sj-docx-1-jpx-10.1177_23743735231224516 - Supplemental material for The Feasibility of Using Point of Care Ultrasound as a Visual Substitute for Physical Examination During Telehealth Visits: A Pilot Project

Supplemental material, sj-docx-1-jpx-10.1177_23743735231224516 for The Feasibility of Using Point of Care Ultrasound as a Visual Substitute for Physical Examination During Telehealth Visits: A Pilot Project by Vida C. Passero, Nicole Conley, Erin P. Finley and Christopher Kevin Schott in Journal of Patient Experience</p

sj-docx-2-jpx-10.1177_23743735231224516 - Supplemental material for The Feasibility of Using Point of Care Ultrasound as a Visual Substitute for Physical Examination During Telehealth Visits: A Pilot Project

Supplemental material, sj-docx-2-jpx-10.1177_23743735231224516 for The Feasibility of Using Point of Care Ultrasound as a Visual Substitute for Physical Examination During Telehealth Visits: A Pilot Project by Vida C. Passero, Nicole Conley, Erin P. Finley and Christopher Kevin Schott in Journal of Patient Experience</p

Use of targeted therapies for advanced renal cell carcinoma in the Veterans Health Administration

BackgroundThe objective of this study is to describe the use of targeted therapies for the treatment of advanced renal cell carcinoma (RCC) and overall survival (OS) among patients in clinical practice in the Veterans Health Administration (VHA).MethodsA retrospective cohort of 286 patients from 24 VHA Medical Centers diagnosed with advanced clear cell RCC between Fiscal Year (FY) 2010 and FY2014 was followed through September 30, 2016. Among patients who received targeted therapy, we described the medications taken, duration of therapy, and overall survival. We also assessed the effect of the first therapy received on overall survival using Cox Proportional Hazards models.ResultsThere were 66 patients who did not receive therapy for their advanced RCC. Of the 220 treated patients, the mean (sd) number of medications received was 1.9 (1.1). The medications most commonly used first were sunitinib (61.8%), pazopanib (17.3%), and temsirolimus (10.9%). The median duration of first-line therapy was 86&nbsp;days (interquartile range [IQR] 42, 210). Median total duration of therapy was 159&nbsp;days (IQR 58, 397). 62.3% of patients had&nbsp;≥&nbsp;1 dose of therapy held or reduced, mainly due to an adverse drug event (ADE). Median survival from the start of treatment to death was 1.08&nbsp;years (IQR 0.80, 1.31). Finally, receipt of temsirolimus vs sunitinib (HR 1.95 [95%CI 1.09,3.47]) as the first targeted therapy was independently associated with an increased hazard of death.ConclusionOur analysis of targeted therapies for advanced RCC in VHA suggests duration of treatment is shorter in a real-world setting than in clinical trials, and dose reductions and ADEs are more common