cancer Centre, Toronto, Canada
| | - J. Cardozo
- University Health Network, Toronto, Canada
| | | | - Z. Tittenbrun
- Union for International Cancer Control, Geneva, Switzerland
| | - J. Papadakos
- Princess Margaret Cancer Centre, Toronto, Canada
| | - J. Brierley
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada
- University of Toronto, Department of Radiation Oncology, Toronto, Canada
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14
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Abdelmutti N, Brual J, Jones J, Goldstein D, Liu G, Eng L, Papadakos J, Papadakos T, Giuliani M. Implementation of a Comprehensive Hospital-Based Smoking-Cessation Program in Cancer. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.98400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background and context: Quitting smoking after a cancer diagnosis minimizes treatment-related effects, improves prognosis and enhances quality of life. However, smoking cessation has yet to be integrated as a standard component of cancer care and cessation programs are underused. Aim: To address this gap between evidence and practice, the Princess Margaret Cancer Centre in Toronto, Canada sought to implement a comprehensive, evidence-based program that would introduce smoking cessation–related screening, referrals and education as standard practice in cancer care. Strategy/Tactics: We adapted the Framework for Managing eHealth Change to guide successful implementation of a Smoking Cessation Program (SCP) utilizing 6 components: 1) Leadership and governance 2) Stakeholder engagement and partnerships 3) Communication 4) Patient and provider education 5) Analysis and clinical integration 6) Monitoring and evaluation of program performance metrics. Program/Policy process: The SCP designed, tested and implemented a multilingual e-referral system (CEASE) to screen patients for smoking status, provide education and advice on quitting, and generate an electronic referral to cessation programs. Partnerships were established with 3 smoking-cessation programs to offer patients a breadth of services tailored to individual needs, preferences and medical history. Patient and provider education was developed to address the unique knowledge gaps, beliefs and stigma associated with smoking and a cancer diagnosis. Outcomes: Program metrics indicate that of 11,366 new patients eligible for screening between April 2017 to March 2018, 62% (n = 6629) were screened with 10% (n = 655) identifying as current smokers and 4% (n = 261) as recent quitters (6 months or less). Of smokers and recent quitters, 21% (n = 170) accepted a referral to a smoking-cessation program. What was learned: The implementation of the SCP presents a comprehensive blueprint to establish a smoking-cessation program as a standard of quality care. Elements of the SCP can be adapted to local, regional and national contexts. Future directions include assessing strategies to increase screening and referral rates, collection of long-term outcomes, and integration into the patient portal.
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Affiliation(s)
- N. Abdelmutti
- Princess Margaret Cancer Centre, Cancer Strategy Stewardship, Toronto, Canada
| | - J. Brual
- Princess Margaret Cancer Centre, Toronto, Canada
| | - J. Jones
- Princess Margaret Cancer Centre, Toronto, Canada
| | - D. Goldstein
- Princess Margaret Cancer Centre, Toronto, Canada
| | - G. Liu
- Princess Margaret Cancer Centre, Toronto, Canada
| | - L. Eng
- Princess Margaret Cancer Centre, Toronto, Canada
| | - J. Papadakos
- Princess Margaret Cancer Centre, Toronto, Canada
| | - T. Papadakos
- Princess Margaret Cancer Centre, Toronto, Canada
| | - M. Giuliani
- Princess Margaret Cancer Centre, Toronto, Canada
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15
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Giuliani ME, Milne RA, Puts M, Sampson LR, Kwan JYY, Le LW, Alibhai SMH, Howell D, Abdelmutti N, Liu G, Papadakos J, Catton P, Jones J. The prevalence and nature of supportive care needs in lung cancer patients. ACTA ACUST UNITED AC 2016; 23:258-65. [PMID: 27536176 DOI: 10.3747/co.23.3012] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE In the present work, we set out to comprehensively describe the unmet supportive care and information needs of lung cancer patients. METHODS This cross-sectional study used the Supportive Care Needs Survey Short Form 34 (34 items) and an informational needs survey (8 items). Patients with primary lung cancer in any phase of survivorship were included. Demographic data and treatment details were collected from the medical charts of participants. The unmet needs were determined overall and by domain. Univariable and multivariable regression analyses were performed to determine factors associated with greater unmet needs. RESULTS From August 2013 to February 2014, 89 patients [44 (49%) men; median age: 71 years (range: 44-89 years)] were recruited. The mean number of unmet needs was 8 (range: 0-34), and 69 patients (78%) reported at least 1 unmet need. The need proportions by domain were 52% health system and information, 66% psychological, 58% physical, 24% patient care, and 20% sexuality. The top 2 unmet needs were "fears of the cancer spreading" [n = 44 of 84 (52%)] and "lack of energy/tiredness" [n = 42 of 88 (48%)]. On multivariable analysis, more advanced disease and higher MD Anderson Symptom Inventory scores were associated with increased unmet needs. Patients reported that the most desired information needs were those for information on managing symptoms such as fatigue (78%), shortness of breath (77%), and cough (63%). CONCLUSIONS Unmet supportive care needs are common in lung cancer patients, with some patients experiencing a very high number of unmet needs. Further work is needed to develop resources to address those needs.
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Affiliation(s)
- M E Giuliani
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - R A Milne
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - M Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON
| | - L R Sampson
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - J Y Y Kwan
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - L W Le
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON
| | - S M H Alibhai
- Department of Medicine, University of Toronto, Toronto, ON
| | - D Howell
- Oncology Nursing Research, Princess Margaret Cancer Centre, Toronto, ON
| | - N Abdelmutti
- Health Promotion and Wellness, Princess Margaret Cancer Centre, Toronto, ON
| | - G Liu
- Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - J Papadakos
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - P Catton
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, ON
| | - J Jones
- Cancer Survivorship Program, Princess Margaret Cancer Centre, Toronto, ON
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