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BackgroundHealth care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. ObjectiveThis study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. MethodsA mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. ResultsA total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. ConclusionsData collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. Trial RegistrationAustralia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

Introduction Central Venous Access Devices (CVAD) are critical for the administration of systemic anticancer therapy for patients with haematology cancers. CVADs in this patient cohort have some of the highest CVAD related complications and premature rates in the literature. However, in Victoria these rates and their impact on patient outcomes is unknown. Objectives/Aims This study primarily aimed to describe all reasons for CVAD removal, complications and expenditure. The secondary aim was to identify opportunities to mitigate preventable, premature CVAD removal, to be tested in future healthcare service initiatives. Methods This multi-site, retrospective cohort PhD study collected quantitative data from hospital administrative and health records of adult haematological cancer patients who had a CVAD inserted between 1 September 2020 to 31 August 2021. Data was obtained from numerous sources to maximise data completeness and quality. Analysis included descriptive statistics and regression modelling to identify modifiable predictors for premature removal. Results/Outcomes Of the 1078 CVADs inserted in 673 patients, 503 CVADs (57%) were removed due to expected reasons for removal, 366 (42%) were removed prematurely and 12 (1%) were removed due to unknown reasons. Most CVADs experienced complications (n=919, 85%). This results in increased system and hospital level expenditure. Variances in multidisciplinary management to current evidence were identified. Conclusion This study highlights unacceptably high rates of complications and premature removal of CVADs in patients with haematology cancers. This negatively impacts the patient, hospital and system levels. Opportunities for multidisciplinary initiatives to align clinical practice with current evidence are critical to improve CVAD outcomes in this high risk patient cohort. [ABSTRACT FROM AUTHOR]

Adolescent and Young Adult (AYA) oncology is an internationally recognized established subspecialty in cancer care. Dedicated programs tailored to local environments endeavor to address unique medical, psychological, cognitive, and social needs that historically, health services have been challenged to meet. In recent years there has been a growing appreciation of the challenges facing AYA with incurable cancer and their parent caregivers. While health care professionals recognize the importance of parents' involvement in the care trajectory, there is less understanding of the services needed for support. This scoping review set out to identify and describe evidence available to better understand the services and approaches required from hospital teams to address the needs of parent caregivers and to identify gaps in knowledge to inform areas for further research. The question guiding this review is: What are the service needs of parent carers of AYA with incurable cancer. Using the Arksey and O'Malley scoping review framework, 1009 studies were identified from a broad search of relevant online databases, gray literature, and reference lists of published studies. After removing duplicates and ineligible studies, 492 abstracts were screened. Of these, 421 were ineligible, and 71 articles underwent full-text review. Eight studies were included in the final review. No single study was focused exclusively on parent caregivers of AYA with incurable cancer, demonstrating a paucity of quantitative and qualitative evidence to inform practice and a need for further research in the field. [ABSTRACT FROM AUTHOR]