7 research outputs found
sj-pdf-1-pmj-10.1177_02692163221133670 â Supplemental material for End-of-life communication strategies for healthcare professionals: A scoping review
Supplemental material, sj-pdf-1-pmj-10.1177_02692163221133670 for End-of-life communication strategies for healthcare professionals: A scoping review by Weilin Chen, Joyce Oi Kwan Chung, Katherine Ka Wai Lam and Alex Molassiotis in Palliative Medicine</p
sj-pdf-2-pmj-10.1177_02692163221133670 â Supplemental material for End-of-life communication strategies for healthcare professionals: A scoping review
Supplemental material, sj-pdf-2-pmj-10.1177_02692163221133670 for End-of-life communication strategies for healthcare professionals: A scoping review by Weilin Chen, Joyce Oi Kwan Chung, Katherine Ka Wai Lam and Alex Molassiotis in Palliative Medicine</p
Additional file 1: of Oncology practitionersâ perspectives and practice patterns of post-treatment cancer survivorship care in the Asia-Pacific region: results from the STEP study
Survivorship care items included in the questionnaire. (DOC 44 kb
Oncology practitionersâ perspectives and practice patterns of post-treatment cancer survivorship care in the Asia-Pacific region: Results from the STEP study
Background: Most efforts to advance cancer survivorship care have occurred in Western countries. There has been limited research towards gaining a comprehensive understanding of survivorship care provision in the Asia-Pacific region. This study aimed to establish the perceptions of responsibility, confidence, and frequency of survivorship care practices of oncology practitioners and examine their perspectives on factors that impede quality survivorship care. Methods: A cross-sectional survey of hospital-based oncology practitioners in 10 Asia-Pacific countries was undertaken between May 2015âOctober 2016. The participating countries included Australia, Hong Kong, China, Japan, South Korea, Thailand, Singapore, India, Myanmar, and The Philippines. The survey was administered using paper-based or online questionnaires via specialist cancer care settings, educational meetings, and professional organisations. Results: In total, 1501 oncology practitioners participated in the study. When comparing the subscales of responsibility perception, frequency and confidence, Australian practitioners had significantly higher ratings than practitioners in Hong Kong, Japan, Thailand, and Singapore (all p < 0.05). Surprisingly, practitioners working in Low- and Mid- Income Countries (LMICs) had higher levels of responsibility perception, confidence and frequencies of delivering survivorship care than those working in High-Income Countries (HICs) (p < 0.001), except for the responsibility perception of care coordination where no difference in scores was observed (p = 0. 83). Physicians were more confident in delivering most of the survivorship care interventions compared to nurses and allied-health professionals. Perceived barriers to survivorship care were similar across the HICs and LMICs, with the most highly rated items for all practitioners being lack of time, dedicated educational resources for patients and family members, and evidence-based practice guidelines informing survivorship care.</p
Risk factors for chemotherapyâinduced peripheral neuropathy in patients receiving taxaneâ and platinumâbased chemotherapy
Background: Chemotherapyâinduced peripheral neuropathy (CIPN) is a significant and difficult to manage side effect of neurotoxic chemotherapies. Several risk factors for CIPN have been identified to date, but inconsistencies and methodological limitations exist in past research. Also, a limited number of potential risk factors has been investigated in the past.
Aim: The objective of this study was to assess the relative contribution of a wider range of risk factors in the development of CIPN.
Methods: This analysis used the 6âmonth data after starting chemotherapy from a larger prospective observational study on CIPN risk, prevalence, and quality of life. Patients were assessed at recruitment for possible CIPN risk factors, including prior history of neuropathies, current/past infectious diseases; neurotoxic medication history; personal and treatment characteristics; smoking history, alcohol use, and vegetable/fruit intake. Neuropathy was assessed at 6âmonths after starting chemotherapy with the neuropathy (motor/sensory) items of the NCIâCTCAE scale and the WHO criterion for neuropathy. Data on symptom burden were also collected.
Results: Data were available from 255 patients from three cancer centers in Hong Kong, Singapore, and UK. The use of different scales did not always identify the same predictor variables. Key risk factors in multivariate regression models included older age (highest OR = 1.08, p < 0.01 with the WHO scale), chemotherapy (platinumâbased chemotherapy had OR = 0.20â0.27 in developing CIPN compared to taxaneâbased chemotherapy), history of neuropathy (for motor CIPN only, OR = 8.36, p < 0.01), symptom burden (OR = 1.06, p < 0.05), number of chemotherapy cycles received (OR = 1.19â1.24, p < 0.01), and alcohol intake (OR = 0.32, p < 0.05). In univariate analysis, the use of statins was implicated with CIPN (p = 0.03â0.04 with different assessments) and diabetes showed a trend (p = 0.09) in the development of CIPN
Psychometric testing of the Functional Assessment of Cancer Therapy/Gynecologic Oncology GroupâNeurotoxicity (FACT/GOG-Ntx)Â subscale in a longitudinal study of cancer patients treated with chemotherapy
Background: The aim of this study was to evaluate the psychometric properties of the Functional Assessment of Cancer Therapy/Gynecologic Oncology GroupâNeurotoxicity (FACT/GOG-Ntx) subscale in a longitudinal study of
cancer patients treated with chemotherapy.
Methods: Patients were assessed with the FACT/GOG-Ntx subscale, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy Scale 20 (EORTC QLQ-CIPN20), National Cancer Institute -Common Terminology Criteria for Adverse Events (NCI-CTCAE), and light touch test using 10 g monofilament for up to ten assessment points from baseline (prior to initiation of first chemotherapy), after the end of each cycle (up to 6 cycles, 3 weeks per cycle), and at 6, 9, and 12 months after starting chemotherapy. Psychometric analyses included internal consistency reliability, convergent validity, factorial validity, sensitivity to change and responsiveness (minimal clinically important difference, MCID).
Results: Cronbachâs alpha coefficients of the FACT/GOG-Ntx subscale were 0.82â0.89 across assessment points. The subscale strongly correlated with the EORTC QLQ-CIPN20 (r = 0.79â0.93) but low-to-moderately correlated with the NCI-CTCAE sensory (rs = 0.23â0.45) and motor items (rs = 0.15â0.50) as well as the monofilament test (rs = 0.23â0.47). The hypothesized 4-factor structure of the FACT/GOG-Ntx subscale was not confirmed at assessment points (Ď2/ df = 2.26â8.50; all P < 0.001). The subscale exhibited small-to-moderate sensitivity to change (r = 0.17â0.37). The MCIDs were between 1.38 and 3.6
Minimal clinically important difference of the EORTC QLQ-CIPN20 for worsening peripheral neuropathy in patients receiving neurotoxic chemotherapy
Context/objectives This is the first study to determine the minimal clinically important difference (MCID) of the European Organisation of Research and Treatment of Cancer Quality of Life Questionnaire-CIPN twenty-item scale (EORTC QLQCIPN20), a validated instrument designed to elicit cancer patientsâ experience of symptoms and functional limitations related to chemotherapy-induced peripheral neuropathy.
Methods Cancer patients receiving neurotoxic chemotherapy completed EORTC QLQ-CIPN20 and the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity [FACT/GOG-NTX] at baseline, second cycle of chemotherapy (T2, n = 287), and 12 months after chemotherapy (T3, n = 191). Anchor-based approach used the validated FACT/GOG-NTX neurotoxicity (Ntx) subscale to identify optimal MCID cutoff for deterioration. Distribution-based approach used one-third standard deviation (SD), half SD, and one standard error of measurement of the total EORTC QLQ-CIPN20 score.
Results There was a moderate correlation between the change scores of the Ntx subscale and sensory and motor subscales of QLQ-CIPN20 (T2: r = â 0.722, p < 0.001 and r = â 0.518, p < 0.001, respectively; T3: r = â 0.699; p < 0.001 and r = â 0.523,
p < 0.001, respectively). The correlation between the change scores of the Ntx subscale and the QLQ-CIPN20 autonomic subscale was poor (T2: r = â 0.354, p < 0.001; T3: r = 0.286, p < 0.001). Based on the MCID derived using distribution-based method, the MCID for the QLQ-CIPN20 sensory subscale was 2.5â5.9 (6.9% to 16.4% of the subdomain score) and for motor subscale was 2.6â5.0 (8.1%â15.6% of the subdomain score).
Conclusion The MCID for the EORTC QLQ-CIPN20 established using distribution-based approaches was 2.5â5.9 for the sensory subscale and 2.6â5.0 for the motor subscale. When noted in assessments even with small change in scores, clinicians can be alerted for appropriate intervention