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  • 1
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2017
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 26, No. 2_Supplement ( 2017-02-01), p. C91-C91
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 26, No. 2_Supplement ( 2017-02-01), p. C91-C91
    Abstract: Background: Human Papillomavirus (HPV) vaccine completion rates in the U.S. are low. Provider recommendation is the most important predictor of vaccine initiation and completion. We sought to understand current practices, perceptions, and likelihood of recommending HPV vaccines among doctors in rural eastern North Carolina. Methods: We distributed a brief 12-item survey to 90 practicing physicians and residents across two community health clinics in eastern North Carolina in March 2015 (44% response rate). The survey asked questions about the likelihood of recommending vaccines to girls and boys of varying ages, comfort in STI discussions, and reasons for not recommending HPV vaccines. Results: Doctors are significantly more likely (p & lt;0.0001) to recommend HPV vaccines to 9-11 year old girls as compared to boys the same age. No significant differences were found for other age groups. Close to half of doctors in our sample (45%) reported to be slightly comfortable, neutral, or not comfortable talking with adolescents about STIs. Doctors who reported being very comfortable in talking with adolescents about STIs were 3.9 times (p & lt;0.05; 1.029-14.996) more likely to recommend the vaccine to 9-11-year-old boys as compared to doctors who reported less comfort. No significant differences were found comfort in talking with adolescents about STIs for girls in the same age group. Conclusion: Results provide a better understanding about specific practices and perceptions regarding HPV vaccines among doctors that may influence their recommendation practices. Our data suggests a need for provider training regarding HPV vaccine recommendation and patient-provider STI communication strategies. Citation Format: Shawna O'Rorke, Essie torres, Alice Richman. Understanding practices, perceptions, and likelihood of recommending the HPV vaccine among doctors in rural eastern North Carolina. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C91.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 2
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2017
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 26, No. 2_Supplement ( 2017-02-01), p. A74-A74
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 26, No. 2_Supplement ( 2017-02-01), p. A74-A74
    Abstract: Background: In recent years, the use of oral chemotherapeutic agents (OCAs) to treat cancer have increased greatly and is expected to continue to increase. According to the World Health Organization, non- adherence with OCAs is the most modifiable factor that can compromise treatment outcomes. WHO estimated that only about 50% of patients take their medications as prescribed, however, adherence varies with compliance rates as low as 16%. The objective of this study is to understand cancer care providers' (oncologists, oncology nurse navigators, and oncologist pharmacists) perspectives regarding challenges patients who are on Oral Chemotherapeutic Agents (OCAs) have adhering to their treatment plans as well as facilitators to adherence. Methods: We conducted 2 focus groups (N= 9) and 2 interviews (N=2), January and February 2016, with 11 cancer care providers practicing in a regional Cancer Center in eastern North Carolina (ENC). The cancer care providers were asked to share their experiences with medication adherence of OCAs among their patient population, and discuss individual-level and structural-level factors that might influence sub-optimal adherence among this population. Participants were also asked about effective strategies they use to help their patients with their medication adherence. Results: The results from this study helped identify and understand the unique factors that contribute to non-adherence to OCAs among the cancer patient population served in ENC. The barriers to adherence to OCAs occur at different levels: policy level (i.e. drug costs and insurance related issues), interpersonal level (i.e. social support, provider communication, and complexity of the regimen), and individual level (i.e. patient related characteristics: education level, health literacy level, anxiety level, and older age). The facilitators identified as increasing adherence to OCAs are: multiple levels of education and reinforcement (i.e. face-to-face, using patient portal system, and repetition of information by cancer care team), social support networks, reminder systems, and nurse navigation program. Cancer care providers reported that utilizing multiple strategies were the most effective in increasing medication adherence among their patient population. Conclusion: This study has identified some modifiable barriers that can help increase medication adherence at multiple levels. The next phase of this study will use results from the formative research phase (identified barriers and facilitators) to develop a tailored nurse coaching intervention component that will significantly improve medication adherence among patients who are at high-risk for non-adherence. Supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this abstract are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. Citation Format: Essie Torres, Alice Richman, Shawna O'Rorke, Paige Field, Lauren Carlston. Cancer Care Providers' Perspectives on Medication Adherence for Cancer Patients on Oral Chemotherapeutic Agents: A Qualitative Assessment. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A74.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
    Library Location Call Number Volume/Issue/Year Availability
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  • 3
    In: Journal of Health Care for the Poor and Underserved, Project MUSE, Vol. 30, No. 4 ( 2019), p. 1499-1517
    Type of Medium: Online Resource
    ISSN: 1548-6869
    Language: English
    Publisher: Project MUSE
    Publication Date: 2019
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  • 4
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2017
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 26, No. 2_Supplement ( 2017-02-01), p. A75-A75
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 26, No. 2_Supplement ( 2017-02-01), p. A75-A75
    Abstract: Background: Oral chemotherapeutic agents (OCAs) are often prescribed to cancer patients during treatment to reduce tumor size, burden of disease, and increase overall survival. Although OCAs are increasingly being used and are commonly preferred by patients, adherence varies with compliance rates as low as 16%. Poor medication adherence encompasses more than patients not taking their medicines as directed. The National Council on Patient Education provided a comprehensive overview of factors that contribute to poor adherence, which include medication-, patient-, prescriber-, pharmacy-related factors. Compounding these issues is low health literacy and transportation barriers that affect timely access to follow-up care which are prominent issues among rural populations. The main objective of this study is to conduct a baseline quantitative assessment to assess baseline medical adherence rates and health literacy among a sample of patients in a regional Cancer Center in Eastern North Carolina. Methods: A baseline survey was created using already validated instruments (Morisky Medication Adherence Scale-8 (MMAS-8), Ask 12, and Realm-Revised). Demographic data includes gender, age, race or ethnicity, highest level of school completed, smart phone possession, type of health insurance, coverage for medication and annual household income. Eligibility criteria included adults over 18 years of age, English-speaking, and currently taking at least one medication in pill-form daily. Surveys were administered to patients in the waiting area in a regional Cancer Center in Eastern North Carolina from March-June 2016. A total of 75 patients completed the baseline survey. Results: Over half of our sample were female (53%), 84% were cancer patients, 49% were African-American and 47% were white, and had a mean age of 59 (SD=13.44). The majority of our sample had a high school education or less (68%), 56% had Medicare/Medicaid, and 72% had an income of less than $40,000 a year. In regards to health literacy, 55% of participants were at risk for poor health literacy. The health literacy is approximately at a fourth grade level or below, and so patients may not be able to read prescription labels, may not be able to read most low-literacy materials; will need repeated oral instructions, materials composed primarily of illustrations, or audio or video tapes. For medication adherence, just over a quarter of our sample fell into the low adherent group (25%), 39% were medium adherent, and a third were highly adherent (32%). This means that the greater majority (64%) fell into the low or medium adherent categories. Conclusion: This study shows that the majority of ENC cancer patients are at risk for poor literacy and have medium to low medication adherence. The next phase of this study will test two telehealth adherence strategies among cancer patients taking OCAs who are at high-risk for non-adherence. We will include multiple levels of education and different education strategies based on each patient's health literacy level and identified barriers to adherence. Supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this abstract are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. Citation Format: Essie Torres, Alice Richman, Shawna O'Rorke, Paige Field, Lauren Carlston. Understanding Baseline Cancer Medication Adherence and Health Literacy among Cancer Patients in Eastern North Carolina. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A75.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2017
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
    Library Location Call Number Volume/Issue/Year Availability
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