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BMC Health Services Research

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Open Access 01-12-2021 | Care | Research article

Barriers to symptom management care pathway implementation in pediatric Cancer

Authors: L. Lee Dupuis, Allison Grimes, Emily Vettese, Lisa M. Klesges, Lillian Sung

Published in: BMC Health Services Research | Issue 1/2021

Abstract

Background

Objectives were 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 prior to randomization 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 may not be a major barrier to clinical research activities in pediatric oncology.

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Title: Barriers to symptom management care pathway implementation in pediatric Cancer
Authors: L. Lee Dupuis
Allison Grimes
Emily Vettese
Lisa M. Klesges
Lillian Sung
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Care
COVID-19
Pediatric Cancer
Published in: BMC Health Services Research / Issue 1/2021
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-021-07047-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Barriers to symptom management care pathway implementation in pediatric Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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