Optimizing Smoking Cessation Treatment for Patients with Bladder Cancer

优化膀胱癌患者的戒烟治疗

• 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
• 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

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，据估计，在美国每年80,000例新诊断的膀胱癌中，吸烟占了一半。诊断后戒烟的患者生活质量得到改善，复发风险降低，与继续吸烟的患者相比，死于膀胱癌的几率降低了3倍。然而，只有五分之一的泌尿科医生为患者提供戒烟治疗，而且在泌尿科环境中，患者意识和指南一致的筛查和转诊方面存在相当大的差距。与所有其他癌症幸存者相比，这些因素导致膀胱癌患者在诊断后戒烟的可能性最低。增加循证戒烟治疗的使用将改善大约10万名继续吸烟的膀胱癌患者的预后。