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Daunov K, Daunov M, Noskoff K, Gan H, Davies S, Farrell M, Hadley W, Baffa A, Giesel J, Egler R, Huang AY, Letterio JJ, Lee RT. Are NCI Cancer Centers Providing Adolescents and Young Adults With Cancer Focused Clinical Services? A National Survey. J Natl Compr Canc Netw 2023; 21:487-495.e15. [PMID: 37156484 DOI: 10.6004/jnccn.2023.7001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/04/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND This study sought to evaluate the current services and delivery models of adolescent and young adult oncology (AYAO)-specific programs at NCI-designated Cancer Centers (NCI-CCs). PATIENTS AND METHODS NCI, academic, and community cancer centers were electronically sent surveys from October to December 2020 and administered via REDCap. RESULTS Survey responses were received from 50 of 64 (78%) NCI-CCs, primarily completed by pediatric oncologists (53%), adult oncologists (11%), and social workers (11%). Half (51%) reported an existing AYAO program, with most (66%) started within the past 5 years. Although most programs combined medical and pediatric oncology (59%), 24% were embedded within pediatrics alone. Most programs saw patients aged 15 (55%) to 39 years (66%) mainly via outpatient clinic consultation (93%). Most centers reported access to a range of medical oncology and supportive services, but dedicated services specifically for adolescent and young adults (AYAs) were available at a much lower extent, such as social work (98% vs 58%) and psychology (95% vs 54%). Although fertility preservation was offered by all programs (100%), only two-thirds of NCI centers (64%) reported providing sexual health services to AYAs. Most NCI-CCs (98%) were affiliated with a research consortium, and a lesser extent (73%) reported collaboration between adult and pediatric researchers. Nearly two-thirds (60%) reported that AYA oncology care was important/very important to their respective institution and reported providing good/excellent care to AYAs with cancer (59%), but to a lesser extent reported good/excellent research (36%), sexual health (23%), and education of staff (21%). CONCLUSIONS Results of this first-ever national survey to assess AYAO programs showed that only half of NCI-CCs report having a dedicated AYAO program, and that areas of improvement include staff education, research, and sexual health services for patients.
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Affiliation(s)
- Katherine Daunov
- 1Case Western Reserve University, Cleveland, Ohio
- 2University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Michael Daunov
- 1Case Western Reserve University, Cleveland, Ohio
- 2University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Kara Noskoff
- 3Children's Hospital of Orange County, Orange, California
| | - Hilary Gan
- 4Teen Cancer America, Los Angeles, California
| | | | | | - Whitney Hadley
- 2University Hospitals Cleveland Medical Center, Cleveland, Ohio
- 5Angie Fowler AYA Cancer Institute, UH Rainbow Babies & Children's Hospital, Cleveland, Ohio
- 6Now with The Gathering Place, Beachwood and Westlake, Ohio
| | - Amelia Baffa
- 2University Hospitals Cleveland Medical Center, Cleveland, Ohio
- 5Angie Fowler AYA Cancer Institute, UH Rainbow Babies & Children's Hospital, Cleveland, Ohio
| | - Jennifer Giesel
- 1Case Western Reserve University, Cleveland, Ohio
- 2University Hospitals Cleveland Medical Center, Cleveland, Ohio
- 5Angie Fowler AYA Cancer Institute, UH Rainbow Babies & Children's Hospital, Cleveland, Ohio
- 7Now with LifeStance Health, Beachwood, Ohio
| | - Rachel Egler
- 1Case Western Reserve University, Cleveland, Ohio
- 2University Hospitals Cleveland Medical Center, Cleveland, Ohio
- 5Angie Fowler AYA Cancer Institute, UH Rainbow Babies & Children's Hospital, Cleveland, Ohio
| | - Alex Y Huang
- 1Case Western Reserve University, Cleveland, Ohio
- 2University Hospitals Cleveland Medical Center, Cleveland, Ohio
- 5Angie Fowler AYA Cancer Institute, UH Rainbow Babies & Children's Hospital, Cleveland, Ohio
| | - John J Letterio
- 1Case Western Reserve University, Cleveland, Ohio
- 2University Hospitals Cleveland Medical Center, Cleveland, Ohio
- 5Angie Fowler AYA Cancer Institute, UH Rainbow Babies & Children's Hospital, Cleveland, Ohio
| | - Richard T Lee
- 1Case Western Reserve University, Cleveland, Ohio
- 8City of Hope Cancer Center, Duarte, California
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Hamad Y, Lane MA, Beekmann SE, Polgreen PM, Keller SC. Perspectives of United States-based Infectious Diseases Physicians on Outpatient Parenteral Antimicrobial Therapy Practice. Open Forum Infect Dis 2019; 6:5552085. [PMID: 31429872 PMCID: PMC6765349 DOI: 10.1093/ofid/ofz363] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 05/24/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND While outpatient parenteral antimicrobial therapy (OPAT) is generally considered safe, patients are at risk for complications and thus require close monitoring. The purpose of this study is to determine how OPAT programs are structured and how United States-based infectious diseases (ID) physicians perceive barriers to safe OPAT care. METHODS We queried members of the Emerging Infections Network (EIN) between November and December 2018 about practice patterns and barriers to providing OPAT. RESULTS 672 members of the EIN (50%) responded to the survey. Seventy-five percent of respondents were actively involved in OPAT, although only 37% of respondents reported ID consultation was mandatory for OPAT. The most common location for OPAT care was at home with home-health support, followed by post-acute-care facilities. Outpatient and inpatient ID physicians were identified as being responsible for monitoring laboratory results (73% and 54% of respondents, respectively), but only 36% had a formal OPAT program. The majority of respondents reported a lack of support in data analysis (80%), information technology (66%), financial assistance (65%), and administrative assistance (60%). Perceived amount of support did not differ significantly across employment models. Inability to access laboratory results in a timely manner, lack of leadership awareness of OPAT value, and failure to communicate with other providers administering OPAT were reported as the most challenging aspects of OPAT care. CONCLUSION ID providers are highly involved in OPAT, but only a third of respondents have a dedicated OPAT program. Lack of financial and institutional support are perceived as significant barriers to providing safe OPAT care.
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Affiliation(s)
- Yasir Hamad
- Department of Internal Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO
| | - Michael A Lane
- Department of Internal Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO.,Center for Clinical Excellence, BJC HealthCare, St. Louis, MO
| | - Susan E Beekmann
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Philip M Polgreen
- Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA
| | - Sara C Keller
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD
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Hardy RY, Gurvitz M, Jackson JL, May S, Miller P, Daskalov R, Foster E. College students with congenital heart disease: A critical time for transition. J Am Coll Health 2018; 66:324-328. [PMID: 29452064 DOI: 10.1080/07448481.2018.1440583] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED As medical and surgical advances improve, more young adults with congenital heart disease (CHD) are attending college. This case study illustrates some of the issues that these young adults may face as they attend college and discusses the role that college health practitioners can play in easing that transition. PARTICIPANTS A case of a male with CHD presenting to the college health clinic with a new onset headache. METHODS The authors discuss some of the unique challenges that college health practitioners may face when caring for students with CHD. In addition, they make recommendations on how best to care for these patients and how best to coordinate care with CHD students other care providers. RESULTS This student with a history of coarctation of the aorta presented with new onset headaches and was found to have high blood pressure. He was diagnosed with recurrent coarctation, underwent percutaneous treatment with stenting and quickly resumed classes. CONCLUSIONS As more students with CHD enter college, college health providers will need to understand some of the health risks that CHD students face. In addition, understanding some of the optimal ways to coordinate care with CHD providers can ease the transition that CHD students face as they enter college.
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Affiliation(s)
- Rose Y Hardy
- a Department of Health Systems , Management and Policy, Colorado School of Public Health , Aurora , Colorado , USA
| | - Michelle Gurvitz
- b Department of Cardiology , Boston Children's Hospital , Boston , Massachusetts , USA
| | - Jamie L Jackson
- c Center for Biobehavioral Health, Nationwide Children's Hospital , Columbus , Ohio , USA
| | - Susan May
- d Congenital Heart Public Health Consortium, American Academy of Pediatrics , Elk Grove Village , Illinois , USA
| | - Paula Miller
- e Adult Congenital Heart Association , Philadelphia , Pennsylvania , USA
| | - Rachel Daskalov
- d Congenital Heart Public Health Consortium, American Academy of Pediatrics , Elk Grove Village , Illinois , USA
| | - Elyse Foster
- f Division of Cardiology, University of California - San Francisco , San Francisco , California , USA
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