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Objective: Suicide remains a serious health problem in the United States and worldwide. Despite changing distributions in sex, race-ethnicity, and age and considerable efforts to reduce the incidence rate, the number of suicides has remained relatively stable. The transition from emergency services to outpatient services is a crucial but often neglected step in treating suicidal individuals. Up to 50% of attempters refuse recommended treatment, and up to 60% drop out after only one session. This point of intervention is crucial for patients at elevated risk of suicide to reduce imminent danger and to increase the chances that patients will follow up on recommended treatment. Methods: PubMed, MEDLINE, and PsycINFO databases were searched for empirical investigations of treatment engagement of suicide attempters. Keywords searched included treatment, intervention, engagement, adherence, compliance, utilization, participation, and suicide attempt. Mapped terms were also included. Thirteen articles were selected. Results: Studies that have examined the effectiveness of postdischarge contact with suicide attempters (phone, letter, and in-person visits) to increase treatment adherence have found some immediate effects after substantial contact that were not sustained. Simple referrals to outpatient care were not effective. Family group interventions for adolescents have improved adherence, as have brief interventions in the emergency department. Conclusions: Despite greater public awareness of suicide, heightened prevention effort, and increased efficacy of treatment interventions, success in reducing suicidal behavior has been limited. Developing brief interventions for use in emergency settings that can reduce suicide risk and enhance treatment follow-up has been a neglected aspect of suicide prevention and may help to reduce suicidal behavior. [ABSTRACT FROM AUTHOR]

Objectives. We compared the quality of care received by managed care Medicaid beneficiaries in counties with a choice of health plans and counties with no choice. Methods. This cross-sectional study among California Medicaid beneficiaries was conducted during 2002. We used a multivariate Poisson model to calculate adjusted rates of hospital admissions for ambulatory care--sensitive conditions by duration of plan enrollment. Results. Among beneficiaries with continuous Medicaid coverage, the percentage with 12 months of continuous enrollment in a health plan was significantly lower in counties with a choice of plans than in counties with no choice (79.2% vs 95.2%; P<.001). Annual ambulatory care--sensitive admission rates adjusted for age, gender, and race/ethnicity were significantly higher among beneficiaries living in counties with a choice of plans (6.58 admissions per 1000 beneficiaries; 95% confidence interval [CI]=6.57, 6.58) than among those in counties with no choice (6.27 per 1000; 95% CI=6.27, 6.28). Conclusions. Potential benefits of health plan choice may be undermined by transaction costs of delayed enrollment, which may increase the probability of hospitalization for ambulatory care--sensitive conditions. [ABSTRACT FROM AUTHOR]

The article presents information on a study which investigated the sex-specific incidence rate and prevalence of heart failure (HF) from 2000 to 2005 in adults ages 18 years old and older. It identifies the predictors of incident HF in women and men. The incidence rates and predictors of HF diagnosed in outpatient contrasted with inpatient settings are compared. It concludes that common modifiable risk factors accurate differentiate women and men at risk for HF diagnosed in either outpatient or inpatient settings.

The objective of this study is to investigate how blood pressure is measured in different outpatient clinics. This is a retrospective study performed with 1,000 patients, randomly selected among patients followed in different outpatient clinics in Fortaleza, Brazil. Among the 1,000 patients, 962 had available records. The older the patient, the greater the possibility of having had blood pressure measured. In subsequent visits, blood pressure was measured more often than in the first visits. Blood pressure was measured more often among patients with chronic disease. The specialty with the highest proportion of blood pressure measurement was cardiology (85%). At the surgery, dermatology and traumatology clinics, blood pressure was measured in less than 5% of visits, and at the ophthalmology, sexually transmitted diseases, psychiatry, proctology and otolaryngology clinics, blood pressure was not measured in any visit. Cardiology, endocrinology, nephrology, geriatrics and internal medicine were the specialties where blood pressure was more frequently measured. It is important to measure blood pressure in any medical specialty in order to give early diagnosis of hypertension and provide adequate blood pressure control. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Aim and objectives. To assess the psychometric characteristics of the Icelandic European Organisation for Research and Treatment of Cancer IN-PATSAT32 (EORTC IN-PATSAT32) version and to compare satisfaction with care between gender and different age groups. Background. The majority of patients with cancer receive either chemotherapy or radiotherapy on an outpatient basis. There is a need to evaluate satisfaction with care and service for these patients using reliable and valid instruments. Design. Cross-sectional comparative study. Method. Participants ( n = 217) who received treatment for cancer as outpatients answered the EORTC IN-PATSAT32 questionnaire. Participants were 22–91 years old and 57% of them were female. Results. Overall high satisfaction was found with communication, information and care that patients receive from doctors and nurses. Principal component analysis extracted four factors: ‘satisfaction with nurses’ conduct’, ‘satisfaction with doctors’ conduct’, ‘satisfaction with information’ and ‘satisfaction with service and care organisation’. Patients were most satisfied with nurses’ conduct but least satisfied with service and care organisation. Cronbach’s alpha for the four factors ranged from 0·95–0·67. Conclusion. Although the validity of this instrument including its sensitivity to patients’ level of dissatisfaction as well as satisfaction with care and service was evident, this needs to be further explored in future studies. The psychometric strengths of the EORTC IN-PATSAT32 are its internal consistency and its construct validity, but there are several issues indicating a need to change and develop the instrument and specifically adopting it to outpatient care. Relevance to clinical practice. Outpatient treatment options offered to cancer patients have increased, and this calls for knowledge of their satisfaction with care and service. Sparse studies are available, and there is a need for further development of reliable instruments. Our study indicates that outpatients with cancer are quite satisfied with the care they receive. Findings may contribute to improvement in outpatients’ clinics that provide treatment to patients with cancer. [ABSTRACT FROM AUTHOR]

OBJECTIVE: There are widespread concerns about disparities in mental health treatment for ethnic minority groups. However, previous research in this area has been limited mainly to the United States and Great Britain, raising doubts about the external validity with respect to other European countries. This study addressed ethnic differences in characteristics of outpatient treatment for depression in the Netherlands. METHODS: Longitudinal data (2001-2005) were extracted from a nationwide psychiatric case register. The sample consisted of 17,270 episodes of outpatient depression care. Information was available about timeliness of the initial treatment contact, treatment intensity, dropout, and early reregistration for mental health care. Data were analyzed with linear, logistic, and Cox regression analyses. RESULTS: When analyses were controlled for illness and demographic characteristics, timeliness and treatment intensity were somewhat less favorable for Moroccan, Turkish, and other non-Western clients compared with ethnic Dutch. No significant differences were found between minority and ethnic Dutch groups in dropout and early reregistration. Some treatment characteristics were in fact more favorable for Surinamese and Antillean clients compared with ethnic Dutch. CONCLUSIONS: The data provided insufficient support for the idea that treatment characteristics are generally less favorable for clients from ethnic minority groups. This finding may be related to the promotion of culturally sensitive approaches to care in mainstream mental health services but may also indicate that the role of traditional barriers, like stigma and taboo, is smaller than is usually suggested. However, the influence of language proficiency, which is notably better among Surinamese and Dutch Antillean compared with Turkish and Moroccan clients, should not be disregarded. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined the infection control practices among ambulatory surgical centers (ASCs) in the U.S. The study included three U.S. states that were selected based on geographic dispersion, number of ASCs to inspect and relative cost per inspection. ASCs that were inspected were from Maryland, North Carolina and Oklahoma. They were assessed on five areas, namely hand hygiene, injection safety and medical handling, environmental cleaning, equipment reprocessing and handling of blood glucose monitoring equipment. Study authors discovered lapses in infection control, such as using single-dose medication vials for more than one patient and failing to comply to recommended reprocessing of equipment.

Objective. This study was undertaken to determine the average relative dose intensity (RDI) of chemotherapy administered to patients in a community-based outpatient cancer center. Methods. A retrospective review of medical records in an outpatient cancer center was conducted for patients initiating systemic chemotherapy in 2007 for a diagnosis of lymphoma, breast, lung, ovary, or colon cancer. Eighty-four records meeting the inclusion criteria were reviewed for demographic information, primary tumor type, chemotherapy regimen, staging at diagnosis, presence of disease progression, and mortality status. Regimen data included: chemotherapeutic agents used, dosages administered, dates of administration, treatment intent (adjuvant vs. metastatic), and granulocyte colony-stimulating factor (G-CSF) usage per cycle. Mean summary statistics were calculated and average RDI was analyzed. Results. The overall RDI at our institution was 83% (n=65). The RDI for those receiving adjuvant chemotherapy was 85% (n=51), whereas for those receiving chemotherapy for metastatic disease the RDI was 76% (n=14). Fifty-four percent (n=35) of the regimens met or exceeded the recommended minimum goal RDI of ⩾ 85%. Conclusions. Overall the average RDI at our institution was 83%, slightly below the goal of ⩾ 85%. Patients with potentially curable malignancies receiving adjuvant chemotherapy reached the threshold RDI; however, areas for quality improvement exist at our institution. [ABSTRACT FROM AUTHOR]

The article focuses on the study regarding the assessment on faith and religious beliefs of outpatients in a military population. It says that the study conducted a cross-sectional survey using 670 outpatients at a military medical center. Furthermore, the study reveals that 87% of the respondents endorses a Christian religious affiliation, 81% believes in God and 42% attends religious services once a week or more and suggests that outpatients should have pastoral care and counseling services.

Colonoscopies are often performed in children for diagnostic and therapeutic purposes. Our study compared two bowel-cleansing solutions: sodium picosulphate, magnesium oxide, and citric acid (Pico-Salax) with liquid magnesium citrate as preparations for colonoscopy. A retrospective chart review of all patients seen in the Gastroenterology outpatient clinic and who underwent bowel cleansing in preparation for colonoscopy from February to December 2006 was undertaken. Thirty-two children received Pico- Salax and 36 received liquid magnesium citrate. The tolerability of both solutions was similar. Most children in both groups had liquid stools and complete colonoscopies. Bowel preparation for a colonoscopy can be successfully achieved using either Pico-Salax or liquid magnesium citrate. [ABSTRACT FROM AUTHOR]

Objectives: The emergency department (ED) is not the ideal setting for dermatologic care, but may be widely used, especially among disadvantaged ethnic minorities. This study was performed to characterize the role of the ED in providing dermatologic care for each racial and ethnic group in the United States.Methods: We analyzed visits from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey from 1993 to 2010. Settings (office-based, outpatient department or ED), diagnoses and race/ethnicity were assessed to compare usage of the ED across groups.Results: Usage of the ED for dermatologic conditions increased over time (p < 0.0001). EDs were more often used for dermatologic care of black (18.3%) and Hispanic (10.5%) patients than for white patients (5.9%) and were used most in rural or small metropolitan areas.Conclusions: Providing better insurance, more dermatologists in rural areas and better dermatologic training for family physicians may help improve care for underserved populations and reduce inappropriate use of the ED. [ABSTRACT FROM PUBLISHER]

The article discusses a randomised trial of adults with non-traumatic out-of-hospital cardiac arrest from ambulance services in Great Britain. It references a research by Gavin Perkins and colleagues published in the journal "The Lancet." Topics discussed include higher rates of return of spontaneous circulation and survival with the use of mechanical cardiopulmonary resuscitation (CPR) devices and low device usage rate due to difficulties in device use, unknown reasons and non-compliance.

Objectives: The study examined availability of psychiatrists for outpatient appointments in three U.S. cities. Methods: Posing as patients, investigators called 360 psychiatrists listed in a major insurer's database in Boston, Houston, and Chicago (N=120 per city) and attempted to make appointments. Callers claimed to have Blue Cross Blue Shield or Medicare or said they would pay out of pocket (N=120 per payer type, divided evenly across cities). Results: In round 1 of calling, investigators were able to reach 119 of the 360 psychiatrists (33%). Of 216 unanswered calls, 36% were returned. After two calling rounds, appointments were made with 93 psychiatrists (26%). Significant differences were noted between cities but not between payer type. Conclusions: Obtaining outpatient appointments with psychiatrists in three cities was difficult, irrespective of payer. Results suggest that expanding insurance coverage alone may do little to improve access to psychiatrists-or worse, expansion might further overwhelm the capacity of available services. [ABSTRACT FROM AUTHOR]

Omphalolith is a benign umbilical growth, uncommonly reported in literature. The author managed one such lesion in a 43-year-old male. The patient was asymptomatic and was treated with complete evacuation on outpatient basis. [ABSTRACT FROM AUTHOR]

We compared emergency department and ambulatory care syndromic surveillance systems during the pandemic (H1N1) 2009 outbreak in New York City. Emergency departments likely experienced increases in influenz-alike-illness significantly earlier than ambulatory care facilities because more patients sought care at emergency departments, differences in case definitions existed, or a combination thereof. [ABSTRACT FROM AUTHOR]

Summary: Purpose: Where population-based studies of epilepsy mortality are impossible to conduct, other sources of data must be considered. We provide descriptive data on mortality and causes of death for epilepsy in Taiwan. Methods: Two settings in Taiwan were used. First, we evaluated the mortality ratio for epilepsy, using the national vital statistics for 1996 with the total population of Taiwan as the denominator. Second, we evaluated mortality in a cohort of prevalent epilepsy cases from a University outpatient clinic. For both, proportionate mortality was calculated to determine the relative contributions of different causes of death in epilepsy. Results: One hundred and sixty-two deaths were correctly coded under ICD code 345 from the 1975 detailed diagnostic listing during the 1-year period of 1996. Epilepsy was the diagnosis in 0.8 deaths/100,000 population. Over an 11-year period, there were 54 deaths (0.9%) among 1,224 prevalent epilepsy cases from a University clinic during 5,704 person-years of follow-up. The most common underlying cause of death was epilepsy-related death in 129 (79.6%) out of 162 deaths from the vital statistics data. There were 13 deaths unrelated to epilepsy (8.0%). Acute reactive seizure as the cause of death was found in 9 patients (5.6%). The leading cause of death in the epilepsy clinic was disease unrelated to epilepsy in 21 deaths (38.9%), epilepsy-related death in 12 patients (22.2%), and death related to the cause of epilepsy in 9 patients (16.7%). Conclusion: Data derived from vital statistics are inadequate to evaluate mortality in people with epilepsy. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the prevalence of scrofuloderma and cutaneous tuberculosis in Erzurum, Turkey and surrounding areas from 1975-2005. Several variables are considered including patients with tuberculosis who visited outpatient clinics, mean age of patients, localization of lesions and mean duration of lesions. The efficacy of using the Mantoux test and bacterial cultures in the diagnosis of the disease is discussed.

The authors discuss research by E. U. Hakemi and colleagues on the identification of low-risk patients with acute pulmonary embolism (PE) who can be treated safely outside the hospital. They said that the researchers showed an incremental added value of highly sensitive cardiac troponin (hs-cTnI) levels to imaging studies, electrocardiograms (ECG) and clinical prediction scores. They also mentioned the benefits of the outpatient management of low-risk PE patients.

The authors content that effective therapies can improve the annual mortality risk among outpatients with heart failure and reduced ejection fraction. Topics discussed include clinical trials which showed a high risk for adverse outcomes after discharge among patients hospitalized for heart failure and complication in the diagnosis and management of heart failure due to the lack of specific diagnostic criteria and clear pathophysiology.

The author conveys his thoughts concerning a critical evaluation of approaches to outpatient monitoring. Topics discussed and mentioned also include the three general approaches to outpatient monitoring, the primary benefit of patient reported outcomes, and information on quantifying self-hybrid models.

Objectives: To determine the frequency of using the potentially toxic combination of methotrexate and trimethoprim-sulfamethoxazole (TMP-SMX) in outpatient practice in the United States. Methods: Data from the National Ambulatory Medical Care Survey for 1993-2010 were used to assess the frequency of using methotrexate with TMP-SMX and associated physician specialties and diagnoses. Results: TMP-SMX was coprescribed in 22,000 methotrexate visits per year (1.0% of methotrexate visits). Pediatricians prescribed the combination most frequently, and the most common diagnosis was acute lymphoblastic leukemia. There was no significant change over time in coprescription of TMP-SMX with methotrexate (P = 0.4). Conclusions: Low-dose TMP-SMX with methotrexate chemotherapy appears to be standard for patients with acute lymphoblastic leukemia; however, other uses appear questionable, and clinicians should be cognizant of the risk for fatal interactions, especially when medications are prescribed by multiple providers. [ABSTRACT FROM AUTHOR]

The article presents the result of a cross-sectional random satisfaction survey of schizophrenics in Nigeria from July-September 2011. The survey covers various issues including the use of the Charleston Psychiatric Outpatient Satisfaction Scale, the score obtained for assessing helpfulness of the services received, staff-patient interactions and perceptions of the value and quality of care provided. The impact of the shortage of physicians on patient care is discussed.

The article discusses the evolution and development of hemato-oncological approach for ambulatory care. The revolution in hemato-oncological care wherein more patients received ambulatory care is outlined. Increase in ambulatory hemato-oncological care use through different courses is noted. The significance of effective and safe anti-emetic therapy as a prerequisite for ambulatory care is also pointed out.

The article presents a simple systematic care procedure for premature infants seeking follow-up care in the outpatient department. Topics discussed include the challenges faced by parents of former neonatal intensive care unit (NICU) infants and their doctors related to follow-up care, the process observed when conducting physical examination on NICU graduate infants and the important role played by healthcare workers on the care of high-risk infants.

The article discusses a study that empirically measured outpatient care tasks associated with the provision of primary care in an entire year in a large group of academic general internists. The study showed that aside from a typical face-to-face episode of care, non visit care by general internists leads to a substantial workload that is not recognized and accounted for. The increased workload inevitably results in longer work hours which have been shown as key drivers for burnout.

The article offers information on several biomedical studies related to primary care medicine. Among the studies discussed include one by a research team from Northern Ireland examining the predictors of contact with healthcare services prior to suicide, one by Norwich researchers in England which aims to investigates the impact of rhinosinusitis on sleep quality, work productivity and mental health, and one by researchers from Imperial College London on urgent care centres (UCCs).

The article discusses the study conducted by L. Diwaker and colleagues which evaluated the effectiveness of outpatient versus inpatient treatment of common gynecological problems. Topics covered include the need to train physicians to understand the system-wide implications of their treatment decisions and the importance of encouraging the provision of incentive and reimbursement plans to reduce direct and indirect costs associated with procedures.

While it is generally accepted that patient quality of life issues play a major role in quality cancer treatment, currently, the literature lacks evidence-based assessments relative to patient satisfaction with the ambulatory method of chemotherapy infusion. The purpose of this study is to determine if adult cancer patients using ambulatory chemotherapy infusion devices are satisfied with this outpatient method of medication delivery. Additional questions explored are the impact of daily quality of life issues on patients, gender and age differences, and the implications on nursing standards of care for ambulatory chemotherapy infusion. Unlike generations of Americans that have gone before, baby boomers are conditioned to expect convenience, choice, and service. It is reasonable to assume that as a group they will continue to value and demand enhanced customer services as they age. The data presented will be beneficial to healthcare providers in facilitating ethical decision-making and will contribute to further advancements in the efficacy of and patient satisfaction with cancer treatment methods. An additional, critical goal of this study was to analyze and gauge geriatric and gender special population subgroup survey data to support the formulation of acceptable clinical practice outcomes. A closer examination of these special population groups will be significant to determining the appropriate method of chemotherapy infusion for their particular needs. A total of 480 on-call support surveys and 480 patient satisfaction surveys were mailed to patients over the period of June 2003 through May 2005. 226 on-call surveys were returned for a 47% response rate; 124 patient satisfaction surveys were returned for a 26% response rate. The study also includes special geriatric and gender population information. The results were NULL in relation to the hypothesis. The study found that the satisfaction rates for both patient satisfaction and on-call support surveys were high. The patient cohort sampled were principally representative of a group born between the years of 1921 to 1945; however, it is acknowledged that these individuals share a different demographic profile than will be presented by future patients, the Baby Boomers. After comparing age and gender satisfaction differences amongst those surveyed and reviewing Baby Boom generation demographics, the study concludes that increased emphasis should be placed on surveying to uncover future patient expectations and lifestyle needs. [ABSTRACT FROM AUTHOR]

The article suggests that outpatient treatment for substance abuse disorders helps recovery and discusses sample of inpatients who received treatment within 30 days of discharge. Data from the Truven Health MarketScan Commercial Claims and Encounters Database (2001-2012) is analyzed. The Healthcare Effectiveness Data and Information Set (HEDIS), which tracks outpatient treatment given to psychiatric inpatients after discharge, is discussed.

Purpose: Recent literature reports that patients and parents of pediatric patients prefer their physician to wear a white coat and to address them informally. This study aims to characterize current practice patterns of pediatric ophthalmologists regarding their use of white coats and salutations during outpatient pediatric encounters. Methods: An eight-question survey was e-mailed to members of the American Academy of Pediatric Ophthalmology and Strabismus in 2012. The questions focused on clinical setting, use of white coats in out-patient encounters, and preferred language used to address the patient's parents. Surveys not completed in full were excluded from data analysis. Results: Of approximately 1,266 members who received the survey, 606 completed the survey. Five hundred ninety-nine surveys were included in the data analysis. Sixty-three percent of attending physicians and 80% of fellows reported they did not routinely wear white coats while examining outpatient children. Forty-six percent of attending physicians and 48% of fellows addressed the patient's parents as "mom" or "dad". There was no significant association between wearing a white coat and type of practice setting, practice characteristics, or location in a children's hospital for attending physicians or fellows. Conclusions: Contrary to preferences expressed by patients and their parents, a majority of pediatric ophthalmologists do not routinely wear white coats during pediatric outpatient examinations. Practice patterns appear to be in line with previously reported parental greeting preferences. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study that estimated the rate of depression screening in the U.S. outpatient office setting. It used the data from the National Ambulatory Medical Care Survey (NAMCS), an annual cross-sectional survey of visits to office-based physicians. Some limitations of the NAMCS included the lack of record whether sampled offices have adequate staff for screening and follow-up care.

The article discusses research on the prevalence of amenorrhea among outpatients with eating disorders. It references a study by Giovanni Abbate-Daga and colleagues, published in "Eating & Weight Disorders." Study authors concluded that amenorrhea cannot be used to predict the severity of an eating disorder. They added that amenorrhea has little prognostic value in patients with eating disorders.

Heart rate variability (HRV) analysis is an established method to characterize the autonomic regulation and is based mostly on 24h Holter recordings. The importance of short-term HRV (less than 30 min) for various applications is growing consistently. Major reasons for this are the suitability for ambulatory care and patient monitoring and the ability to provide an almost immediate test result. So far, there have been only a few studies that provided statistically relevant reference values for short-term HRV. In our study, 5 min short-term HRV indices were determined from 1906 healthy subjects. From these records, linear and nonlinear indices were extracted. To determine general age-related influences, HRV indices were compared from subjects aged 25–49 years with subjects aged 50–74 years. In a second approach, we examined the development of HRV indices by age in terms of age decades (25–34, 35–44, 45–54, 55–64 and 65–74 years). Our results showed significant variations of HRV indices by age in almost all domains. While marked dynamics in terms of parameter change (variability reduction) were observed in the first age decades, in particular the last two age decades showed certain constancy with respect to the HRV indices examined. [ABSTRACT FROM AUTHOR]

The article offers information on a study which examined the effect of continuous positive airway pressure (CPAP) on 24-hour ambulatory blood pressure monitoring values in patients with obstructive sleep apnea and new onset of untreated systemic hypertension. A description of the study design is offered. Main outcome measures include net changes in the different 24 hour ambulatory blood pressure monitoring values from baseline to three months of optimal or fake CPAP. An overview of the research findings is presented.

As a harbinger of possibly deleterious changes, cognitive impairment can alert the oncology provider into the need for medically important interventions. Symptoms of cognitive impairment may be distressing, profoundly impact an individual's quality of life, and should be openly and routinely communicated in cancer care settings. The purpose of this study was to describe the incidence of self-reported cognitive dysfunction or distress in a sample of ambulatory patients with cancer and to evaluate the nature of the clinical discussions between patients and their providers regarding patient-reported cognitive changes experienced during their disease and treatment trajectory. The Quality Health Outcomes Model guided our approach to this study. This model illustrates how aspects of the healthcare system mediate patient outcomes. A secondary analysis was performed with data collected in a larger randomized trial. Specifically, scores for cognitive symptoms on the EORTC QLQ C-30 Cognitive Function subscale and Symptom Distress Scale were evaluated for threshold levels, and corresponding audio- recordings of clinic visits were content-analyzed. Cognitive symptom reports of dysfunction or distress were found in 36 (19%) of a sample of 187 patients from hematopoietic cell transplant, radiation-oncology, and medical oncology ambulatory care settings, 4-6 weeks after treatment initiation. Content analysis of 31 recorded outpatient visits at this time period revealed minimal communication about cognitive function in which only 2 patients or family members provided unsolicited cognitive symptom information. The providers did not initiate assessment for cognitive symptoms in any participant nor did they intervene to address the symptoms when they became apparent during the patient-provider dialogue. Funding Sources: National Institutes of Health R01 NR 008726 [ABSTRACT FROM AUTHOR]