Examining Delivery of Integrated Tobacco Treatment in Cancer Care

检查癌症护理中综合烟草治疗的实施

基本信息

批准号：
9115566
负责人：
Elyse R. Park
金额：
$ 17.29万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-07-24 至 2020-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9115566
关键词：
Academic Medical Centers Advocate American Society of Clinical Oncology Area Back Cancer Center Cancer Patient Cancer Survivor Caring Clinical Communication Communities Counseling Data Data Analyses Data Collection Diagnosis Distress Effectiveness Electronic cigarette Evidence based treatment FDA approved Guidelines Health Health behavior Interview Knowledge Lead Malignant Neoplasms Malignant neoplasm of lung Medical Mental Depression Mentors Mentorship Methods National Comprehensive Cancer Network Online Systems Pain Patients Pharmaceutical Preparations Phase Population Positioning Attribute Primary Neoplasm Qualifying Quality Indicator Radiosurgery Randomized Clinical Trials Recommendation Relapse Reporting Research Research Personnel Risk Scientist Site Sleep Smoke Smoker Smoking Survival Rate Symptoms Target Populations Telephone Time Tobacco Translations Treatment outcome United States Dept. of Health and Human Services United States Public Health Service Visit Withholding Treatment Work base cancer care cancer diagnosis chemotherapy comparative efficacy cost evidence base improved innovation interest medication compliance multidisciplinary older patient oncology patient oriented patient oriented research patient population pilot trial programs psychosocial smoking cessation social stigma socioeconomics standard of care stress symptom telehealth varenicline

项目摘要

DESCRIPTION (provided by applicant): Documented risks associated with continued smoking following cancer diagnosis include decreased survival time; increased complications from surgery, radiation, and chemotherapy; and increased risk of second primary tumors. Although 10%-30% of cancer patients are current smokers at the time of cancer diagnosis, an effective smoking cessation treatment for cancer patients has not been established. Evidence-based tobacco treatment guidelines, and ASCO quality recommendations, have not been integrated into cancer care. With NCI support I have created a research focus and commitment to advocate for integrating evidence-based quality tobacco treatment as part of comprehensive cancer care. I am currently conducting a two site randomized clinical trial (1R01CA166147) to compare the efficacy and cost of an intensive treatment (counseling delivered over 6 months (weekly x 1 month, biweekly x two months, and monthly x 3 months) plus choice of 12-weeks of FDA approved medication) to a standard of care treatment (counseling delivered over one month plus medication advice) to 295 cancer patients at the time of diagnoses. An R21 has been proposed to conduct a pilot trial to assess integration of the intensive treatment into community-based cancer centers, delivered via a web-based telehealth program. This K24 proposal fills a needed gap in patient-oriented tobacco treatment for cancer patients. Junior clinician-scientists are needed in this area of patient-oriented care; the population of cancer patients is growing, and an interdisciplinary cadre of clinical researchers are needed who have a unique interest in both tobacco treatment and cancer care and are dedicated to improving tobacco treatments targeted for cancer patients as well as pursuing innovative treatment delivery options. The proposed K24 work would enable me, together with a highly qualified group of mentees, to 1) determine and create the best quality evidence-based treatment, 2) further expand its relevance and appeal to diverse cancer patients, 3) determine the most effective assessment of this treatment, and 4) expand its reach. Mentorship Aim: To expand my ability to mentor multidisciplinary junior clinician-scientists in patient oriented research relatig to tobacco treatment for cancer patients. The proposed work includes 10 mentee-lead projects. Research Aim: To build upon my R01, integrating tobacco treatment into academic medical settings, to 1) further develop and refine patient-oriented tobacco treatment for diverse cancer patients who are smoking at diagnosis and 2) position myself to expand and improve the reach and effectiveness of tobacco treatment delivery into community-based oncology settings. The proposed work will involve multiple phases of patient- oriented research, which will culminate in translation of information gained back into the cancer patient population. The phases include: 1) qualitative data collection (exit interviews) with a subset of R01 patients (n=60), 2) data analyses and mixed methods interpretation of R01 patient data on a) cancer distress and symptoms , b) health behaviors, and target populations and patient communication.

描述（由申请人提供）：已记录的与癌症诊断后继续吸烟相关的风险包括生存时间缩短；手术、放疗和化疗引起的并发症增加以及第二原发肿瘤的风险增加；尽管目前有 10%-30% 的癌症患者患有这种疾病。癌症诊断时的吸烟者尚未制定针对癌症患者的有效戒烟治疗指南，并且 ASCO 质量建议尚未纳入癌症护理中。和承诺倡导将循证优质烟草治疗纳入综合癌症护理的一部分我目前正在进行一项两中心随机临床试验 (1R01CA166147)，以比较强化治疗（为期 6 个月（每周 x 1 个月）的咨询）的功效和成本。），每两周一次，每月一次，三个月）加上选择 12 周 FDA 批准的药物）到标准护理治疗（一个月内提供的咨询加上药物建议）已提议在诊断时对 295 名癌症患者进行试点试验，以评估通过基于网络的远程医疗计划提供的强化治疗的整合。以患者为导向的癌症患者的烟草治疗领域需要初级临床医生和科学家；癌症患者的数量正在不断增长，并且需要对两者都有独特兴趣的跨学科临床研究人员队伍。烟草治疗与癌症护理并致力于高度改进针对癌症患者的烟草治疗以及追求创新的治疗方案。拟议的 K24 工作将使我和一群合格的学员能够 1) 确定并创建最佳质量的循证治疗。治疗，2) 进一步扩大其对不同癌症患者的相关性和吸引力，3) 确定该治疗的最有效评估，以及 4) 扩大其指导范围目标：扩大我以患者为导向的多学科初级临床医生科学家的能力。研究拟议的工作包括 10 个受训者主导的项目：以我的 R01 为基础，将烟草治疗纳入学术医疗环境，以 1) 进一步开发和完善针对不同癌症的以患者为导向的烟草治疗。诊断时吸烟的患者；2）使自己能够扩大和提高烟草治疗在社区肿瘤学环境中的覆盖范围和有效性。拟议的工作将涉及以患者为中心的多个阶段的研究，最终将转化为信息。这些阶段包括：1) 对 R01 患者子集 (n=60) 进行定性数据收集（退出访谈），2) 对 R01 患者数据进行数据分析和混合方法解释：a) 癌症困扰。和症状，b) 健康行为，以及目标人群和患者沟通。