Health Care Providers Research Articles

Assessing Anaphylaxis: Improving Residents' Identification of a Life-Threatening Condition via a Focused Didactic and Case-Based Discussion.

Anaphylaxis is a life-threatening condition encountered by all physicians and healthcare providers. Data indicate that physicians often fail to recognize this syndrome, leading to misdiagnosis, mismanagement, and adverse outcomes. This educational program aimed to assess knowledge about anaphylaxis in a cohort of internal medicine residents and develop and test the efficacy of an educational intervention in addressing gaps in understanding of this critical condition. An in-person educational intervention, including a lecture and case-based open discussion, was delivered to 44 internal medicine residents at an academic medical center with pre- and post-intervention self- assessments. Our primary outcome was the change in the rate of residents being able to correctly identify critical features of anaphylaxis and appropriate treatment. Longer-term follow-up was completed in a subset of residents to assess knowledge retention. Immediately following the educational intervention, there was increased likelihood of diagnosing anaphylaxis in a written case scenario from 69% to 91% (RR: 1.30; 95% CI 1.09,1.56) and reporting the correct dose and route of administration of epinephrine from 19% to 95% (RR:4.96; 95% CI: 2.26, 10.88). Residents also demonstrated increased identification of cardiovascular compromise in anaphylaxis, as well as often underrecognized gastrointestinal and neurological symptoms after the intervention. In an assessment evaluating longitudinal retention up to 15 months after the intervention, approximately 50% of those who responded to the longitudinal survey correctly recalled the dosing and route of administration of epinephrine for treating anaphylaxis. A brief educational session on anaphylaxis was successful in improving residents' short-term knowledge about diagnosis and treatment of anaphylaxis and may also impact long-term retention.

A Survey on Awareness Regarding Pediatric and Adolescent Gynecology (PAG) Services in Malaysia-Are We Lacking?

A Survey on Awareness Regarding Pediatric and Adolescent Gynecology (PAG) Services in Malaysia-Are We Lacking?

Tackling healthcare provider bias in care and research: A systematic review.

e23222 Background: Despite efforts in oncology to provide personalized and patient-centered care, clinical research lacks real-world representation leading to skewed clinical data and unequal health outcomes. Healthcare provider (HCP) bias can be a cause of this uneven inclusion. We conducted a systematic review on interventions addressing HCP bias as part of a larger project aiming to build a toolkit for inclusion and diversity in oncology research. Methods: Scopus, Cochrane, and PubMed (2004-2024) were searched for English-language studies of interventions targeting HCP bias and cultural competence. Data extraction included participant demographics, intervention components, and outcomes. Oncology-focused studies were analyzed separately to explore intervention content and efficacy within this specific field. Results: A total of 104 studies involving 14,296 HCPs were included, 9 of which focused on oncology. Regarding studies conducted in oncology, 90% (8/9) were conducted in the USA, with predominantly white and female participants and primarily aimed to enhance HCPs’ cultural competence or mitigate racial or gender bias. Intervention components included awareness techniques coupled with educational and/or experiential (interactive activities, live experiences and skill building) learning methods. Outcomes assessed explicit bias, cultural competence, knowledge of healthcare disparities, clinical knowledge related to minority groups, and feasibility. While most interventions resulted in significant short-term improvements in cultural competence and knowledge, changes in attitudes and behaviors were less consistent, with lack of long-term efficacy data. All interventions focusing on mitigating clinical trials inclusion bias among HCP’s were conducted in the oncology setting (4/4), with 2 studies yielding promising results on practical outcomes, such as improved clinical trial accrual rates or recruitment practices. In the full dataset, including studies in non-oncology settings, 97 evaluated short-term and 26 long-term efficacy, with positive results in 75% (73/97) and 70% (18/26) respectively, while 35 evaluated qualitative feasibility metrics. In multivariable analysis, HCP category was associated with lower efficacy (non-physicians vs. all HCPs; OR = 0.08, 95% CI 0.01–0.53, p = 0.009), as was work experience ( > 10y vs. less; OR = 0.02, 95% CI 0.00–1.27, p = 0.065 – data available from 40 studies), albeit marginally. Conclusions: This systematic review describes promising results of interventions focused on reducing HCP bias in research and care in the oncology setting. It also provides learnings from other medical fields that could inform future interventions in oncology, including insights on factors associated with lower efficacy. Future studies should apply standardized methods to evaluate short and long-term outcomes, as well as investigate implementation and engagement challenges.

Caregiver burden and healthcare providers perspectives in epilepsy: An observational study in China, Taiwan, and Argentina.

Caregiver burden and healthcare providers perspectives in epilepsy: An observational study in China, Taiwan, and Argentina.

Inequitable access to PrEP among gay, bisexual, and other men who have sex with men in Canada: A network analysis of social indicators.

Inequitable access to PrEP among gay, bisexual, and other men who have sex with men in Canada: A network analysis of social indicators.

Healthcare provider experiences in managing antibody-drug conjugate dosing adjustments due to nausea and vomiting: SABCS and ESMO survey findings.

e13108 Background: Antibody-drug conjugates (ADCs) such as trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan (SG) have revolutionized breast cancer (BC) treatment, delivering superior efficacy that allows for extended treatment durations. Nausea and vomiting (NV) are among the most frequent adverse effects associated with T-DXd and SG. Persistent nausea can significantly impact patients, negatively affecting their quality of life leading to treatment interruptions, delays, or dose adjustments with potential impact on treatment outcomes. With limited real-world data on ADC dose-intensity adjustments due to NV, surveys of healthcare providers (HCPs) were conducted to assess their experience. Methods: At the 2024 SABCS and 2024 ESMO Congress, HCPs were recruited to complete a short web-based survey in the exhibit hall. Eligible participants included HCPs who used ADCs in clinical practice or clinical trials and were caring for patients with solid tumors. Participants were asked, “How often have you implemented an adjustment (see Table) to ADC treatment due to NV?” Responses included “never,” “rarely,” “sometimes,” “often,” and “always.” Results: A total of 288 HCPs were eligible and participated (90 at SABCS and 198 at ESMO). Most (77%) were oncologists who treated patients with BC. Participants had the most experience with T-DXd and SG. Approximately a third of HCPs had at least sometimes implemented an ADC dose reduction or delay due to NV, while a quarter reported interrupting or discontinuing ADC treatment (Table). Over half of HCPs at least sometimes use rescue medication for NV. Conclusions: Given the increased prominence of ADCs for the treatment of advanced BC, these real-world findings underscore the critical need to optimize NV prevention to reduce dose adjustments or discontinuation. Guideline-recommended NK1 receptor antagonist-based antiemetic prophylaxis may optimize ADCs’ uninterrupted dosing and therapeutic potential. Prospective studies assessing maintenance of dose intensity with optimal antiemetics are needed. SABCS + ESMON = 288 SABCS + ESMON = 288 SABCS only*N = 90 SABCS only*N = 90 SABCS only*N = 90 Implemented Due to Nausea/Vomiting ADC Dose Reduction ADC Dose Delay ADC Dose Interruption ADC Discontinuation Use of Rescue Medication Always 1% 1% 0% 0% 1% Often 6% 5% 8% 6% 16% Sometimes 33% 26% 18% 18% 40% Rarely 35% 36% 42% 31% 34% Never 25% 33% 32% 46% 9% *not asked in the ESMO survey.

Best practices and key barriers for light chain (AL) amyloidosis patient care at US specialized amyloidosis centers: An analysis of ARC-ASPIRE.

e13574 Background: AL (amyloid light chain) amyloidosis is associated with poor prognosis especially if diagnosis occurs with cardiac involvement. Current AL treatments target the plasma cell clone producing the light chains that misfold, aggregate and deposit in various tissues. The multi-organ manifestations of AL amyloidosis require a multidisciplinary care team of hematologist-oncologists, cardiologists, and other healthcare providers (HCPs) for comprehensive, patient-centric management. Since 2022, Amyloidosis Stakeholder Partnerships for Impact, Reach & Equity (ASPIRE), facilitated by Amyloidosis Research Consortium (ARC) has been bringing together biotech and pharmaceutical companies with the shared goal of optimizing amyloidosis patient care. Through this study, ARC-ASPIRE sought to document and share the current best practices and key barriers to patient-centric amyloidosis care at US specialized amyloidosis centers (SACs). A broad range of stakeholders in amyloidosis care – healthcare providers at SACs, patients, referring physicians, and patient advocacy group representatives – were interviewed for this study. This abstract presents findings relevant to the management of patients with AL amyloidosis. Methods: Structured interviews were conducted between December 2023 and February 2024 with 77 amyloidosis stakeholders (physicians, advanced practice providers, registered nurses from 17 SACs, patients, referring physicians, and patient advocacy group representatives), including 12 hematology-oncologists and 8 AL patients. SACs were selected to be representative of current US amyloidosis care, based on geography, amyloidosis patient volume, years since establishment, and types of amyloidosis treated. Results: Three-quarters of participating SACs treat AL patients under a single multidisciplinary amyloidosis program. Multidisciplinary care is facilitated by regular team meetings, dedicated clinic days, and informal communications across specialties. At diagnosis, collaboration between cardiology and hematology-oncology ensures AL patients are accurately diagnosed and promptly treated. Sixty percent of SACs have a centralized intake system, and patients suspected with AL are prioritized to ensure an appointment within 1 week of referral. Key barriers were delayed or missed diagnosis due to low awareness of AL amyloidosis within community oncologists, travel burden to SACs, lack of seamless medical records sharing and telehealth regulations. Conclusions: The best practices outlined in this study serve to educate AL amyloidosis and non-AL amyloidosis HCPs for better multidisciplinary collaboration and early diagnosis. The key barriers identified should be addressed to improve patient care.

Screening and Interventions for Intimate Partner Violence in Pregnancy: The Perspective of Survivors.

Screening and Interventions for Intimate Partner Violence in Pregnancy: The Perspective of Survivors.

Fertility preservation in young breast cancer patients: A nationwide survey on knowledge, attitudes, and practices among breast surgical healthcare providers in China.

Fertility preservation in young breast cancer patients: A nationwide survey on knowledge, attitudes, and practices among breast surgical healthcare providers in China.

Outpatient Diuretic Use and Respiratory Outcomes in Children with Bronchopulmonary Dysplasia During the First Three Years of Life.

Outpatient Diuretic Use and Respiratory Outcomes in Children with Bronchopulmonary Dysplasia During the First Three Years of Life.

Patient and healthcare providers' perspectives on participation in a postpartum pilot trial of venous thromboembolism prophylaxis: a qualitative study.

Patient and healthcare providers' perspectives on participation in a postpartum pilot trial of venous thromboembolism prophylaxis: a qualitative study.

Occurrence rate and risk factors for rest and procedural pain in critically ill patients: A systematic review and meta-analysis.

Occurrence rate and risk factors for rest and procedural pain in critically ill patients: A systematic review and meta-analysis.

International competencies of nurses with advanced practice in anesthesia nursing: An integrative review.

International competencies of nurses with advanced practice in anesthesia nursing: An integrative review.

Artificial Intelligence in Paediatric Cancer: Insights from Innovation Experts in the UNICA4EU Project

Artificial Intelligence in Paediatric Cancer: Insights from Innovation Experts in the UNICA4EU Project

Geriatric patients' views on a pharmacist-led follow-up programme after discharge from hospital.

Geriatric patients' views on a pharmacist-led follow-up programme after discharge from hospital.

The Use of Pharmacogenomics in Cardiovascular Care.

The Use of Pharmacogenomics in Cardiovascular Care.

Medical provider perspectives on children with incarcerated parents: A mixed-methods study.

Medical provider perspectives on children with incarcerated parents: A mixed-methods study.

Is Less More? Maximizing Outcomes by Tailoring Treatments to Patients: Oncofertility and Oncomenopause.

Notable advances have been made in improving survival outcomes in various cancers, but some have incurred undesirable costs and effects to patients with respect to fertility and menopause. Patients are living longer with cancer, and patient reported outcomes are influencing decision-making by individuals and their health care providers. It is essential to evaluate existing standards of care on an ongoing basis and prioritize quality of life and long-term survivorship, particularly for interventions in early-stage cancers and risk-reducing strategies that often yield long-term life expectancy.

Needs of bereaved families of patients with cancer towards artificial intelligence in palliative care: A web-based survey.

Needs of bereaved families of patients with cancer towards artificial intelligence in palliative care: A web-based survey.

Identifying the landscape and contribution of advanced nurse practitioners in supporting healthcare provision in Ireland in the 21st century: An integrative review.

Identifying the landscape and contribution of advanced nurse practitioners in supporting healthcare provision in Ireland in the 21st century: An integrative review.