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19. Additional file 4 of Symptom management care pathway adaptation process and specific adaptation decisions

Author

Vettese, Emily, Sherani, Farha, King, Allison A., Yu, Lolie, Aftandilian, Catherine, Baggott, Christina, Agarwal, Vibhuti, Nagasubramanian, Ramamoorthy, Kelly, Kara M., Freyer, David R., Orgel, Etan, Bradfield, Scott M., Kyono, Wade, Roth, Michael, Klesges, Lisa M., Beauchemin, Melissa, Grimes, Allison, Tomlinson, George, Dupuis, L. Lee, and Sung, Lillian

Abstract

Additional file 4: Distribution of Sections and Adaptation Choices by Symptom Care Pathway

Published
2023
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20. Additional file 1 of Feasibility of three times weekly symptom screening in pediatric cancer patients

Author

Calligan, Maryann, Chakkalackal, Lauren, Dadzie, Grace, Tardif-Theriault, Cassandra, Cook, Sadie, Vettese, Emily, Soman, Dilip, Kuczynski, Susan, Schechter, Tal, Dupuis, L. Lee, and Sung, Lillian

Abstract

Additional file 1: Supplementary file: Appendices. Appendix 1: Feasibility Metrics by Cohort. Appendix 2: Symptom Documentation and Intervention Overall and by SSPedi Scores. Appendix 3: Number of Unplanned Healthcare Encounters (N=29). Appendix 4: Symptoms Associated with Unplanned Healthcare Encounters Documentation and Intervention Overall and by SSPedi Scores.

Published
2023
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21. Additional file 3 of Symptom management care pathway adaptation process and specific adaptation decisions

Author

Vettese, Emily, Sherani, Farha, King, Allison A., Yu, Lolie, Aftandilian, Catherine, Baggott, Christina, Agarwal, Vibhuti, Nagasubramanian, Ramamoorthy, Kelly, Kara M., Freyer, David R., Orgel, Etan, Bradfield, Scott M., Kyono, Wade, Roth, Michael, Klesges, Lisa M., Beauchemin, Melissa, Grimes, Allison, Tomlinson, George, Dupuis, L. Lee, and Sung, Lillian

Abstract

Additional file 3: Clinical Practice Guideline and Care Pathway Utilization for Symptom Management at Baseline (N=10)

Published
2023
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22. Additional file 1 of Symptom management care pathway adaptation process and specific adaptation decisions

Author

Vettese, Emily, Sherani, Farha, King, Allison A., Yu, Lolie, Aftandilian, Catherine, Baggott, Christina, Agarwal, Vibhuti, Nagasubramanian, Ramamoorthy, Kelly, Kara M., Freyer, David R., Orgel, Etan, Bradfield, Scott M., Kyono, Wade, Roth, Michael, Klesges, Lisa M., Beauchemin, Melissa, Grimes, Allison, Tomlinson, George, Dupuis, L. Lee, and Sung, Lillian

Abstract

Additional file 1: Care Pathway Template Example

Published
2023
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23. Additional file 2 of Symptom management care pathway adaptation process and specific adaptation decisions

Author

Vettese, Emily, Sherani, Farha, King, Allison A., Yu, Lolie, Aftandilian, Catherine, Baggott, Christina, Agarwal, Vibhuti, Nagasubramanian, Ramamoorthy, Kelly, Kara M., Freyer, David R., Orgel, Etan, Bradfield, Scott M., Kyono, Wade, Roth, Michael, Klesges, Lisa M., Beauchemin, Melissa, Grimes, Allison, Tomlinson, George, Dupuis, L. Lee, and Sung, Lillian

Abstract

Additional file 2: Options for Adaptations Considering Degree of Bothersome Symptoms

Published
2023
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24. Additional file 5 of Symptom management care pathway adaptation process and specific adaptation decisions

Author

Vettese, Emily, Sherani, Farha, King, Allison A., Yu, Lolie, Aftandilian, Catherine, Baggott, Christina, Agarwal, Vibhuti, Nagasubramanian, Ramamoorthy, Kelly, Kara M., Freyer, David R., Orgel, Etan, Bradfield, Scott M., Kyono, Wade, Roth, Michael, Klesges, Lisa M., Beauchemin, Melissa, Grimes, Allison, Tomlinson, George, Dupuis, L. Lee, and Sung, Lillian

Abstract

Additional file 5: Results of the Implementation Survey to all Healthcare Professionals across Institutions (N=84)

Published
2023
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37. Symptom documentation and intervention in paediatric cancer care-association with severity: observational study.

Author

Tomlinson D, Chakkalackal L, Calligan M, Tardif-Theriault C, Kuczynski S, Schechter T, Vettese E, Tomlinson GA, Dupuis LL, and Sung L

Subjects
Child, Humans, Documentation, Fatigue, Child, Preschool, Neoplasms complications, Neoplasms therapy, Neoplasms diagnosis
Abstract

Objectives: Primary objectives were to determine the relationship between prevalence of symptom documentation and intervention provision, and increasing severity of bothersome symptoms, as identified by guardians using guardian-reported Symptom Screening in Pediatrics Tool (proxy-SSPedi), which is validated and measures the extent of bothersome symptoms in paediatric patients with cancer., Methods: We included guardians of children 2-7 years of age receiving cancer treatments and seen in hospital daily for 4 consecutive days. Guardians reported proxy-SSPedi at study enrolment and 3 days later. Chart review was performed between the day prior and the day following proxy-SSPedi completion. Symptom documentation and intervention provision were determined by two independent abstractors., Results: We enrolled 190 guardians who provided 371 proxy-SSPedi assessments in 190 children. The most common severely bothersome symptoms were 'feeling tired', 'feeling more or less hungry than they usually do' and 'feeling cranky or angry'. Among those with increasing severity of bother, documentation was significantly more common for 12 symptoms while intervention was significantly more common for 7 symptoms. Intervention was not significantly more common with increasing severity of bother due to 'feeling tired', 'feeling more or less hungry than they usually do' and 'feeling cranky or angry'., Conclusions: Symptom documentation was generally more common in patients with severely bothersome symptoms. Intervention was not more common among those with increasing severity of bother due to fatigue, changes in hunger or anger, which were the most common severely bothersome symptoms. Future efforts should focus on facilitating intervention provision to patients with bothersome symptoms., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2024
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38. Readiness to Implement Symptom Management Care Pathways in Pediatric Cancer.

Author

Dupuis LL, Grimes A, Vettese E, Klesges LM, and Sung L

Abstract

Background: To describe barriers to pediatric cancer symptom management care pathway implementation and the impact of the COVID-19 pandemic on clinical research evaluating their implementation. Methods: We included 25 pediatric oncology hospitals in the United States that supported a grant submission to perform a cluster randomized trial in which the intervention encompassed care pathways for symptom management. A survey was distributed to site principal investigators to measure contextual elements related to care pathway implementation. Questions included the inner setting measures of the Consolidated Framework for Implementation Research (CFIR), study-specific potential barriers and the impact of the COVID-19 pandemic on clinical research. The Wilcoxon rank sum test was used to compare characteristics of institutions that agreed that their department supported the implementation of symptom management care pathways vs. institutions that did not agree. Results: Of the 25 sites, one withdrew because of resource constraints and one did not respond, leaving 23 institutions. Among the seven CFIR constructs, the least supported was implementation climate; 57% agreed there was support, 39% agreed there was recognition and 39% agreed there was prioritization for symptom management care pathway implementation at their institution. Most common barriers were lack of person-time to create care pathways and champion their use (35%), lack of interest from physicians (30%) and lack of information technology resources (26%). Most sites reported no negative impact of the COVID-19 pandemic across research activities. Sites with fewer pediatric cancer patients were more likely to agree that staff are supported to implement symptom management care pathways (P=0.003). Conclusions: The most commonly reported barriers to implementation were lack of support, recognition and prioritization. The COVID-19 pandemic was not a major barrier to clinical research activities in pediatric oncology. Clinical Trial Registration: NCT04614662.

Published
2020
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