Team-Based Care for Cancer Survivors With Comorbidities: A Systematic Review

Doose, Michelle; Verhoeven, Dana; Sanchez, Janeth I.; Livinski, Alicia A.; Mollica, Michelle; Chollette, Veronica; Weaver, Sallie J.

doi:10.1097/jhq.0000000000000354

Cited by 11 publications

(11 citation statements)

References 56 publications

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“…Although practice guidelines and recommendations have encouraged team-based care for almost two decades, 10,55,56 there is surprisingly little evidence identifying MTS composition during the critical treatment planning period. 18 This study addresses this gap by defining the roster of players or component teams who could (and may ideally) be coordinating or sharing information during care planning for this patient population. Future research is needed to identify optimal MTS configurations to develop and test health care delivery models that provide patient-centered, coordinated, and equitable care for cancer patients with MCC.…”

Section: Discussionmentioning

confidence: 99%

“…15,16 However, little evidence to date explores clinical MTS composition among newly diagnosed cancer patients with pre-existing comorbidities or potential disparities among underserved populations with limited access to specialty care. [17][18][19][20] Building on the limited research, this descriptive populationbased study quantifies and characterizes clinical MTS composition and high-complexity MTS care among older adults newly diagnosed with one of three early-stage (I, II, III) cancer types with the highest incidence and mortality rates in the United States (ie, breast, colorectal, and non-small-cell lung cancer) between 2007 and 2015 and a codiagnosis of cardiovascular disease, diabetes, pulmonary disease, and/or chronic kidney disease. Additionally, we measure the incidence differences of high-complexity MTS care by patient groups, with a particular focus on groups that experience health and health care disparities.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Multiteam System Composition and Complexity Among Newly Diagnosed Early-Stage Breast, Colorectal, and Lung Cancer Patients With Multiple Chronic Conditions: A SEER-Medicare Analysis

Doose

Verhoeven

Sanchez

et al. 2023

JCO Oncology Practice

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PURPOSE: Sixty percent of adults have multiple chronic conditions at cancer diagnosis. These patients may require a multidisciplinary clinical team-of-teams, or a multiteam system (MTS), of high-complexity involving multiple specialists and primary care, who, ideally, coordinate clinical responsibilities, share information, and align clinical decisions to ensure comprehensive care needs are managed. However, insights examining MTS composition and complexity among individuals with cancer and comorbidities at diagnosis using US population-level data are limited. METHODS: Using SEER-Medicare data (2006-2016), we identified newly diagnosed patients with breast, colorectal, or lung cancer who had a codiagnosis of cardiopulmonary disease and/or diabetes (n = 75,201). Zaccaro's theory-based classification of MTSs was used to categorize clinical MTS complexity in the 4 months following cancer diagnosis: high-complexity (≥ 4 clinicians from ≥ 2 specialties) and low-complexity (1-3 clinicians from 1-2 specialties). We describe the proportions of patients with different MTS compositions and quantify the incidence of high-complexity MTS care by patient groups. RESULTS: The most common MTS composition was oncology with primary care (37%). Half (50.3%) received high-complexity MTS care. The incidence of high-complexity MTS care for non-Hispanic Black and Hispanic patients with cancer was 6.7% (95% CI, −8.0 to −5.3) and 4.7% (95% CI, −6.3 to −3.0) lower than non-Hispanic White patients with cancer; 13.1% (95% CI, −14.1 to −12.2) lower for rural residents compared with urban; 10.4% (95% CI, −11.2 to −9.5) lower for dual Medicaid-Medicare beneficiaries compared with Medicare-only; and 16.6% (95% CI, −17.5 to −15.8) lower for colorectal compared with breast cancer. CONCLUSION: Incidence differences of high-complexity MTS care were observed among cancer patients with multiple chronic conditions from underserved populations. The results highlight the need to further understand the effects of and mechanisms through which care team composition, complexity, and functioning affect care quality and outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Multiteam System Composition and Complexity Among Newly Diagnosed Early-Stage Breast, Colorectal, and Lung Cancer Patients With Multiple Chronic Conditions: A SEER-Medicare Analysis

Doose

Verhoeven

Sanchez

et al. 2023

JCO Oncology Practice

Self Cite

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“…Depending on the cohort studied and population characteristics, various evidence on the comorbidity effect on LC are inconsistent [ 17 – 21 ]. Some of them reported the impact of cardiac and pulmonary comorbidities on treatments and thus survival [ 19 – 22 ], while others suggest that family history of cancer, precisely LC, is associated with an increased risk of developing the disease.…”

Section: Discussionmentioning

confidence: 99%

Lung cancer in middle and southern Morocco

Tafenzi¹,

Choulli²,

Baladi³

et al. 2023

ecancer

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Purpose Determining risk factors associated with a fatal disease such as lung cancer (LC) remains an important key to understanding the factors related to its development and therefore using the correct emergent or accessible treatments. For that, we sought to highlight by describing, and analysing, the risk factors related to LC survival, reflecting the actual situation in Morocco. Patients and methods We included 987 LC patients diagnosed from 2015 to 2021 at the Medical Oncology Department at the Mohammed VI University Hospital of Marrakech. An overview of the LC situation was described, and analysed, to determine the risk factors related to survival. The independent prognostic factors were determined using Cox Proportional Hazards Regression Analysis. To create a distinction between different risks group in the survival curve, stratification was done, respectively, within sex, age, histology type, treatments and radiation therapy. Results We finally included 862 patients with 15 parameters among the 27 extracted, all meeting the inclusion criteria. 89.1% of the patients were male ( n = 768) and 10.9% were female ( n = 94), of whom 83.5% had a history of tobacco smoking ( n = 720). The median survival of both sexes was 716 (5–2,167) days. The average age at diagnosis was 60 years. Five hundred and thirty-four patients presented with advanced stage. Patients above 66 years were the more diagnosed category with adenocarcinoma at T4N2M1c pathological category, and endocrinal comorbidity, in addition to pleurisy syndrome. Moreover, family history was found to be a bad prognostic factor. Interestingly, smoking status was not a bad contributor to survival. Age at diagnosis, histology subtype, performance status, haemoglobin, numbers of cures of the first-line chemotherapy, radiotherapy, anaemia and treatments were identified as risk factors related to survival. Conclusion We established a descriptive and analytical overview of the current LC epidemiology situation in the oncology division of Mohammed VI University Hospital in a non-industrialised state taking into account smoking status.

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“…In the UK, the National Institute for Health and Care Excellence (NICE) provides comprehensive clinical guidelines covering various aspects of cancer care, including survivorship. These collective endeavors, which are supported by guidelines from multiple leading global organizations, shape the trajectory of survivorship care on a worldwide scale [ 25 ].…”

Section: Towards Shaping the Future Of Cancer Survivorship: Current G...mentioning

confidence: 99%

Reviewing the Landscape of Cancer Survivorship: Insights from Dr. Lidia Schapira’s Programs and Beyond

Cortiana,

Abbas,

Nadar

et al. 2024

Cancers

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The constantly escalating population of cancer survivors worldwide has prompted a focused exploration of their unique needs and experiences within the context of healthcare medicine. This review initiates its analysis inspired by Dr. Lidia Schapira’s insightful keynote conference on the Survivorship 1.0 and Survivorship 2.0 Programs, shedding light on their implementation challenges and setting the stage for a comprehensive analysis of cancer survivorship initiatives. Within the transformed landscape of cancer care, patient-centric strategies embedded in cancer survivorship programs comprising vital elements such as connection, support, and education are presented. While placing cancer recurrence surveillance at the forefront, the review underlines concern regarding the potential oversight of the enduring impact on mental and physical health. Dr. Schapira’s insights further extend into the exploration of mental health challenges faced by survivors, promoting an examination of diverse strategies to address these concerns. Furthermore, the discussion continues toward promising areas of research, notably Precision Medicine’s role in de-escalating cancer therapies, and advocates for measures such as early cancer awareness and timely referrals to supportive services. Highlighting the significance of education, the role of online resources in enhancing the knowledge of healthcare practitioners and future generations in cancer care is then explored. The paper concludes by presenting some of the most prominent global current survivorship programs, identifying critical knowledge gaps in cancer care and projecting future developments aimed at delivering accurate and holistic care, improving the quality of life for survivors, and enhancing both mental and physical well-being. Drawing upon the insights from Dr. Schapira, this review lays the groundwork for a nuanced exploration of cancer survivorship and its multifaceted implications.

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Team-Based Care for Cancer Survivors With Comorbidities: A Systematic Review

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 11 publications

References 56 publications

Clinical Multiteam System Composition and Complexity Among Newly Diagnosed Early-Stage Breast, Colorectal, and Lung Cancer Patients With Multiple Chronic Conditions: A SEER-Medicare Analysis

Clinical Multiteam System Composition and Complexity Among Newly Diagnosed Early-Stage Breast, Colorectal, and Lung Cancer Patients With Multiple Chronic Conditions: A SEER-Medicare Analysis

Lung cancer in middle and southern Morocco

Reviewing the Landscape of Cancer Survivorship: Insights from Dr. Lidia Schapira’s Programs and Beyond

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