Engaging PCPs to optimize active surveillance of low-risk prostate cancer

让 PCP 参与优化低风险前列腺癌的主动监测

基本信息

批准号：
10684624
负责人：
Archana Radhakrishnan
金额：
$ 24.48万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-06 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10684624
关键词：
Active Learning Address Adherence Anxiety Award Breast Cancer Patient Caring Case Study Chronic Disease Clinical Complex Dedications Development Plans Diabetes Mellitus Diagnosis Disease Management Ensure Environment Evaluation Fellowship Fostering Foundations Future Goals Growth Guidelines Heart Diseases Impact evaluation Infrastructure Intervention Interview Intestines Knowledge Light Malignant Neoplasms Malignant neoplasm of prostate Medical Mentors Michigan Modeling Monitor Older Population Operative Surgical Procedures Outcome Outcome Measure Patient Outcomes Assessments Patients Primary Care Prostate Provider Psychosocial Assessment and Care Qualitative Methods Quality of Care Quality of life Radiation Radiation Oncologist Recommendation Reporting Research Research Design Research Personnel Resources Role Scientist Specialist Surveys System Testing Theoretical Domains framework Thyroid Gland Training Universities Urologic Surgical Procedures Urologist Urology Visit Work cancer care cancer diagnosis cancer risk care coordination care delivery career career development clinical examination comorbidity design effectiveness evaluation experience implementation outcomes implementation science improved men multidisciplinary patient oriented preference primary care provider prostate cancer risk psychological distress rapid growth response side effect skills success team-based care therapy design therapy development tool treatment guidelines treatment strategy tumor progression urinary user centered design web-based tool

项目摘要

PROJECT SUMMARY The population of older and medically complex cancer patients is growing exponentially, calling for the involvement of primary care providers (PCPs) in team-based models to deliver high-quality care to cancer patients across the continuum. Team-based care is especially needed in light of the rapid growth in diagnoses of low-risk cancers (such as prostate, thyroid, and breast). Not only are these patients typically older and with more comorbidities, but treatment strategies are increasingly moving away from surgery and radiation to active surveillance. Because guidelines for low-risk prostate cancer now recommend active surveillance as the primary disease management strategy, it represents the ideal case for studying how to better engage PCPs. A key gap where PCP involvement can help is in improving adherence to active surveillance; though a growing number of men are choosing this strategy, adherence to active surveillance once chosen remains suboptimal. Thus, it is critical to understand how to support men with low-risk prostate cancer to maximize adherence to active surveillance and importantly, how to effectively engage PCPs in low-risk cancer management. Dr. Radhakrishnan’s long-term career goal is to become an independent clinician-investigator focused on optimizing the role of PCPs in team-based care delivery across the cancer continuum. She is focusing on low- risk cancer management given the timely and critical need to meet the demands of the growing number of low- risk cancer patients. Leveraging the Michigan Urological Surgery Improvement Collaborative (MUSIC), this project aims to: 1) characterize provider and patient perspectives on active surveillance adherence; 2) design a patient-centered intervention that enables providers to support men on active surveillance to maximize adherence; and 3) perform a pilot evaluation of the intervention on key outcomes at primary care and urology practices. Successful completion of this work, and subsequent R01 studies, will improve low-risk cancer management by developing a patient-centered intervention integrated into primary care delivery systems. Dr. Radhakrishnan seeks to build upon her clinical background as a PCP and her research fellowship training to acquire additional skills and experiences to achieve her long-term career goal. With her mentoring team, she has developed a comprehensive career development plan that will support her to: 1) accomplish her training aims and develop a strong skillset in qualitative methods and expertise in intervention design, evaluation, and implementation; and 2) engage in career development activities to enable her to transition to independence as a clinician-investigator. She will be supported by a multidisciplinary team of dedicated mentors and advisors, who will oversee a broad range of coursework and experiential learning, and are committed to ensuring her success. Additionally, the University of Michigan offers Dr. Radhakrishnan the ideal environment for this proposal, with its exceptional resources and an outstanding mentoring team with proven success in developing junior clinician-scientists.

项目概要老年和病情复杂的癌症患者数量呈指数级增长，呼吁让初级保健提供者 (PCP) 参与基于团队的模型，为癌症提供高质量的护理鉴于诊断的快速增长，特别需要基于团队的护理。低风险癌症（如前列腺癌、甲状腺癌和乳腺癌）的患者不仅年龄较大且患有癌症。更多的合并症，但治疗策略逐渐从手术和放疗转向积极的治疗因为低风险前列腺癌指南现在建议积极监测。原发疾病管理策略，它代表了研究如何更好地让 PCP A 参与的理想案例。 PCP 的参与可以帮助改善积极监测的依从性；许多男性选择了这种策略，但一旦选择，坚持主动监测仍然不够理想。因此，了解如何支持患有低风险前列腺癌的男性最大限度地坚持治疗至关重要。积极监测，重要的是如何让 PCP 有效参与低风险癌症管理。 Radhakrishnan 博士的长期职业目标是成为一名独立的临床医生研究员，专注于优化 PCP 在整个癌症治疗过程中以团队为基础的护理服务中的作用。鉴于及时和迫切需要满足日益增长的低收入人群的需求，风险癌症管理利用密歇根泌尿外科改进合作组织 (MUSIC)，这项目旨在：1) 描述提供者和患者对主动监测依从性的看法；2) 设计一个以患者为中心的干预措施使提供者能够支持男性进行主动监测，以最大限度地提高依从性；3) 对初级保健和泌尿科的主要结果进行干预试点评估成功完成这项工作以及随后的 R01 研究将改善低风险癌症。通过开发以患者为中心的干预措施并将其纳入初级保健服务系统来进行管理。 Radhakrishnan 博士寻求以她作为 PCP 的临床背景和研究奖学金培训为基础她与导师团队一起获得额外的技能和经验来实现她的长期职业目标。制定了全面的职业发展计划，该计划将支持她：1）完成培训旨在并发展一套强大的定性方法技能和干预设计、评估和专业知识实施；2) 参与职业发展活动，使她能够过渡到独立她将得到由专门的导师和顾问组成的多学科团队的支持，她将监督广泛的课程作业和体验式学习，并致力于确保她此外，密歇根大学为 Radhakrishnan 博士提供了实现这一目标的理想环境。提案，凭借其卓越的资源和出色的指导团队，在开发方面取得了成功初级临床医生科学家。

项目成果

期刊论文数量（1）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Primary Care Physician Perspectives on Low Risk Prostate Cancer Management: Results of a National Survey.

初级保健医生对低风险前列腺癌管理的看法：全国调查结果。

DOI：
发表时间：
2021-07
期刊：
影响因子：
0.8
作者：
Radhakrishnan, Archana;Wallner, Lauren P;Skolarus, Ted A;Shahinian, Vahakn B;Abrahamse, Paul H;Fetters, Michael D;Hawley, Sarah T
通讯作者：
Hawley, Sarah T