■综合肿瘤学[IO]受到患者的追捧,得到临床指南的认可,并在国家癌症研究所中心内受到重视。共享医疗预约[SMA]利用健康教育和社会联系来提供增强的患者体验。人口健康,降低成本,和临床医生的福祉。综合肿瘤学共享医疗任命增加了对综合医疗的访问,但尚未评估通过远程医疗提供这些服务。
■我们创建了,和飞行员测试了虚拟综合肿瘤学共享医疗预约系列(VIOSMAS)以评估其可行性,可接受性,和效率在城市学术教学医院。
■为期7个小时的癌症和癌症之后的生活系列包括教学法,多学科体验式会议,和小组讨论。主题包括(1)介绍,(2)草药/植物药/真菌,(3)正念运动,(4)针灸,(5)叙事与自然,(6)饮食和烹饪医学,和(7)维生素/补充剂。在大流行期间,通过远程医疗提供了虚拟访问,以增强患者的参与。成果措施包括征聘、保留,系列前/后患者调查和定性临床医生反馈。
■在2021年9月至2023年4月之间,72名独特患者被招募到5个队列中,总共进行了332次VIOSMAS访问。共有50名患者(69%)参加了7个疗程系列中的4个或更多;60名(83%为女性);患者年龄从28岁到93岁(中位数66岁);36名(50%)居住在市中心以外;最常见的癌症诊断是乳腺癌,淋巴瘤还有肺癌.患者来自不同的人口统计学。预编程,患者报告希望帮助解决包括疲劳在内的各种症状,失眠,疼痛,胃肠道(GI)症状,焦虑,和抑郁症。后系列,患者报告说,VIOSMAS解决了他们的目标和症状;他们还报告了在饮食中纳入推荐的生活方式改变,锻炼,睡眠,和压力管理;他们对会议次数和远程医疗格式感到满意。参与的临床医生报告对VIOSMAS的满意度很高。VIOSMAS对该机构的收入超过了个人就诊时间的收入潜力,同时支持长期的医患联系。
■VIOSMAS对患者和临床医生是可行的,解决患者的症状和有关生活方式和补充疗法的问题,并产生比个人访问更多的收入。建议使用适当的对照组进行较大的实施试验。
UNASSIGNED: Integrative oncology [IO] is sought-after by patients, endorsed by clinical guidelines, and valued within National Cancer Institute Centers. Shared Medical Appointments [SMA] leverage health education and social connection to deliver enhanced patient experience, population health, cost-reduction, and clinician well-being. Integrative Oncology Shared Medical Appointments increase access to integrative medicine but delivering these services via telehealth have not been evaluated.
UNASSIGNED: We created, and pilot tested a Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) to assess its feasibility, acceptability, and efficacy at an urban academic teaching hospital.
UNASSIGNED: The 7-session hour-long Living Well with and after Cancer series included didactics, multi-disciplinary experiential sessions, and group discussion. Topics included (1) Introduction, (2) Herbs/Botanicals/Fungi, (3) Mindful Movement, (4) Acupuncture, (5) Narratives and Nature, (6) Diet and Culinary Medicine, and (7) Vitamins/Supplements. Virtual visits via telehealth were offered to enhance patient participation during the pandemic. Outcome measures included recruitment, retention, pre/post-series patient survey and qualitative clinician feedback.
UNASSIGNED: Between 9/2021 and 4/2023, 72 unique patients were recruited to 5 cohorts and had a total of 332 VIOSMAS visits. A total of 50 patients (69%) attended 4 or more of the 7-session series; 60 (83% were women); patients ranged in age from 28 to 93 years (median 66); 36 (50%) lived outside the city center; the most common cancer diagnoses were breast, lymphoma, and lung cancer. Patients were from diverse demographics. Pre-program, patients reported desiring assistance in addressing diverse symptoms including fatigue, insomnia, pain, gastrointestinal (GI) symptoms, anxiety, and depression. Post-series, patients reported that the VIOSMAS addressed their goals and symptoms; they also reported incorporating recommended lifestyle changes in diet, exercise, sleep, and stress management; they were satisfied with the number of sessions and telehealth format. The participating clinicians reported high levels of satisfaction with VIOSMAS. Revenue to the institution from VIOSMAS exceeded the revenue potential of equivalent time spent for individual visits while supporting extended physician-patient contact.
UNASSIGNED: VIOSMAS is feasible for patients and clinicians, addresses patients\' symptoms and questions about lifestyle and complementary therapies, and generates more revenue than individual visits. Larger implementation trials with appropriate comparison groups are recommended.