Cancer
Conditions
Brief summary
Significant challenges and gaps remain in navigating transitions between acute care and outpatient care for many cancer survivors. This study underscores 1) implementation of Emergency Department (ED) risk-stratified treatments protocols that standardize patient care and would allow for rapid re-assessment and access to specialist care with well-coordinated cancer care plans, and 2) the significant numbers of minority cancer survivors seeking episodic care in the ED that are at increased risk of not receiving recommended post cancer treatment surveillance.
Detailed description
The over-arching goal of this study is to develop a portable model for ED cancer treatment guidelines and management using evidence based protocols in a population at high risk for poor cancer -related outcomes by identifying & overcoming specific barriers to enhanced survivorship. Based on the demographics of ED population (currently, 70% racial/ethnic minorities), the majority of participants will be underrepresented (African-American and Hispanic) and low-income individuals. The investigators propose a feasibility study of 150 patients in the ED over a 1 year period. The specific aims are: Aim 1: Evaluate the effectiveness of ED Risk-Stratified, Evidence-Based Treatment protocols on the primary outcome of ED utilization rates and subsequent acute inpatient admissions at 6 -months post-intervention. Aim 2: Evaluate the effectiveness of an ED-based Cancer Patient Navigator on the secondary outcomes of patient engagement and primary care engagement at 6 -months post-intervention. Aim 3: Examine barriers and facilitators to compliance for cancer survivorship recommendations that occur in an ED setting at 6-months post intervention.
Interventions
None listed
Sponsors
Centers for Disease Control and Prevention
University of Illinois at Chicago
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Cancer survivor (has had cancer in their lifetime, and is currently disease-free) * Verbal fluency in English or Spanish * Age 18-75 years
Exclusion criteria
* Unable to verbalize comprehension of study or impaired decision making (e.g., dementia) * Plans to move from Chicago area within the next year
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ED utilization rate | 6 months from study entry | Emergency department utilization over 6 month period |
| Mortality | 30 days from study entry | Mortality due to deep vein thrombosis/pulmonary embolism, due to sepsis, and overall mortality |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Admission and Readmission rate | 6 months from study entry | all cause, and related to sepsis |
Countries
United States
Outcome results
None listed