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Published in: Annals of Surgical Oncology 5/2019

01-05-2019 | Care | Pancreatic Tumors

Oncology Navigation Decreases Time to Treatment in Patients with Pancreatic Malignancy

Authors: Laura M. Enomoto, MS, MD, Joyce Fenstermaker, RN, Rodwige J. Desnoyers, MD, Boris C. Pasche, MD, PhD, A. William Blackstock Jr., MD, Russell M. Howerton, MD, Clancy J. Clark, MD, Edward A. Levine, MD, Perry Shen, MD

Published in: Annals of Surgical Oncology | Issue 5/2019

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Abstract

Background

Care of pancreatic cancer patients has become increasingly complex, which has led to delays in the initiation of therapy. Nurse navigators have been added to care teams, in part, to ameliorate this delay. This study investigated the difference in time from first oncology visit to first treatment date in patients with any pancreatic malignancy before and after the addition of an Oncology Navigator.

Methods

A single-institution database of patients with any pancreatic neoplasm evaluated by a provider in radiation, medical, or surgical oncology between 1 October 2015 and 30 September 2017 was analyzed. After 1 October 2016, an Oncology Navigator met patients at their initial visit and coordinated care throughout treatment. The cohort was divided into two groups: patients evaluated prior to the implementation of an Oncology Navigator and patients evaluated after implementation. Patient demographics and time from first visit to first intervention were compared.

Results

Overall, 147 patients with a new diagnosis of pancreatic neoplasm were evaluated; 57 patients were seen prior to the start of the Oncology Navigator program and 79 were evaluated after the navigation program was implemented. On univariate analysis, time from first contact by any provider to intervention was 46 days prior to oncology navigation and 26 days after implementation of oncology navigation (p = 0.005). While controlling for other covariates, employment of the Oncology Navigator decreased the time from first contact by any provider to intervention by almost 16 days (p = 0.009).

Conclusions

Implementing an oncology navigation program significantly decreased time to treatment in patients with pancreatic malignancy.
Literature
3.
go back to reference Khan S, Sclabas G, Reid-Lombardo KM. Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients. World J Gastrointest Surg. 2010;2(10):314–8.CrossRefPubMedPubMedCentral Khan S, Sclabas G, Reid-Lombardo KM. Population-based epidemiology, risk factors and screening of intraductal papillary mucinous neoplasm patients. World J Gastrointest Surg. 2010;2(10):314–8.CrossRefPubMedPubMedCentral
4.
go back to reference Jones RV, Greenwood B. Breast cancer: causes of patients’ distress identified by qualitative analysis. Br J General Pract. 1994;44(385):370–1. Jones RV, Greenwood B. Breast cancer: causes of patients’ distress identified by qualitative analysis. Br J General Pract. 1994;44(385):370–1.
5.
go back to reference Rapoport Y, Kreitler S, Chaitchik S, Algor R, Weissler K. Psychosocial problems in head-and-neck cancer patients and their change with time since diagnosis. Ann Oncol. 1993;4(1):69–73.CrossRefPubMed Rapoport Y, Kreitler S, Chaitchik S, Algor R, Weissler K. Psychosocial problems in head-and-neck cancer patients and their change with time since diagnosis. Ann Oncol. 1993;4(1):69–73.CrossRefPubMed
6.
go back to reference Gray RE, Fitch MI, Phillips C, Labrecque M, Klotz L. Presurgery experiences of prostate cancer patients and their spouses. Cancer Pract. 1999;7(3):130–5.CrossRefPubMed Gray RE, Fitch MI, Phillips C, Labrecque M, Klotz L. Presurgery experiences of prostate cancer patients and their spouses. Cancer Pract. 1999;7(3):130–5.CrossRefPubMed
7.
go back to reference Bilimoria KY, Ko CY, Tomlinson JS, et al. Wait times for cancer surgery in the United States: trends and predictors of delays. Ann Surg. 2011;253(4):779–85.CrossRefPubMed Bilimoria KY, Ko CY, Tomlinson JS, et al. Wait times for cancer surgery in the United States: trends and predictors of delays. Ann Surg. 2011;253(4):779–85.CrossRefPubMed
8.
go back to reference Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington (DC): National Academies Press (US); 2001. Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington (DC): National Academies Press (US); 2001.
9.
go back to reference Freund KM, Battaglia TA, Calhoun E, et al. National Cancer Institute Patient Navigation Research Program: methods, protocol, and measures. Cancer. 2008;113(12):3391–9.CrossRefPubMedPubMedCentral Freund KM, Battaglia TA, Calhoun E, et al. National Cancer Institute Patient Navigation Research Program: methods, protocol, and measures. Cancer. 2008;113(12):3391–9.CrossRefPubMedPubMedCentral
10.
go back to reference Rosenberg K. Patient navigators improve colorectal cancer screening rates. Am J Nurs. 2011;111(10):15.CrossRefPubMed Rosenberg K. Patient navigators improve colorectal cancer screening rates. Am J Nurs. 2011;111(10):15.CrossRefPubMed
11.
go back to reference Basu M, Linebarger J, Gabram SG, Patterson SG, Amin M, Ward KC. The effect of nurse navigation on timeliness of breast cancer care at an academic comprehensive cancer center. Cancer. 2013;119(14):2524–31.CrossRefPubMed Basu M, Linebarger J, Gabram SG, Patterson SG, Amin M, Ward KC. The effect of nurse navigation on timeliness of breast cancer care at an academic comprehensive cancer center. Cancer. 2013;119(14):2524–31.CrossRefPubMed
12.
go back to reference Luckett R, Pena N, Vitonis A, Bernstein MR, Feldman S. Effect of patient navigator program on no-show rates at an academic referral colposcopy clinic. J Womens Health (Larchmt). 2015;24(7):608–15.CrossRef Luckett R, Pena N, Vitonis A, Bernstein MR, Feldman S. Effect of patient navigator program on no-show rates at an academic referral colposcopy clinic. J Womens Health (Larchmt). 2015;24(7):608–15.CrossRef
13.
go back to reference Ell K, Vourlekis B, Lee PJ, Xie B. Patient navigation and case management following an abnormal mammogram: a randomized clinical trial. Prev Med. 2007;44(1):26–33.CrossRefPubMed Ell K, Vourlekis B, Lee PJ, Xie B. Patient navigation and case management following an abnormal mammogram: a randomized clinical trial. Prev Med. 2007;44(1):26–33.CrossRefPubMed
14.
go back to reference Battaglia TA, Roloff K, Posner MA, Freund KM. Improving follow-up to abnormal breast cancer screening in an urban population. A patient navigation intervention. Cancer. 2007;109(2 Suppl):359–67.CrossRefPubMed Battaglia TA, Roloff K, Posner MA, Freund KM. Improving follow-up to abnormal breast cancer screening in an urban population. A patient navigation intervention. Cancer. 2007;109(2 Suppl):359–67.CrossRefPubMed
15.
go back to reference Freund KM, Battaglia TA, Calhoun E, et al. Impact of patient navigation on timely cancer care: the Patient Navigation Research Program. J Natl Cancer Inst. 2014;106(6):dju115.CrossRefPubMedPubMedCentral Freund KM, Battaglia TA, Calhoun E, et al. Impact of patient navigation on timely cancer care: the Patient Navigation Research Program. J Natl Cancer Inst. 2014;106(6):dju115.CrossRefPubMedPubMedCentral
16.
go back to reference Thomas AA, Gallagher P, O’Ceilleachair A, Pearce A, Sharp L, Molcho M. Distance from treating hospital and colorectal cancer survivors’ quality of life: a gendered analysis. Support Care Cancer. 2015;23(3):741–51.CrossRefPubMed Thomas AA, Gallagher P, O’Ceilleachair A, Pearce A, Sharp L, Molcho M. Distance from treating hospital and colorectal cancer survivors’ quality of life: a gendered analysis. Support Care Cancer. 2015;23(3):741–51.CrossRefPubMed
17.
go back to reference Fazio L, Cotterchio M, Manno M, McLaughlin J, Gallinger S. Association between colonic screening, subject characteristics, and stage of colorectal cancer. Am J Gastroenterol. 2005;100(11):2531–9.CrossRefPubMed Fazio L, Cotterchio M, Manno M, McLaughlin J, Gallinger S. Association between colonic screening, subject characteristics, and stage of colorectal cancer. Am J Gastroenterol. 2005;100(11):2531–9.CrossRefPubMed
18.
go back to reference White MG, Applewhite MK, Kaplan EL, Angelos P, Huo D, Grogan RH. A tale of two cancers: traveling to treat pancreatic and thyroid cancer. J Am Coll Surg. 2017;225(1):125–136 e126.CrossRefPubMed White MG, Applewhite MK, Kaplan EL, Angelos P, Huo D, Grogan RH. A tale of two cancers: traveling to treat pancreatic and thyroid cancer. J Am Coll Surg. 2017;225(1):125–136 e126.CrossRefPubMed
19.
go back to reference Lidsky ME, Sun Z, Nussbaum DP, Adam MA, Speicher PJ, Blazer DG 3rd. Going the extra mile: improved survival for pancreatic cancer patients traveling to high-volume centers. Ann Surg. 2017;266(2):333–8.CrossRefPubMed Lidsky ME, Sun Z, Nussbaum DP, Adam MA, Speicher PJ, Blazer DG 3rd. Going the extra mile: improved survival for pancreatic cancer patients traveling to high-volume centers. Ann Surg. 2017;266(2):333–8.CrossRefPubMed
20.
go back to reference Riall TS, Townsend CM Jr, Kuo YF, Freeman JL, Goodwin JS. Dissecting racial disparities in the treatment of patients with locoregional pancreatic cancer: a 2-step process. Cancer. 2010;116(4):930–9.CrossRefPubMedPubMedCentral Riall TS, Townsend CM Jr, Kuo YF, Freeman JL, Goodwin JS. Dissecting racial disparities in the treatment of patients with locoregional pancreatic cancer: a 2-step process. Cancer. 2010;116(4):930–9.CrossRefPubMedPubMedCentral
21.
go back to reference Singal V, Singal AK, Kuo YF. Racial disparities in treatment for pancreatic cancer and impact on survival: a population-based analysis. J Cancer Res Clin Oncol. 2012;138(4):715–22.CrossRefPubMed Singal V, Singal AK, Kuo YF. Racial disparities in treatment for pancreatic cancer and impact on survival: a population-based analysis. J Cancer Res Clin Oncol. 2012;138(4):715–22.CrossRefPubMed
Metadata
Title
Oncology Navigation Decreases Time to Treatment in Patients with Pancreatic Malignancy
Authors
Laura M. Enomoto, MS, MD
Joyce Fenstermaker, RN
Rodwige J. Desnoyers, MD
Boris C. Pasche, MD, PhD
A. William Blackstock Jr., MD
Russell M. Howerton, MD
Clancy J. Clark, MD
Edward A. Levine, MD
Perry Shen, MD
Publication date
01-05-2019
Publisher
Springer International Publishing
Keyword
Care
Published in
Annals of Surgical Oncology / Issue 5/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07157-6

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