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Angela Meredith Criswell



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    MA17 - New Methods to Improve Lung Cancer Patients Outcomes (ID 918)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Nursing and Allied Professionals
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 13:30 - 15:00, Room 205 AC
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      MA17.02 - Early Accrual to a Precision Lung Cancer Survivorship Intervention: The Kentucky LEADS Collaborative Lung Cancer Survivorship Care Program (ID 14179)

      13:35 - 13:40  |  Author(s): Angela Meredith Criswell

      • Abstract
      • Presentation
      • Slides

      Background

      Recent advances in early detection and treatment of lung cancer have created a need for survivorship care interventions to reduce the psychosocial and symptom burden of lung cancer, but few interventions address the unique experience of lung cancer survivors and their caregivers. Leveraging shared decision making and motivational interviewing, the Kentucky LEADS Collaborative developed a precision psychosocial intervention addressing the unique experiences and challenges of individuals diagnosed with lung cancer and their caregivers. This sub-study describes the demographic, diagnostic, and psychosocial characteristics of the initial participants in the Kentucky LEADS Collaborative Lung Cancer Survivorship Care Program.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Participants include 61 lung cancer survivors across 9 lung cancer care sites in Kentucky, USA. Data were drawn from baseline surveys of demographic characteristics, disease/treatment information, symptom burden, psychosocial functioning and quality of life administered to lung cancer survivors and caregivers enrolled in the single-arm intervention trial.

      4c3880bb027f159e801041b1021e88e8 Result

      Of the first 61 LC survivors enrolled, 32 had a caregiver join them as participants in the intervention (53%). Participants had a mean age of 62 years. Approximately 20% of LC survivors did not have a caregiver available to participate, and 27% declined to invite a caregiver join the program. Most participating caregivers were spouses (63%), but siblings (10%) and children (19%) were also included. Most survivors were female (66%), Caucasian (97%), and covered by health insurance (95%), and 59% were married or living in a committed relationship. Most participants had been diagnosed with non-small cell lung cancer (84%) and late-stage disease (IIIB-IV; 53%). Most participants had a history of smoking (95%); 30% had smoked within the past 30 days, and 29% were current smokers. Among current smokers, participants reported very high levels of quit planning (9.23±2.77) and quitting confidence (9.14±2.89). Finally, approximately 55% reported clinically significant distress, with a mean level of distress of 3.98 (2.99) on a scale from 0-10.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Early accrual to the trial has exceeded expectations. Most survivors had advanced disease and reported significant distress. A substantial minority continued to use tobacco. Data suggest that modifications made to the survivorship approach emphasizing empathy and patient preference may help improve intervention acceptability and feasibility. Subsequent analyses will evaluate the impact of the intervention on quality of life, psychosocial functioning, and symptom burden. Data will also be collected regarding acceptability of the intervention and potential program changes to optimize benefits.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P3.11 - Screening and Early Detection (Not CME Accredited Session) (ID 977)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.11-04 - Trends and Barriers in Lung Cancer Screening Implementation Across the United States. (ID 13925)

      12:00 - 13:30  |  Author(s): Angela Meredith Criswell

      • Abstract
      • Slides

      Background

      In 2010, the National Lung Screening Trial was halted after showing a 20% reduction in mortality for high risk individuals when three years of annual lung cancer screening was performed by low dose computed tomography(NEJM, 2011). Many questions remained about whether screening could be properly implemented in non-academic, community settings. Lung Cancer Alliance developed a National Framework for Excellence in Lung Cancer Screening and Continuum of Care in 2012 and began a nationwide network dedicated to responsible lung cancer screening. The Screening Center of Excellence (SCOE) designation requires a center to ensure shared decision-making, comply with best practice standards, work with a multidisciplinary care team, deliver or refer for smoking cessation, provide results in a timely manner, and meet technical specifications set by the American College of Radiology. Our aim is to promote high-quality, responsible lung cancer screening throughout the United States, including in community settings where most lung cancer is diagnosed.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      From 2012 through 2017, over 500 centers were designated as SCOEs. These centers represented 42 states and more than 60% were from community/non-academic centers. High-risk individuals who come to the Lung Cancer Alliance website or contact the organization by phone to find a screening center are directed to a SCOE. A data collection effort in 2017, being repeated in 2018, collected comprehensive information about the state of lung cancer screening and care at the SCOEs. Nearly 70% of SCOEs responded to the 2017 survey.

      4c3880bb027f159e801041b1021e88e8 Result

      The SCOE program data shows that screening is being performed widely across the United States, including in non-academic centers. For centers who were able to provide numbers of screenings performed and diagnoses, we identified a clear trend in diagnosis of Stage 1 lung cancer, indicating these screenings are able to find lung cancer early. We also identified a number of implementation challenges around referral patterns, insurance and billing, and determining appropriate risk criteria. Rates of adherence to both annual scans and recommended follow-up varied widely across different institutions indicating a key area of focus for future implementation research.

      8eea62084ca7e541d918e823422bd82e Conclusion

      We have shown that a patient advocacy group working with medical professionals can help deliver high quality care to a broad population. Data collection from the SCOEs provides a snapshot of the state of lung cancer screening in the United States that underscores the success of screening and the importance of early detection but also identifies barriers in implementation that still need to be addressed.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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