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Cancer Survivor Care

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41. Statin use in cancer survivors versus the general population: cohort study using primary care data from the UK clinical practice research datalink. (PubMed)

Statin use in cancer survivors versus the general population: cohort study using primary care data from the UK clinical practice research datalink. Cancer survivors may be at increased risk of cardiovascular diseases, but little is known about whether prescribing guidelines for the primary prevention of cardiovascular disease are adequately implemented in these patients. We compared levels of statin initiation and cessation among cancer survivors compared to the general population to determine (...) differences in uptake of pharmaceutical cardiovascular risk prevention measures in these groups.The study population included individuals aged ≥40 during 2005-13 within the UK Clinical Practice Research Datalink primary care database. Within this population we identified cancer survivors who were alive and under follow-up at least 1 year after diagnosis, and controls with no cancer history. Follow-up time prior to cancer diagnosis was included in the control cohort. Using logistic regression, we compared

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2018 BMC Cancer

42. Managing chronic pain in cancer survivors prescribed long-term opioid therapy: a national survey of ambulatory palliative care providers. (PubMed)

Managing chronic pain in cancer survivors prescribed long-term opioid therapy: a national survey of ambulatory palliative care providers. Chronic pain, or pain lasting more than three months, is common among cancer survivors, who are often prescribed long-term opioid therapy (LTOT).Our objective was to explore palliative care providers' experiences with managing chronic pain in cancer survivors prescribed LTOT, specifically in ambulatory palliative care settings, and their strategies (...) for overcoming challenges.We recruited providers through leading national palliative care organizations who manage chronic pain in cancer survivors. Asked to consider only cancer survivors with chronic pain when responding, participants completed an online survey that included questions about use of opioid risk mitigation tools, confidence in addressing opioid misuse behaviors and discussing/recommending management approaches, and access to addiction treatment.Of 157 participants, most were physicians (83

2018 Journal of pain and symptom management

43. Disparities in receipt of follow-up care instructions among female adult cancer survivors: Results from a national survey. (PubMed)

Disparities in receipt of follow-up care instructions among female adult cancer survivors: Results from a national survey. To evaluate predictors of receipt of follow-up instructions at completion of cancer treatment among women with breast and gynecologic cancers (cervical, endometrial, ovarian) in the United States, and determine if the factors differ by cancer type.We designed a cross-sectional study using data from the "Cancer Survivorship" module of the 2016 Behavioral Risk Factor (...) Surveillance System (BRFSS). We created logistic regression models to determine characteristics associated with receipt of follow-up care instructions, and stratified by models by cancer type to evaluate differences in factors.Our sample included 954 (66%) and 492 (34%) women with breast and gynecologic cancers respectively. Even after adjustment, women treated for gynecologic cancer had 63% lower odds [0.37 (0.25-0.55)] of receiving follow-up instructions compared to women with breast cancer. Among breast

2018 Gynecologic Oncology

44. Reproductive intentions and use of reproductive health care among female survivors of childhood cancer. (PubMed)

Reproductive intentions and use of reproductive health care among female survivors of childhood cancer. Do female childhood cancer survivors (CCSs) express a decreased desire to have children and do they use reproductive health care more often compared to women without a history of cancer?Overall, no difference was found in the desire to have children between CCSs and controls, whereas CCSs consult a fertility specialist more often, at a younger age, and sooner after their first attempt (...) at conceiving.Female CCSs may face a shorter than anticipated reproductive window as a result of their cancer treatment. Little is known about their desire to have children and use of reproductive health care, especially in relation to their former cancer treatment.This study is part of the DCOG LATER-VEVO study, a nationwide retrospective cohort study on female fertility in Dutch CCSs. In total, 1749 CCSs and 1673 controls were invited for the study. Data collection took place between January 2008 and May 2014

2018 Human Reproduction

45. Systematic review of health care costs related to mental health conditions among cancer survivors. (PubMed)

Systematic review of health care costs related to mental health conditions among cancer survivors. This systematic review examines healthcare costs associated with mental health conditions among cancer survivors in the United States.Ten published studies were identified. Studies varied substantially in terms of population, mental health conditions examined, data collection methods, and type of cost reported. Cancer survivors with mental health conditions incurred significantly higher total (...) medical costs and costs of most service types compared to cancer survivors without a mental health condition. Additionally, the total healthcare expenditure related to mental health was higher among cancer survivors compared with people without history of cancer.Mental health conditions are associated with increased healthcare costs among cancer survivors. Future examination of other components of economic burden, including patient out-of-pocket costs, nonmedical costs, such as transportation

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2018 Expert review of pharmacoeconomics & outcomes research

46. Bowel symptoms and self-care strategies of survivors in the process of restoration after low anterior resection of rectal cancer. (PubMed)

Bowel symptoms and self-care strategies of survivors in the process of restoration after low anterior resection of rectal cancer. The purpose of this research is to identify the bowel symptoms and self-care strategies for rectal cancer survivors during the recovery process following low anterior resection surgery.A total of 100 participants were investigated under the structured interview guide based on the dimensions of "symptom management theory".92% of participants reported changes in bowel (...) participants of this subgroup with significant improvements, 70.5% participants reported the length of time it took was at least 6 months. Self-care strategies adopted by participants included diet, bowel medications, practice management and exercise.It is necessary to educate patients on the symptoms experienced following low anterior resection surgery. Through the process of trial and error, participants have acquired self-care strategies. Healthcare professionals should learn knowledge

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2018 BMC Surgery

47. 'Oncokompas', a web-based self-management application to support patient activation and optimal supportive care: a feasibility study among breast cancer survivors. (PubMed)

'Oncokompas', a web-based self-management application to support patient activation and optimal supportive care: a feasibility study among breast cancer survivors. Cancer survivors have to deal with symptoms related to cancer and its treatment. In Oncokompas, cancer survivors monitor their quality of life by completing patient reported outcome measures (PROMs), followed by personalized feedback, self-care advice, and supportive care options to stimulate patient activation. The aim of this study (...) satisfaction. This study shows the value of tailoring eHealth applications for cancer survivors to their specific tumor type. Oncokompas including the BC module seems to improve patient activation among BC survivors.

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2018 Acta Oncologica

48. Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors. (PubMed)

Patient Protection and Affordable Care Act Medicaid expansion and gains in health insurance coverage and access among cancer survivors. The Patient Protection and Affordable Care Act extends Medicaid coverage to millions of low-income adults, including many survivors of cancer who were unable to purchase affordable health insurance coverage in the individual health insurance market.Using data from the 2011 to 2015 Behavioral Risk Factor Surveillance System, the authors compared changes (...) in coverage and health care access measures for low-income cancer survivors in states that did and did not expand Medicaid.The study population of 17,381 individuals included adults aged 18 to 64 years, and was predominantly female, white, and unmarried. The authors found a relative reduction in the uninsured rate of 11.7 percentage points and a relative increase in the probability of having a personal physician of 5.8 percentage points. Stratifying by whether states expanded Medicaid by 2015, the authors

2018 Cancer

49. Evaluation of the delivery of survivorship care plans for South Asian female breast cancer survivors residing in Canada (PubMed)

Evaluation of the delivery of survivorship care plans for South Asian female breast cancer survivors residing in Canada This paper focuses on phase iii of a study evaluating the development and implementation of a survivorship care plan (scp) that could ultimately improve post-treatment quality of life for South Asian (sa) breast cancer survivors (bcss). Evaluating the utility of the scp was important to understand how sociocultural influences might affect uptake of the scp by sa bcss (...) patients or family members in relationship, and translating key information through interpreters.It is important to evaluate the utility of scps for sa female survivors, who might differ from the general bcs population because of a different understanding of the disease; language barriers; strong influence of family members; societal stigmas; and personal, social, cultural, and religious beliefs and values. A formal nurse-led discharge appointment with discussions about follow-up care

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2018 Current Oncology

50. Affordable Care Act and Disparities in Health Services Utilization among Ethnic Minority Breast Cancer Survivors: Evidence from Longitudinal Medical Expenditure Panel Surveys 2008–2015 (PubMed)

Affordable Care Act and Disparities in Health Services Utilization among Ethnic Minority Breast Cancer Survivors: Evidence from Longitudinal Medical Expenditure Panel Surveys 2008–2015 Breast cancer is the most prevalent female cancer in the US. Incidence rates are similar for white and black women but mortality rates are higher for black women. This study draws on rich, nationally representative data, the 2008⁻2015 Medical Expenditure Panel Surveys, to estimate effects of the Affordable Care (...) Act (ACA) on reducing disparities in and access to use of diagnostic and medical services for black and Hispanic breast cancer survivors. Random effects multinomial logit, flexible hurdle and Box-Cox estimation techniques are used. The robust estimates indicate that the ACA narrowed the racial/ethnic disparity in health insurance coverage, health care utilization and out-of-pocket prescription drug expenditures among breast cancer survivors. Gaps in uninsurance significantly declined for black

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2018 International journal of environmental research and public health

51. Strategies for caring for the well cancer survivor. (PubMed)

Strategies for caring for the well cancer survivor. Surveillance of existing cancer, management of treatment-related adverse effects, and screening for second cancers are key to the care you'll provide.

2018 Journal of Family Practice

52. Caring for survivors of childhood cancer: it takes a village. (PubMed)

Caring for survivors of childhood cancer: it takes a village. Over 80% of children diagnosed with cancer are now cured. The burgeoning population of survivors of childhood cancer experiences high rates of morbidity and mortality due to 'late-effects' of treatment. These can be defined as any consequence of treatment that persists beyond or develops after the completion of cancer therapy. Awareness of late-effects is critically important for pediatricians and adult providers alike, as late (...) -effects impact children in proximity to cancer treatment, as well as adults many decades removed. This review presents the importance of lifelong follow-up care for survivors, highlights existing screening guidelines, and reviews various models of survivor care.National and international guidelines have been developed to standardize screening for survivors, and multiple models of survivorship care exist. The optimal model likely depends on individual factors, including the survivor's needs

2018 Current Opinion in Pediatrics

53. Perceptions of shared care among survivors of colorectal cancer from non-English-speaking and English-speaking backgrounds: a qualitative study. (PubMed)

Perceptions of shared care among survivors of colorectal cancer from non-English-speaking and English-speaking backgrounds: a qualitative study. Colorectal cancer (CRC) survivors experience difficulty navigating complex care pathways. Sharing care between GPs and specialist services has been proposed to improve health outcomes in cancer survivors following hospital discharge. Culturally and Linguistically Diverse (CALD) groups are known to have poorer outcomes following cancer treatment (...) but little is known about their perceptions of shared care following surgery for CRC. This study aimed to explore how non-English-speaking and English-speaking patients perceive care to be coordinated amongst various health practitioners.This was a qualitative study using data from face to face semi-structured interviews and one focus group in a culturally diverse area of Sydney with non-English-speaking and English-speaking CRC survivors. Participants were recruited in community settings and were

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2018 BMC Family Practice

54. Moving Beyond Static Survivorship Care Plans: A Systems Engineering Approach to Population Health Management for Cancer Survivors. (PubMed)

Moving Beyond Static Survivorship Care Plans: A Systems Engineering Approach to Population Health Management for Cancer Survivors. 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 (...) that care-planning processes are dynamic, clearly assigned, resilient, and integrated with electronic health record systems.© 2018 American Cancer Society.

2018 Cancer

55. Economic evaluation of patient-centered care among long-term cancer survivors. (PubMed)

Economic evaluation of patient-centered care among long-term cancer survivors. To evaluate the economic outcomes associated with patient perceptions of patient-centered medical home (PCMH) characteristics among long-term cancer survivors in the United States.A retrospective analysis of the 2008 to 2012 Medical Expenditure Panel Survey.A nationally representative sample of adult long-term cancer survivors (≥3 years since diagnosis) was categorized into either patient-centered care (PCC) or non (...) and non-PCC groups.A total of 4288 long-term cancer survivors were identified, with a mean (SD) age of 65.2 (13.8) years. The PCC group was associated with a reduction in mean adjusted healthcare expenditures at follow-up (savings of $1596 per cancer survivor; P = .020). These findings are driven by lower odds of hospitalization (odds ratio, 0.81; 95% CI, 0.66-0.99; P = .035) and lower hospitalization-related healthcare expenditures (PCC: $3323; 95% CI, $2727-$3918; non-PCC: $4912; 95% CI, $4039-$5785

2018 American Journal Of Managed Care

56. Equitably improving outcomes for cancer survivors and supporting caregivers: A blueprint for care delivery, research, education, and policy. (PubMed)

Equitably improving outcomes for cancer survivors and supporting caregivers: A blueprint for care delivery, research, education, and policy. Cancer care delivery is being shaped by growing numbers of cancer survivors coupled with provider shortages, rising costs of primary treatment and follow-up care, significant survivorship health disparities, increased reliance on informal caregivers, and the transition to value-based care. These factors create a compelling need to provide coordinated (...) , comprehensive, personalized care for cancer survivors in ways that meet survivors' and caregivers' unique needs while minimizing the impact of provider shortages and controlling costs for health care systems, survivors, and families. The authors reviewed research identifying and addressing the needs of cancer survivors and caregivers and used this synthesis to create a set of critical priorities for care delivery, research, education, and policy to equitably improve survivor outcomes and support caregivers

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2018 CA: a cancer journal for clinicians

57. Randomized Trial of the Impact of Empowering Childhood Cancer Survivors With Survivorship Care Plans. (PubMed)

Randomized Trial of the Impact of Empowering Childhood Cancer Survivors With Survivorship Care Plans. A survivorship care plan (SCP), that is, individualized treatment summary and schedule of off-therapy surveillance, will be mandated by January 2019. It is unclear whether SCPs improve adherence to recommended follow-up care in the community. In this trial, we evaluated the impact of randomly assigning childhood cancer survivors to 1) SCPs to be taken to their primary care physician (PCP (...) ) to implement or 2) survivorship clinic (SC) on health care quality measures.Eligibility included cancer diagnosis younger than age 18 years (2000-2012), cancer free, one or more years off therapy, and no prior survivorship clinic attendance. At 12 months, the random assignment groups were compared (SCP+PCP vs SC) by intent-to-treat analysis with two-sided statistical tests in terms of patient adherence to guideline-recommended surveillance tests (eg, echocardiogram) and number of newly identified late

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2018 Journal of the National Cancer Institute

58. Geospatial patterns of access to self-care resources for obesity among endometrial cancer survivors in a high poverty urban community. (PubMed)

Geospatial patterns of access to self-care resources for obesity among endometrial cancer survivors in a high poverty urban community. To examine endometrial cancer survivors' access to recommended obesity-related self-care resources.Participants included women treated 2010-2015 for endometrial cancer at an academic medical center who lived in the surrounding 16 ZIP code area on Chicago's South Side. Demographic and health data were abstracted from medical records. A socioeconomic status (SES (...) ) score (SES-1 = low, SES-5 = high) was generated for each patient using census block group-level data. Self-care resources for exercise, healthy weight, and diet were obtained from a community resource census. Geospatial techniques assessed "walkable access" (~½-mile radius around a patient's home) to obesity-related resources. Multivariable logistic regression investigated associations between access to obesity-related resources and patient characteristics.Of 195 endometrial cancer survivors, 81

2018 Gynecologic Oncology

59. Morbidity and Mortality Differences Between Hematopoietic Cell Transplantation Survivors and Other Cancer Survivors

to 1.5). Risks of digestive, skin, and musculoskeletal complications also were greater among HCT versus non-HCT cancer survivors. The two groups had similar risks of circulatory complications and second cancers. Both HCT and non-HCT cancer survivors had significantly greater 10-year cumulative incidences of all major organ-system outcomes versus the general population. Conclusion History of HCT was associated with late morbidity and mortality among cancer survivors. In particular, clinicians who care (...) Morbidity and Mortality Differences Between Hematopoietic Cell Transplantation Survivors and Other Cancer Survivors Purpose To compare the risks of serious health outcomes among hematopoietic cell transplantation (HCT) survivors versus a matched population of patients with cancer who did not undergo HCT, where the primary difference may be exposure to HCT. Methods Two-year HCT survivors treated at a comprehensive cancer center from 1992 through 2009 who were Washington State residents (n

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2017 EvidenceUpdates

60. Physical activity in the community improves mobility for cancer survivors

cancer teams, not just in palliative care. NHS England’s 2016 Commissioning Guidance recommends rehabilitation for a number of conditions, including cancer. What are the implications? Older cancer survivors can find their physical functioning reduced after cancer and treatment, adding to any physical issues they may already have associated with ageing. Home- and community-based physical rehabilitation appears to help to improve these cancer survivors’ physical functioning. The participants were (...) . London: National Institute for Health and Care Excellence; 2014. NICE. CG80. London: National Institute for Health and Care Excellence; 2017. NICE. CG175. London: National Institute for Health and Care Excellence; 2014. Why was this study needed? As cancer treatments improve, more people are surviving cancer. Recent projections indicate that by 2040, nearly three out of four cancer survivors will be 65 years and older. However, cancer and its treatments affect the body and can impact on people’s

2019 NIHR Dissemination Centre

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