Geriatric Conditions and Treatment Burden in Older Adults with Non-Muscle-Invasive Bladder Cancer and Their Caregivers

患有非肌肉浸润性膀胱癌的老年人及其护理人员的老年病和治疗负担

• 批准号: 9812107
• 负责人: Tullika Garg
• 金额: $ 13.58万
• 依托单位: GEISINGER CLINIC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9812107
• 关键词: Adult; Affect; Age; Aging; Ambulatory Surgical Procedures; American Society of Clinical Oncology; Appointment; Assessment tool; Body Weight decreased; Cancer Patient; Caregiver well-being; Caregivers; Caring; Chronic; Chronic Disease; Clinic; Clinic Visits; Complex; Cross-Sectional Studies; Data; Data Set; Decision Making; Dementia; Dependence; Development Plans; Diagnosis; Disease; Elderly; Financial Hardship; Frequencies; Future; Geriatric Assessment; Goals; Guidelines; Health system; Healthcare; High Prevalence; Hour; Impaired cognition; Impairment; Individual; Intervention; Intravesical Instillation; K-Series Research Career Programs; Link; Malignant Neoplasms; Malignant neoplasm of urinary bladder; Malnutrition; Measures; Medical; Medicare; Medicare claim; Medication Management; Mental Depression; Mentors; Methods; Outcome; Outcomes Research; Outpatients; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Personal Satisfaction; Pharmaceutical Preparations; Physicians; Public Health; Quality of life; Recurrence; Reporting; Research; Research Personnel; Research Project Grants; Role; Sleep; Surveys; Translating; Transportation; Urinary Incontinence; Urologic Oncology; Urology; Visit; Work; age related; cancer diagnosis; cancer site; cancer therapy; care coordination; care delivery; caregiver strain; design; experience; falls; frailty; functional status; health care service utilization; improved; indexing; informal caregiving; innovation; medical specialties; multiple chronic conditions; non-muscle invasive bladder cancer; therapy design; trend

PROJECT SUMMARY/ABSTRACT Treatment burden, defined as “the work of being a patient and how it impacts patients' functioning and well-being,” is emerging as an important concept that affects quality of life and caregiver well-being in other chronic conditions. Despite the fact that cancer is a burdensome chronic disease, few studies have specifically evaluated treatment burden in cancer. Importantly, cancer is more prevalent in older adults who may already experience high treatment burden from existing geriatric conditions. Compared to younger counterparts, older cancer patients tend to value non-traditional outcomes (e.g. quality of life) and rely on caregivers to coordinate transportation for clinic visits, manage medications, and assist in decision-making. A lack of understanding of the relationships between cancer, aging, treatment burden, and caregiver roles may result in care delivery that is misaligned with the goals of older adults. Non-muscle invasive bladder cancer (NMIBC) is an ideal cancer for studying treatment burden for three reasons: highest median age at diagnosis of all cancer sites; a high recurrence rate necessitating frequent visits for surveillance, bladder instillations, and ambulatory surgery; and a high prevalence of baseline multimorbidity. The objective of this application is to elucidate the relationship between geriatric conditions and treatment burden in older NMIBC patients and their caregivers. The Specific Aims are: 1) Assess the relative contribution of individual geriatric conditions to overall healthcare utilization in the year following NMIBC diagnosis in SEER- Medicare, a nationally representative dataset, 2). Evaluate the associations of specific geriatric conditions and cumulative frailty with patient-reported treatment burden after NMIBC diagnosis in 100 older adults, and 3) Evaluate the associations of patient-reported treatment burden, specific geriatric conditions, and cumulative frailty with caregiver-reported strain in 100 caregivers. This study is innovative because it engages patient and caregiver perspectives to define the new concept of treatment burden within aging and cancer. This study is significant because understanding the relationship between cancer, geriatric conditions, and treatment burden is the critical next step towards redesigning care to reduce the footprint of healthcare work for older cancer patients and caregivers. This GEMSSTAR research project, mentoring committee, and professional development plan will help the PI to become one of the few independent investigators with expertise at the intersection of aging, urologic oncology, and patient-centered outcomes research.

项目摘要/摘要 治疗负担，定义为“作为患者的工作及其对患者的影响” 功能和幸福感“正在成为影响生活质量和生活质量的一个重要概念 照顾者在其他慢性疾病中的幸福感。尽管癌症是一种负担 对于慢性疾病，很少有研究专门评估癌症的治疗负担。 重要的是，癌症在老年人中更为普遍，他们可能已经经历了高发期 现有老年疾病造成的治疗负担。与年轻的同行相比，年长的 癌症患者倾向于重视非传统的结果(例如生活质量)，并依赖于 护理员协调诊所就诊的交通，管理药物，并协助 决策。对癌症、衰老、治疗之间的关系缺乏了解 负担和护理者的角色可能会导致护理提供与老年人的目标不一致 成年人。摘要非肌肉浸润性膀胱癌是研究治疗的理想肿瘤。 三个原因造成的负担：确诊时的中位年龄在所有癌症部位中最高；复发率高 有必要频繁就诊进行监测、膀胱灌输和门诊手术的比率； 以及基线多发病的高患病率。本申请的目的是阐明 老年NMIBC患者的老年状况与治疗负担的关系 他们的照顾者。具体目标是：1)评估个体老年人的相对贡献 SEER中NMIBC诊断后一年的总体医疗利用状况- 联邦医疗保险，一个具有全国代表性的数据集，2)。评估特定老年患者的关联性 NMIBC诊断后患者报告的治疗负担的状况和累积脆弱性 在100名老年人中，以及3)评估患者报告的治疗负担的相关性， 特定的老年疾病，以及100名照顾者报告的累积虚弱 照顾者。这项研究具有创新性，因为它从患者和护理者的角度出发 定义老龄化和癌症治疗负担的新概念。这项研究具有重要意义 因为了解癌症、老年疾病和治疗之间的关系 负担是重新设计医疗保健以减少医疗足迹的关键下一步 为老年癌症患者和照顾者工作。这个GEMSSTAR研究项目，导师 委员会和专业发展计划将帮助PI成为为数不多的 在老龄化、泌尿外科肿瘤学和 以患者为中心的结果研究。