MP66-20 PATIENT PERSPECTIVES ON THE IMPLEMENTATION OF RISK-ALIGNED CYSTOSCOPIC SURVEILLANCE FOR NON-MUSCLE INVASIVE BLADDER CANCER (NMIBC) - SYSTEMATIC EVALUATION USING THE TAILORED IMPLEMENTATION FOR CHRONIC DISEASES FRAMEWORK

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III (MP66)1 Apr 2020MP66-20 PATIENT PERSPECTIVES ON THE IMPLEMENTATION OF RISK-ALIGNED CYSTOSCOPIC SURVEILLANCE FOR NON-MUSCLE INVASIVE BLADDER CANCER (NMIBC) - SYSTEMATIC EVALUATION USING THE TAILORED IMPLEMENTATION FOR CHRONIC DISEASES FRAMEWORK Florian Schroeck*, Amanda St. Ivany, William Lowrance, Danil Makarov, Philip Goodney, and Lisa Zubkoff Florian Schroeck*Florian Schroeck* More articles by this author , Amanda St. IvanyAmanda St. Ivany More articles by this author , William LowranceWilliam Lowrance More articles by this author , Danil MakarovDanil Makarov More articles by this author , Philip GoodneyPhilip Goodney More articles by this author , and Lisa ZubkoffLisa Zubkoff More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000941.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Many patients living with NMIBC do not undergo surveillance that is aligned with their risk for recurrence or progression, which exposes them to unnecessary risk and burden of procedures. To implement risk-aligned surveillance as recommended by multiple guidelines, we need to understand patient-, provider-, and system-level factors contributing to the delivery of risk-aligned surveillance. This work sought to systematically assess patient-level factors. METHODS: Guided by the Tailored Implementation for Chronic Diseases (TICD) framework, we conducted semi-structured interviews with 22 NMIBC patients undergoing surveillance cystoscopy procedures at 3 facilities within the Department of Veterans Affairs. Patients were sampled using quantitative data on bladder cancer risk category (low vs. high) and on surveillance category (aligned vs. not aligned with cancer risk). Interview transcripts were analyzed using a priori codes from the TICD framework. Quantitative and qualitative data were integrated by cross-tabulating salient themes across risk and surveillance categories. RESULTS: Participants included 7 low-risk and 15 high-risk patients; 10 underwent risk-aligned surveillance and 12 did not. In mixed methods analyses, perception of risk appropriately differed by risk, but not by surveillance category (low-risk: “Right now I don’t think it is [serious]” vs. high-risk: “I do know that I had an aggressive bladder cancer”). Participants understood the recommended surveillance schedule according to their risk category (Table). Participants emphatically expressed that adhering to providers’ recommendations is prudent; intentions to adhere did not vary across risk and surveillance categories (“If I chose not to show up I believe that’s clinically classified as passive suicide”). CONCLUSIONS: Participants intended to adhere to providers’ recommendations and strongly endorsed the importance of adherence. These findings suggest implementation strategies to improve risk-aligned surveillance may be most effective when targeting provider- and system-level rather than patient-level factors. Source of Funding: Conquer Cancer Foundation; Dow-Crichlow Award, Dartmouth-Hitchcock © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e992-e992 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Florian Schroeck* More articles by this author Amanda St. Ivany More articles by this author William Lowrance More articles by this author Danil Makarov More articles by this author Philip Goodney More articles by this author Lisa Zubkoff More articles by this author Expand All Advertisement PDF downloadLoading ...