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2. Oncology providers’ perspectives on endocrine therapy prescribing and management

Author

Wheeler SB, Roberts MC, Bloom D, Reeder-Hayes KE, Espada M, Peppercorn J, Golin CE, and Earp JA

Subjects
breast cancer, endocrine therapy, oncology, oncologist, qualitative interviews, Medicine (General), R5-920
Abstract

Stephanie B Wheeler,1,2 Megan C Roberts,1 Diane Bloom,1 Katherine E Reeder-Hayes,2,3 Maya Espada,1 Jeffrey Peppercorn,4 Carol E Golin,5,6 Jo Anne Earp2,5 1Department of Health Policy and Management, 2Lineberger Comprehensive Cancer Center, 3Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 4Division of Hematology/Oncology, Massachusetts General Hospital, Boston, MA, 5Department of Health Behavior, 6Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Purpose: Adjuvant endocrine therapy (ET) can reduce the risk of recurrence among females with hormone receptor-positive breast cancer. Overall, initiation and adherence to ET are suboptimal, though reasons are not well described. The study’s objective was to better understand ET decision making, prescribing, and patient management from oncology providers’ perspectives.Methods: Using purposive sampling, we recruited oncology providers who saw five or more breast cancer patients per week (n=20). We conducted 30–45-minute telephone interviews, using a semistructured guide to elicit perspectives on ET use. We used thematic content analysis to systematically identify categories of meaning and double-coded transcripts using Atlas.ti.Results: Providers recommend ET to all eligible patients except those with contraindications or other risk factors. Providers base their ET prescribing decisions on the patient’s menopausal status, side effects, and comorbidities. ET is typically discussed multiple times: at the onset of breast cancer treatment and in more detail after other treatment completion. Providers felt that the associated recurrence risk reduction is the most compelling argument for patients during ET decision making. While providers rarely perceived noninitiation as a problem, nonadherence was prevalent, often due to unresolvable side effects.Conclusion: From the clinicians’ perspectives, side effects from ET are the dominant factor in nonadherence. Efforts to improve adherence should focus on strategies to minimize side effects and ensure clinicians and patients are well informed regarding optimal side effect management. This finding has important implications for novel endocrine regimens that offer improved outcomes through longer duration or more intensive therapy. Keywords: breast cancer, endocrine therapy, oncology, oncologist, qualitative interviews

Published
2016

4. The global macroeconomic burden of Alzheimer's disease and other dementias: estimates and projections for 152 countries or territories

Author

Chen, S., Cao, Z., Nandi, A., Counts, N., Jiao, L., Prettner, K., Kuhn, M., Seligman, B., Tortorice, D., Vigo, D., Wang, C., Bloom, D., Chen, S., Cao, Z., Nandi, A., Counts, N., Jiao, L., Prettner, K., Kuhn, M., Seligman, B., Tortorice, D., Vigo, D., Wang, C., and Bloom, D.

Abstract

Background: Alzheimer's disease and other dementias (ADODs) severely threaten the wellbeing of older people, their families, and communities, especially with projected exponential growth. Understanding the macroeconomic implications of ADODs for policy making is essential but under-researched. Methods: We used a health-augmented macroeconomic model to calculate the macroeconomic burden of ADODs for 152 countries or territories, accounting for: the effect on labour supply of reduced working hours of informal caregivers; the effect on labour supply of ADODs-related mortality and morbidity; age-sex-specific differences in education, work experience, labour market participations, and informal caregivers; and treatment and formal care costs diverting from savings and investments. Findings: ADODs will cost the world economy 14 513 billion international dollars (INT$, measured in the base year 2020; 95% uncertainty interval [UI] 12 106-17 778) from 2020 to 2050, equivalent to 0·421% (95% UI 0·351-0·515) of annual global GDP. Japan incurs the largest annual GDP loss at 1·463% (1·225-1·790). China (INT$2961 billion [2507-3564]), the USA (INT$2331 billion [1989-2829]), and Japan (INT$1758 billion [1471-2150]) face the largest absolute economic burdens. The economic burden of informal care ranges from 60·97% in high-income countries to 85·45% in lower-middle-income countries, and treatment and formal care costs range from 10·50% in lower-middle-income countries to 30·80% in high-income countries. Interpretation: The macroeconomic burden of ADODs is substantial and unequally distributed across countries and regions. Global efforts to reduce the burden, especially with regard to informal care, are urgently needed.

Published
2024
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15. Problems

Author

Jones, Lenny, Nomura, Yasutoshi, Bracken, Paul, Kitchen, Edward, Seiffert, Heinz-Jurgen, Klamkin, Murray S., Rabinowitz, Stanley, Rose, Ruby, Bloom, D. M., Anastasiu, Doru Popescu, Csete, Lajos, Konecny, Vaclav, Lord, Nick, Holshouser, Arthur L., Klein, Benjamin G., Andreoli, Michael H., Athanasiadis, Christos, and Lossers, O. P.

Published
1995
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16. Problems

Author

Bloom, D. M., Anastasiu, Doru Popescu, Konecny, Vaclav, Holshouser, Arthur L., Klein, Benjamin G., Athanasiadis, Christos, Klamkin, Murray S., Gulicher, Herbert, Fischer, Ismor, Turcu, Cristian, Blumberg, Walter, Bulman-Fleming, Syd, Callan, David, Pirvanescu, Florin S., Fukuta, Jiro, Campbell-Wright, Randall K., Lord, Nick, Golomb, Michael, and Diao, Yuanan

Published
1994
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17. Problems

Author

Klamkin, Murray S., Gan, Wee Liang, Doster, David, Fukuta, Jiro, Weinstein, Elliott A., Li, Wenbo V., Goffinet, Daniel, Goffinet, Patrick, Friedlander, Richard, Wagon, Stan, Bloom, D. M., Gauchman, Hillel, Rosenholtz, Ira, Martin, Reiner, Demir, Huseyin, Laugwitz, Detlef, Callan, David, and Barrett, David Jonathan

Published
1993
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25. Early Moves: A Protocol for A Population-Based Prospective Cohort Study to Establish General Movements As An Early Biomarker of Cognitive Impairment in Infants

Author

Elliott, C, Alexander, C, Salt, A, Spittle, AJ, Boyd, RN, Badawi, N, Morgan, C, Silva, D, Geelhoed, E, Ware, RS, Ali, A, McKenzie, A, Bloom, D, Sharp, M, Ward, R, Bora, S, Prescott, S, Woolfenden, S, Le, V, Davidson, SA, Thornton, A, Finlay-Jones, A, Jensen, L, Amery, N, Valentine, J, Elliott, C, Alexander, C, Salt, A, Spittle, AJ, Boyd, RN, Badawi, N, Morgan, C, Silva, D, Geelhoed, E, Ware, RS, Ali, A, McKenzie, A, Bloom, D, Sharp, M, Ward, R, Bora, S, Prescott, S, Woolfenden, S, Le, V, Davidson, SA, Thornton, A, Finlay-Jones, A, Jensen, L, Amery, N, and Valentine, J

Abstract

Introduction The current diagnostic pathways for cognitive impairment rarely identify babies at risk before 2 years of age. Very early detection and timely targeted intervention has potential to improve outcomes for these children and support them to reach their full life potential. Early Moves aims to identify early biomarkers, including general movements (GMs), for babies at risk of cognitive impairment, allowing early intervention within critical developmental windows to enable these children to have the best possible start to life. Method and analysis Early Moves is a double-masked prospective cohort study that will recruit 3000 term and preterm babies from a secondary care setting. Early Moves will determine the diagnostic value of abnormal GMs (at writhing and fidgety age) for mild, moderate and severe cognitive delay at 2 years measured by the Bayley-4. Parents will use the Baby Moves smartphone application to video their babies' GMs. Trained GMs assessors will be masked to any risk factors and assessors of the primary outcome will be masked to the GMs result. Automated scoring of GMs will be developed through applying machine-based learning to the data and the predictive value for an abnormal GM will be investigated. Screening algorithms for identification of children at risk of cognitive impairment, using the GM assessment (GMA), and routinely collected social and environmental profile data will be developed to allow more accurate prediction of cognitive outcome at 2 years. A cost evaluation for GMA implementation in preparation for national implementation will be undertaken including exploring the relationship between cognitive status and healthcare utilisation, medical costs, health-related quality of life and caregiver burden. Ethics and dissemination Ethics approval has been granted by the Medical Research Ethics Committee of Joondalup Health Services and the Health Service Human Research Ethics Committee (1902) of Curtin University (HRE2019-0739). Tria

Published
2021

44. Temperature dependence of the photorefractive effect in Bi12GeO20

Author

Bloom, D. and McKeever, S.W.S.

Subjects
Crystals -- Thermal properties, Refraction -- Research, Electrons -- Research, Physics
Abstract

A study was conducted on the temperature dependence of the photorefractive effect in undoped and Ga-doped Bi12GeO20 (BGO) crystals over the temperature of 40 to 300 K. Comparison of the decay curves of the laser-induced grating with thermally stimulated current and photoconductivity curves suggested that the major decay steps were due to the thermal release of trapped electrons from a distribution of traps near 0.3 eV. This indicated that the photorefractive effect in BGO is caused by trapping of electrons at the localized energy states.

Published
1998

46. A Recurrence Generating Multiples of Primes: 10655

Author

Bencze, Mihaly, Saracino, Dan, Stenger, Allen, Amghibech, S., Anglesio, J., Bauer, R., Siegel, A., Bloom, D. M., Body, G. L., Callan, D., Chapman, R. J., Ford, K., Gagola, S. M., Gauthier, N., Grounds, W. V., Hagedorn, T., Koether, R. T., Komanda, N., Krishnan, R. N., Lindsey, J. H., Mattics, L. E., Minh, C. A., Ozsoylev, H. N., Yildirim, C. Y., Poonacha, P. G., Sanjeev, N. R., Robertson, J., Shallit, J. O., Stadler, A., Terr, D. C., Triff, T. V., Trimble, T., and Trojovsky, P.

Published
2000
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48. European Demographic Data Sheet 2020

Author

Sobotka, T., Zeman, K., Spitzer, S., Reiter, C., di Lego, V., Yildiz, D., Özdemir, C., Goujon, A., Binder-Hammer, B., Bloom, D., Fan, V., Kufenko, V., Ogbuoji, O., Prettner, K., Yamey, K., Rowe, F., Bell, M., Bernard, A., Charles-Edwards, E., Scherbov, S., Sobotka, T., Zeman, K., Spitzer, S., Reiter, C., di Lego, V., Yildiz, D., Özdemir, C., Goujon, A., Binder-Hammer, B., Bloom, D., Fan, V., Kufenko, V., Ogbuoji, O., Prettner, K., Yamey, K., Rowe, F., Bell, M., Bernard, A., Charles-Edwards, E., and Scherbov, S.

Published
2020

50. E2467

Author

Reznick, Bruce, Yoder, Michael, Gallin, Daniel, Sturm, Jacob, McCarty, C. P., and Bloom, D. M.

Published
1975
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