Polaris Oncology Survivor Transition (POST) System

Polaris 肿瘤幸存者过渡 (POST) 系统

• 批准号: 9147558
• 负责人: Erin Lee O'Hea
• 金额: $ 51.42万
• 依托单位: POLARIS HEALTH DIRECTIONS, INC.
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-10 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9147558
• 关键词: Accreditation; Adherence; Affect; American College of Surgeons; Award; Back; Breast Cancer Patient; Businesses; Cancer Survivorship; Caring; Client satisfaction; Clinical; Communication; Consent; Diagnosis; Electronic Health Record; Electronics; Ensure; Failure; Future; Gold; Health; Health Personnel; Health behavior; Healthcare Systems; Individual; Institute of Medicine (U.S.); Knowledge; Life; Long-Term Effects; Malignant Neoplasms; Massachusetts; Mediating; Medical; Mental Health; Modeling; Oncologist; Online Systems; Outcome; Paper; Participant; Patient Care Planning; Patient-Focused Outcomes; Patients; Phase; Physical Function; Plug-in; Primary Care Physician; Primary Health Care; Printing; Problem Solving; Provider; Psychological adjustment; Psychologist; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Readiness; Recommendation; Recruitment Activity; Research Assistant; Research Institute; Role; SF-36; Science; Scientist; Services; Single-Blind Study; Social Workers; Supportive care; Survivors; System; Testing; Universities; Woman; active method; behavioral health; blind; cancer care; cancer therapy; clinical practice; computer generated; design; group support; health care service utilization; heuristics; improved; indexing; innovation; interest; malignant breast neoplasm; medical schools; meetings; oncology; patient oriented; physical symptom; primary outcome; programs; psychological distress; psychosocial; satisfaction; survivorship; treatment as usual

 DESCRIPTION (provided by applicant): By January 2015, oncology care providers will be expected to craft Survivorship Care Plans (SCPs) for all individuals ending active treatment for cancer; however, there is a lack of systematic study of the impact survivorship planning has on patients, providers, or healthcare systems. The Polaris Oncology Survivorship Transition (POST) program is a web-based system that incorporates recommendations from the Institute of Medicine (IOM) and American College of Surgeons (ACS) to assist with cancer survivorship planning. It is a patient-centered approach that integrates input from both the treating oncology team and the patient. Phase I built and iteratively modified (N=25) the POST system and Phase II will test whether the SCPs impact patient and provider outcomes using a single blind, randomized controlled trial (RCT). Breast cancer patients (n=230) transitioning out of active treatment will be recruited and randomly assigned to receive Treatment as Usual (n=115) or the POST (n=115). All participants will be assessed at 1, 3, and 6 months by a research assistant blind to baseline status and group assignment. Primary outcomes will include quality of life, mechanisms of action such as confidence in entering survivorship, and other outcomes such as (1) psychological distress, (2) adherence to medical and behavioral health recommendations, (3) health care utilization, (4) patient satisfaction with the SCP and their oncologists' care, and (5) oncology provider as well as PCP satisfaction with the POST system. The POST will innovate the clinical setting through being the first system to produce computer generated tailored survivorship plans fully reflecting IOM recommendations and the new ACS 2015 requirements; incorporating information from both the oncology provider and the patient; featuring readily available "plug in" for two-way electronic health record integration; providing dynamic, electronic referrals for specialized support services; and facilitating care coordination between the oncologist and PCP. This study's impact will be significant. If hypotheses are confirmed, clear scientific evidence will exist for supporting survivorship care planning into oncology clinical practice. If hypotheses are disconfirmed, important lessons will guide future directions for care planning, including whether failure to affect outcomes was due to failure to impact several hypothesized mechanisms of action. Commercial interest in the POST is brisk as it may facilitate survivorship planning, improve care, and improve compliance with accreditation standards.

 描述（由申请人提供）：到2015年1月，预计肿瘤护理提供者将为所有结束癌症积极治疗的个人制定生存护理计划（SCP）;然而，缺乏对生存计划对患者，提供者或医疗保健系统影响的系统研究。Polaris Oncology Survivorship Transition（POST）计划是一个基于网络的系统，结合了医学研究所（IOM）和美国外科医生学会（ACS）的建议，以协助癌症生存计划。这是一种以患者为中心的方法，整合了肿瘤治疗团队和患者的意见。第I阶段构建并迭代修改（N=25）POST系统，第II阶段将使用单盲随机对照试验（RCT）测试SCP是否影响患者和提供者结局。将招募从活性治疗中过渡出来的乳腺癌患者（n=230），并随机分配至接受药物治疗（n=115）或POST治疗（n=115）。所有受试者将在1、3和6个月时由研究助理进行评估，研究助理对基线状态和分组不知情。主要结局将包括生活质量、行动机制（如进入生存期的信心）和其他结局，如（1）心理困扰，（2）遵守医疗和行为健康建议，（3）卫生保健利用率，（4）患者对SCP及其肿瘤学家护理的满意度，以及 (5)肿瘤提供者以及PCP对POST系统的满意度。POST将通过成为第一个生成计算机生成的定制生存计划的系统来创新临床环境，该计划充分反映IOM建议和ACS 2015新要求;整合来自肿瘤学提供者和患者的信息;具有随时可用的“插件”，用于双向电子健康记录集成;为专业支持服务提供动态电子转诊;以及促进肿瘤学家和PCP之间的护理协调。这项研究的影响将是巨大的。如果假设得到证实，将有明确的科学证据支持将生存护理计划纳入肿瘤学临床实践。如果假设被否定，重要的经验教训将指导未来的护理规划方向，包括是否未能影响结果是由于未能影响几个假设的行动机制。对POST的商业兴趣很活跃，因为它可以促进生存规划，改善护理，并提高对认证标准的遵守。