Nathan A Boucher1, Jonathan Nicolla2, Adeboye Ogunseitan3, Elizabeth R Kessler4, Christine S Ritchie5, Yousuf Y Zafar6. 1. 1 Durham VA GRECC, Duke Center for the Study of Aging and Human Development; Sanford School of Public Policy, Duke University , Durham, North Carolina. 2. 2 Duke Cancer Institute, Duke University Medical Center , Durham, North Carolina. 3. 3 Northwestern University Feinberg School of Medicine, Chicago, Illinois. 4. 4 University of Colorado School of Medicine , Aurora, Colorado. 5. 5 University of California-San Francisco , San Francisco, Carolina. 6. 6 Duke University School of Medicine, Duke Cancer Institute , Durham, North Carolina.
Abstract
CONTEXT: Best supportive care (BSC) is often not standardized across sites, consistent with best evidence, or sufficiently described. We developed a consensus-based checklist to document BSC delivery, including symptom management, decision making, and care planning. We hypothesized that BSC can be feasibly documented with this checklist consistent with consolidated standards of reporting trials. OBJECTIVE: To determine feasibility/acceptability of a BSC checklist among clinicians. METHODS: To test feasibility of a BSC checklist in standard care, we enrolled a sample of clinicians treating patients with advanced cancer at four centers. Clinicians were asked to complete the checklist at eligible patient encounters. We surveyed enrollees regarding checklist use generating descriptive statistics and frequencies. RESULTS: We surveyed 15 clinicians and 9 advanced practice providers. Mean age was 41 (SD = 7.9). Mean years since fellowship for physicians was 7.2 (SD = 4.5). Represented specialties are medical oncology (n = 8), gynecologic oncology (n = 4), palliative care (n = 2), and other (n = 1). For "overall impact on your delivery of supportive/palliative care," 40% noted improved impact with using BSC. For "overall impact on your documentation of supportive/palliative care," 46% noted improvement. Impact on "frequency of comprehensive symptom assessment" was noted to be "increased" by 33% of providers. None noted decreased frequency or worsening impact on any measure with use of BSC. Regarding feasibility of integrating the checklist into workflow, 73% agreed/strongly agreed that checklists could be easily integrated, 73% saw value in integration, and 80% found it easy to use. CONCLUSION: Clinicians viewed the BSC checklist favorably illustrating proof of concept, minor workflow impact, and potential of benefit to patients.
CONTEXT: Best supportive care (BSC) is often not standardized across sites, consistent with best evidence, or sufficiently described. We developed a consensus-based checklist to document BSC delivery, including symptom management, decision making, and care planning. We hypothesized that BSC can be feasibly documented with this checklist consistent with consolidated standards of reporting trials. OBJECTIVE: To determine feasibility/acceptability of a BSC checklist among clinicians. METHODS: To test feasibility of a BSC checklist in standard care, we enrolled a sample of clinicians treating patients with advanced cancer at four centers. Clinicians were asked to complete the checklist at eligible patient encounters. We surveyed enrollees regarding checklist use generating descriptive statistics and frequencies. RESULTS: We surveyed 15 clinicians and 9 advanced practice providers. Mean age was 41 (SD = 7.9). Mean years since fellowship for physicians was 7.2 (SD = 4.5). Represented specialties are medical oncology (n = 8), gynecologic oncology (n = 4), palliative care (n = 2), and other (n = 1). For "overall impact on your delivery of supportive/palliative care," 40% noted improved impact with using BSC. For "overall impact on your documentation of supportive/palliative care," 46% noted improvement. Impact on "frequency of comprehensive symptom assessment" was noted to be "increased" by 33% of providers. None noted decreased frequency or worsening impact on any measure with use of BSC. Regarding feasibility of integrating the checklist into workflow, 73% agreed/strongly agreed that checklists could be easily integrated, 73% saw value in integration, and 80% found it easy to use. CONCLUSION: Clinicians viewed the BSC checklist favorably illustrating proof of concept, minor workflow impact, and potential of benefit to patients.
Authors: S Yousuf Zafar; David C Currow; Nathan Cherny; Florian Strasser; Robin Fowler; Amy P Abernethy Journal: Lancet Oncol Date: 2012-02 Impact factor: 41.316
Authors: David Hui; Maxine De La Cruz; Masanori Mori; Henrique A Parsons; Jung Hye Kwon; Isabel Torres-Vigil; Sun Hyun Kim; Rony Dev; Ronald Hutchins; Christiana Liem; Duck-Hee Kang; Eduardo Bruera Journal: Support Care Cancer Date: 2012-08-31 Impact factor: 3.603
Authors: Anna Louise Beavis; Awa Sanneh; Rebecca L Stone; Margaret Vitale; Kimberly Levinson; Anne F Rositch; Amanda Nickles Fader; Kristin Topel; Ashley Abing; Stephanie L Wethington Journal: Am J Obstet Gynecol Date: 2020-05-17 Impact factor: 8.661