Optimizing Smoking Cessation Treatment for Patients with Bladder Cancer

优化膀胱癌患者的戒烟治疗

基本信息

批准号：
10371383
负责人：
Richard Steven Matulewicz
金额：
$ 19.41万
依托单位：
SLOAN-KETTERING INST CAN RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2027-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10371383
关键词：
Academic Medical Centers Active Learning Address Adult Biometry Cancer Patient Cancer Survivor Caring Clinic Clinic Visits Collaborations Computerized Medical Record Counseling Development Plans Diagnosis Drug Prescriptions Evidence based practice Evidence based treatment Face Familiarity Focus Groups Future Goals Health Services Research Institution Interview Investigation K-Series Research Career Programs Malignant Neoplasms Malignant neoplasm of urinary bladder Medical Mentors Methodology Methods Modeling Morbidity - disease rate Oncology Outcome Patient-Focused Outcomes Patients Peripheral Pharmaceutical Preparations Pharmacotherapy Phase Positioning Attribute Prevalence Primary Health Care Process Provider Qualitative Methods Quality of life Research Research Methodology Research Personnel Research Priority Research Project Grants Research Proposals Research Training Risk Risk Factors Science Smoke Smoker Smoking Smoking Cessation Intervention Time Training Treatment outcome United States Urologic Oncology Urologist Urology Variant Veterans Veterans Health Administration Vulnerable Populations Work base cancer diagnosis cancer recurrence care delivery career development clinical decision support comorbidity data warehouse effectiveness/implementation study evidence base implementation science implementation strategy implementation study improved member mortality multidisciplinary nicotine replacement novel patient screening preservation primary care setting recruit research and development screening skills smoking cessation support tools theories

项目摘要

Smoking is the leading risk factor for bladder cancer and is estimated to account for half of the 80,000 new diagnoses each year in the United States. Patients who quit after diagnosis have improved quality-of-life, lower risk of recurrence, and a 3-fold lower chance of dying from bladder cancer compared to those who continue to smoke. Yet only one in 5 urologists delivers smoking cessation treatment to patients, and considerable gaps in patient awareness and guideline-concordant screening and referral exist in the urology setting. These factors contribute to adults with bladder cancer being the least likely to quit smoking after diagnosis, compared to all other cancer survivors. Increased use of evidence-based smoking cessation treatment will improve outcomes for the estimated 100,000 patients with bladder cancer who continue to smoke. The proposed research project aims to investigate and optimize the delivery of evidence-based smoking cessation treatment for patients with bladder cancer at Memorial Sloan Kettering Cancer Center (MSK). Specific Aim 1 will evaluate how smoking cessation treatment is given to patients with bladder cancer by quantifying practice patterns and exploring factors associated with sub-optimal care delivery. Specific Aim 2 will identify determinants of smoking cessation treatment using qualitative methods that will help elucidate multi-level determinants of evidence-based practices. Specific Aim 3 will adapt our current tobacco treatment strategy to the urology context using theory-based implementation science methods informed by our mixed-methods explanatory study (Aims 1 and 2) and will pilot promising strategies. The proposed research represents a significant step towards understanding and improving the delivery of evidence-based smoking cessation treatment for patients with bladder cancer. Our findings will establish a theory-based paradigm to facilitate smoking cessation treatment within diverse surgical oncology contexts at MSK while improving patient outcomes and advancing the field of implementation science. The proposed research project is accompanied by a training plan that will provide the candidate with critical expertise in advanced biostatistics and data science, qualitative research methods, and implementation science. This will be accomplished through a detailed plan that involves coursework, collaboration, and experiential learning corresponding to each Specific Aim of the study. This career development and training plan will give the candidate a set of skills unique among urologists and will be guided by a world-class group of mentors and collaborators at a premier academic medical center and partner hospitals. The members of this multidisciplinary team will each contribute unique expertise to the candidate’s novel and innovative career development plan and research proposal. This career development award will position him to make significant contributions in the future as an independent investigator in health services research and urologic oncology.

吸烟是膀胱癌的主要危险因素，估计在美国每年80,000个新诊断中的一半。与继续吸烟的患者相比，诊断后戒烟的患者改善了生活质量，较低的复发风险以及死于膀胱癌的可能性低3倍。然而，只有五分之一的泌尿科医生向患者提供了戒烟治疗，并且在泌尿外科环境中存在大量患者意识和指导方案筛查和转诊的差距。与所有其他癌症存活相比，这些因素导致膀胱癌成年人在诊断后戒烟的可能性最低。循证戒烟治疗的使用增加将改善估计100,000名继续吸烟的膀胱癌患者的预后。拟议的研究项目旨在调查和优化在纪念斯隆·凯特林癌症中心（MSK）的膀胱癌患者的循证吸烟戒烟治疗。具体目标1将通过量化练习模式和探索与亚最佳护理递送相关的因素来评估如何对膀胱癌患者进行戒烟治疗。具体目标2将使用定性方法来确定戒烟治疗的决定者，这将有助于阐明多层确定基于证据的实践。具体目标3将使用基于理论的实施科学方法将我们当前的烟草治疗策略调整到泌尿外科环境中，该方法由我们的混合方法剥削研究（AIMS 1和2）介绍，并将驾驶承诺策略。拟议的研究代表了理解和改善膀胱癌患者的循证戒烟治疗的重要一步。我们的发现将建立一个基于理论的范式，以促进MSK潜水员手术肿瘤学环境中的戒烟治疗，同时改善患者的结果并推进实施科学领域。拟议的研究项目是由培训计划完成的，该计划将为候选人提供高级生物统计学和数据科学，定性研究方法和实施科学方面的重要专业知识。这将通过一个详细计划来完成，该计划涉及课程，协作和专家学习与研究的每个特定目标相对应。这项职业发展和培训计划将为候选人提供一系列泌尿科医生的技能，并将在首屈一指的学术医疗中心和合作伙伴医院的世界一流的导师和合作者的指导下进行指导。这个跨学科团队的成员将为候选人的小说和创新的职业发展计划和研究建议贡献独特的专家。该职业发展奖将使他成为卫生服务研究和泌尿科肿瘤学独立研究者的未来做出重大贡献。