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Multi-modality Clinical Trials Tracking Mechanisms UPMC Health System sites (UPMC McKeesport, New Castle, Murtha Cancer Pavilion) Scan UPMC Cancer Centers protocol listings on monthly basis to identify service area patients Navigators will work with on-site department nurses and med-onc protocol nurses to identify patients as they are put on trials Mercy Cancer Institute No multi-modality trials offered Somerset Oncology Center No trials offered at this site to date Remains a challenge 2 0 to infrastructure but progress being made
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CDRP Program UpdateUPMC McKeesport
Program Steering CommitteeRTOG Meeting
Toronto, CanadaJune 23rd, 2006
Overview
Multi-modality & RT trials clinical trialsUPMC Cancer Center InitiativesClinical trials accrualNavigators updateTELESYNERGY updateMentors update
Multi-modality Clinical Trials Tracking Mechanisms
UPMC Health System sites (UPMC McKeesport, New Castle, Murtha Cancer Pavilion)
Scan UPMC Cancer Centers protocol listings on monthly basis to identify service area patients
Navigators will work with on-site department nurses and med-onc protocol nurses to identify patients as they are put on trials
Mercy Cancer InstituteNo multi-modality trials offered
Somerset Oncology CenterNo trials offered at this site to dateRemains a challenge 20 to infrastructure but progress being made
UPMC Cancer Centers Initiative
African American Cancer Care Partnership (AACCP)$750,000 provided by UPMC Health System
4 UPMC sites designated – including UPMC McKeesportProvides payment for initial consult for newly
diagnosed breast, colorectal, lung or prostate cancerOn consult patients are evaluated for clinical trials as well
as needs for resource programs such as Patient NavigatorTo date 8 of 38 patients at the four sites have been entered
on clinical trials!!
All Clinical Trials Distributionby ethnicity (A/A = 14%) May 2006
0
1
2
3
4
5
6
7
8
2004 2005 2006
BlackWhiteHispanicOther
Population by Race* White Black Other Total
Allegheny County 1,069,111 159,112 43,389 1,271,61284% 13% 3% 100%
PA DOH 2001 Estimates
All Clinical TrialsComparison of multi-modality to RT enrollment
0123456789
10
Combo RT
Patients
All Clinical TrialsBy age: A/A (2004 – 2005)
0
1
2
3
4
5
6
7
8
A/A Non A/A
<65=/> 65
All Clinical Trialsby gender – May 2006
0
1
2
3
4
5
6
7
8
2004 2005 2006
MaleFemale
Other Clinical Trials
Patient NavigatorTotal patients: 195African American: 48 (25% over all 5 sites) Hispanic: 2 Asian: 1
ASTRO-Sponsored StudyHow Can Radiation Oncologists Better Serve Their
Patients? A Randomized Study to Determine Whether Radiation Oncologists Can Improve Patient Satisfaction by Attempting to Meet Their Patients’ Preferences (anticipated accrual = 500)
Patient NavigatorMay 2006
0
10
20
30
40
50
60
70
80
Jameson McKeesport Mercy
A/AWhiteHispanicAsian
14% A/A 18% A/A 32% A/A
Evaluation of the Tailored Patient Navigator Programs
for the Underserved Populations with Cancer is a “process” evaluation of a PNPstudy has enrolled 44 African Americans and
130 non-African Americans from the target areas who have a confirmed diagnosis of cancer
174 participants enrolled from January 2005 through May 2006, 32.1% of enrollees within the urban facility were African Americans versus 14.7% at the non-urban facility
52.9%
64.1%
47.1%
35.9%
0%
20%
40%
60%
80%
Under 65 65 and Older
Age
Distribution of Patient Age by Facility
Rural Facility Urban Facility
14.7%
32.1%
82.4%
67.0%
2.9% 0.9%
0%
20%
40%
60%
80%
100%
Black White Other
Distribution of Patient Race/Ethnicity by Facility Type
Rural Facility Urban Facility
26.5%23.6%
14.7%
23.6%
8.8%6.6%
0%
10%
20%
30%
Breast Cancer Lung Cancer Prostate
Distribution of Primary Type of Cancers among Patients Participating in Navigator Programs
Rural Facility Urban Facility
20.6%
16.0% 16.2%
35.8%
7.4%8.5%
0%
10%
20%
30%
Insurance Approval Transportation Co-payment
Primary Barriers to Cancer Treatment by Facility Type
Rural Facility Urban Facility
80
49
57
27
48
32
47
30
25
17
23
16 15
26
15
10
72
63
0
20
40
60
80
Min
utes
Finance Transportation Socialservices
Child services AmericanCancerSociety
Schedule End of life Reach toRecovery
Average timeper patient
Type of Services
Average Time Spent in Various Services by Patient Navigators
Rural Facility Urban Facility
TELESYNERGY®
Continue to formulate ways to integrate its use with mentors, esp. for professional development
System is integral to tumor board @ McKeesport
Streaming video capabilities allows for wider audience participation with teleconferencing
Demo at this meeting
Abstracts Publications Abstracts accepted for ASTRO 2006
A Comprehensive Outcomes-Based Planning and Evaluation Program for Implementing TELESYNERGY® and Other Videoconferencing Approaches in Radiation Oncology –Ed Ricci, PhD
Analysis of “Best Practice” Treatment Patterns for a Radiation Oncology Community Outreach Group (ROCOG) Engaged in Cancer Disparities Outcome-Julian Proctor, MD
Cancer Health Disparities symposium 2006 UPMC McKeesport Radiation Oncology Minorities Community
Outreach Group- Dwight Heron, MD International Intercultural Council 2006
Breaking Barriers: A Navigator Program of Cancer Care for the Underserved Populations-Karen Schwaderer, RN
Academy Health Symposium Evaluation of the Tailored Patient Navigator Programs for the
Underserved Populations with Cancer-Cho Cho Lin, PhD American Telemedicine Association
A Multi-institutional Mobility Initiative for TELESYNERGY® and other Teleconferencing Systems”-Larry Schenken, PhD
4 Manuscripts in preparation at various stages