Number Of Clinicians Research Articles

Location, Location, Location- Impact Of Introducing A Local Clinic On Clients’ Waiting Time, Travel Time And Cost

Abstract Background Comprehensive Geriatric Assessment (CGA) is the first, essential step to develop and implement a coordinated and integrated plan for older persons’ care. The National Clinical Programme for Older People recommends that older adults identified as being frail or at risk of frailty should have a timely CGA performed (HSE 2012). This pilot quality improvement project relates to a recently established (June 2023) Integrated Care Programme for Older Persons (ICPOP) team. As our current office lies in a different county to our clients’ homes, all CGAs have been domiciliary to date. This project aims to investigate if running a clinic closer to clients’ homes could result in earlier CGA and reduce travel time and cost. Methods Three CGA-pilot clinics occurred over six weeks (29thFebruary-11thApril 2024 inclusive). Clients’ addresses, Clinical frailty Scale (CFS), average waiting time six weeks prior to and during the CGA-clinic period was recorded. Staffing was unchanged during data collection. Distance between office and clients’ homes was calculated using Google Maps. Travel time was calculated on the same weekday at the same time as CGA-clinics ran. As clinicians tend to conduct consecutive visits, unidirectional distances only were populated. National Integrated Staff Records and Pay Programme system was used to calculate mileage cost. Results Of twelve clients that confirmed their appointment, eleven clients attended clinic (92% attendance rate). All were frail or at risk of frailty (CFS ≥4). Average waiting time reduced from 28 days to 23 days post introduction of CGA-clinic. Clinicians saved a total of 3 hours 38 minutes, and 44.31 euro was saved on mileage. Conclusion Pilot shows the benefits of offering in-clinic CGA closer to home in terms of reducing waiting time, optimising clinician time and reducing cost. Client satisfaction and numbers of clinicians seen will be included in the next steps of this ongoing project.

Geographic variation in point of care ultrasound provision: results from a national audit

BackgroundThere is an emerging consensus that point-of-care ultrasound is an essential skill in acute care. This is reflected in recent changes to the Acute Internal Medicine curriculum in the UK. The need to develop and maintain specific ultrasound competencies is now a mandatory component of training. There is a degree of uncertainty as to how existing training infrastructure can best accommodate these changes.MethodsData were obtained from the latest annual Society for Acute Medicine Benchmarking Audit 2021. All Acute Medical Units in the UK are eligible to participate. Data pertaining to the number of ultrasound machines and number of clinicians that regularly use point of care ultrasound were collected. This was used to develop a series of maps demonstrating variation in provision at the national level.ResultsIn total, 123 AMUs responded to the questions related to ultrasound prevalence and numbers of trained clinicians. Of these, 78.9% (97/123) reported having access to at least one ultrasound machine. There was at least one clinician that regularly used ultrasound in 81 responding hospitals (65.9%). There was significant geographic heterogeneity in the use of ultrasound and availability of accredited supervisors. At a regional level, ultrasound expertise is typically concentrated within a relatively small number of hospitals.ConclusionGeographic variation in the use of ultrasound and availability of registered supervisors represents a significant challenge to ultrasound training provision at the national level. Targeted interventions in areas with less developed training infrastructure, such as regional training hubs may be required to ensure more equitable access to training opportunities.

Understanding clinician connections to inform efforts to promote high-quality inflammatory bowel disease care.

Highly connected individuals disseminate information effectively within their social network. To apply this concept to inflammatory bowel disease (IBD) care and lay the foundation for network interventions to disseminate high-quality treatment, we assessed the need for improving the IBD practices of highly connected clinicians. We aimed to examine whether highly connected clinicians who treat IBD patients were more likely to provide high-quality treatment than less connected clinicians. We used network analysis to examine connections among clinicians who shared patients with IBD in the Veterans Health Administration between 2015-2018. We created a network comprised of clinicians connected by shared patients. We quantified clinician connections using degree centrality (number of clinicians with whom a clinician shares patients), closeness centrality (reach via shared contacts to other clinicians), and betweenness centrality (degree to which a clinician connects clinicians not otherwise connected). Using weighted linear regression, we examined associations between each measure of connection and two IBD quality indicators: low prolonged steroids use, and high steroid-sparing therapy use. We identified 62,971 patients with IBD and linked them to 1,655 gastroenterologists and 7,852 primary care providers. Clinicians with more connections (degree) were more likely to exhibit high-quality treatment (less prolonged steroids beta -0.0268, 95%CI -0.0427, -0.0110, more steroid-sparing therapy beta 0.0967, 95%CI 0.0128, 0.1805). Clinicians who connect otherwise unconnected clinicians (betweenness) displayed more prolonged steroids use (beta 0.0003, 95%CI 0.0001, 0.0006). The presence of variation is more relevant than its magnitude. Clinicians with a high number of connections provided more high-quality IBD treatments than less connected clinicians, and may be well-positioned for interventions to disseminate high-quality IBD care. However, clinicians who connect clinicians who are otherwise unconnected are more likely to display low-quality IBD treatment. Efforts to improve their quality are needed prior to leveraging their position to disseminate high-quality care.

Analysis of US County Characteristics and Clinicians With Waivers to Prescribe Buprenorphine After Changes in Federal Education Requirements

This cross-sectional study investigates the growth in the number of clinicians in the US who obtained waivers for prescribing buprenorphine after the elimination of federal educational requirements.

Prevalence and predictive factors for infertility-related stress among infertile couples: A cross-sectional study from Jordan and the occupied Palestinian territories.

To assess the level of infertility-related stress, associated socio-economic, and demographic factors among infertile couples living in Jordan and those living under the chronic Israeli-Palestinian conflict in the occupied Palestinian territories. A cross-sectional study was carried out in a number of fertility and reproductive clinics in Jordan and occupied Palestinian territories over a period of 6 months. Trained clinical pharmacists interviewed the identified couples. A total of 443 participants were interviewed. Three variables were significantly and independently associated with global stress scores. The need of parenthood appears higher in women than men among infertile couples in Jordan and Palestine (p=0.005). The country of origin (p<0.001) made the greatest contribution of unique variance followed by family type (p=0.035). Additionally, a significant contribution to the model was carried out by the number of clinicians who followed up on the case (p=0.013). The average total cost of treatment since the problem had been diagnosed was 2936±4529 Jordanian dinar, which may be of concern to both Jordanians and Palestinians given the limited resources available in developing nations. This study shows a significant degree of stress among infertile couples. The place of origin, family structure, and presence of medical insurance had a significant impact on the infertility global stress score. This study emphasizes the necessity for specific psychological therapies that are currently lacking in public healthcare practices in both Jordan and Palestine.

Review of investigational medical devices' clinical trials and regulations in Africa as a benchmark for new innovations.

Medical technologies present a huge potential in improving global health playing a key role toward achieving Sustainable Development Goal 3 by 2030. A number of clinicians, innovators, business entities and biomedical engineers among others have developed a number of innovative medical devices and technologies to address the healthcare challenges especially in Africa. Globally, medical devices clinical trials present the most acceptable method for determining the risks and benefits of medical device innovations with the aim of ascertaining their effectiveness and safety as compared with established medical practice. However, there are very few medical device clinical trials reported in Africa compared to other regions like USA, UK and Europe. Most of the medical device clinical trials reported in Africa are addressing challenges around HIV/AIDS, maternal health and NCDs. In this mini review, we report about some of the published medical device clinical trials in Africa PubMed and Google Scholar and their associated challenges.

AWARENESS, INTEREST AND LIMITING FACTORS IN MEDICAL RESEARCH: MEDICAL STUDENTS PERSPECTIVE IN A NORTH INDIAN MEDICAL COLLEGE

Introduction: In recent times there is decline in the number of clinicians involved in research activities all over the world including India. A medical student having the knowledge of scientific concepts along with his clinical experience can serve a key role in the advancement of medical science. Introduction of research methodology at an early stage will help medical students to inculcate the aptitude of evidence-baseddecision-making in their clinical practice. Methods: We designed a cross-sectional study, in which 198 students (98 female and 100 male) from the 1st year M.B.B.S batch of Pt. B.D. Sharma Post Graduate institute of medical sciences, Rohtak, Haryana, India, completed a self-administered questionnaire to assess their awareness, interests and possible limitations in medical research. Results: Out of 198 students, more females were aware about the scope of research in medical education than males. Females showed more interest in participating in Under Graduate research projects as compared to males. Lack of time and burden of studies were considered limiting factors more in females than males Students coming from rural background were lagging behind the ones from urban background in their awareness and interest in research. Conclusion: Though majority of students were aware and showed interest in participating in research activities, lack of time and burden of studies were the major limiting factors in their research participation.

Interactions in Sociotechnical Systems: Achieving Balance in the Use of an Augmented Reality Mobile Application.

We explore relationships between barriers and facilitators experienced by users to understand dynamic interactions in sociotechnical systems and improve a mobile phone-based augmented reality application that teaches users about the contents of a standardized pediatric code cart. Understanding interactions between performance obstacles and facilitators can provide guidance to (re)designing sociotechnical systems to improve system outcomes. Clinicians should know about contents and organization of code carts, and an augmented reality mobile application may improve that knowledge but changes the sociotechnical system in which they learn. Prior work identified barriers and facilitators impacting the use of this application-participants described dimensions together, indicating interactions that are explored in the current study. We conducted four focus groups (number of clinicians = 18) and two interviews with clinicians who used the application. We performed a secondary analysis of focus group data exploring interactions between previously identified barriers and facilitators to application use. We used epistemic network analysis to visualize these interactions. Work system barriers interacted with barriers and facilitators interacted with facilitators to amplify cumulative negative or positive impact, respectively. Facilitators balanced barriers, mitigating negative impact. Facilitators also exacerbated barriers, worsening negative impact. Barriers and facilitators interact and can amplify, balance, and exacerbate each other-notably, positives are not always positive. To obtain desired outcomes, interactions must be further considered in sociotechnical system design, for example, the potential improvements to the application we identified.

Increased Number of Colorectal Interval Cancers in Lynch Syndrome after the SARS-CoV-2 Pandemic: A Survey-Based Study

Background: Hereditary colorectal cancer syndromes require timely endoscopic surveillance. Methods: This study evaluated the approach of Italian gastroenterologists to the management of such patients. It then assessed the impact of SARS-CoV-2. All members affiliated with the leading Italian gastroenterology societies (AIGO, SIED, and SIGE) received an online questionnaire. Results: One hundred and twenty-one clinicians from 96 centers answered, not necessarily experts in the field (mean age 50.26 ± 11.22 years). Many collected family history for genetic risk assessment (74.4%), but only 14.0% used an online predictive software. 65.6% discussed cases in multidisciplinary units. Genetic analysis was available to most centers, but only a few hospitals offered dedicated endoscopy (19.0%), outpatient clinics (33.9%), or surgeries (23.1%). Since the start of the SARS-CoV-2 pandemic, the number of clinicians with a high volume of patients decreased (from 38.8% to 28.1%). Almost half of the responders (45.5%) reported a delay in the surveillance (median: 4–12 months). Ultimately, 30.6% detected one interval colorectal cancer in at least one of their patients. Conclusion: The SARS-CoV-2 pandemic directly affected the surveillance of hereditary colorectal cancer syndromes in Italy. Endoscopic surveillance should resume in all centers to avoid the possible long-term consequences of its interruption, especially for inherited colorectal cancer syndromes.

\u201cThere hasn\u2019t been a career structure to step into\u201d: a qualitative study on perceptions of allied health clinician researcher careers

BackgroundThere are many demonstrated benefits for health service organizations engaging in research. As a result, growing numbers of clinicians are being encouraged to pursue research as part of their clinical roles, including in allied health (AH). However, while the benefits of having clinician researchers embedded in AH services have been well established, the career needs of those engaged in these dual roles are poorly understood. The aim of this study was to examine perspectives of the career pathway for AH clinicians engaged in “clinician researcher” roles within Australian health services.MethodsA qualitative descriptive study was conducted, utilizing semi-structured interviews. Purposive sampling was used to ensure selection of varied locations, professions and role types. Results were analysed using thematic analysis. Trustworthiness was established using regular peer debriefing during theme development, and respondent validation of final themes.ResultsFifty-seven AH clinician researchers, including those who did and did not have research as a formal component of their current role, participated in semi-structured interviews. Key themes were as follows: (1) clinician researchers prefer roles which are embedded in health services; (2) current opportunities for clinician researcher roles in health are insufficient; (3) there are deficiencies in the pathway for clinician researcher careers; (4) clinician researchers are not always valued or incentivized by health services; (5) the current career challenges impair the viability of clinician researcher careers; and (6) the clinician researcher career path has been improving, and there is hope it will continue to improve.ConclusionThis study outlines a number of weaknesses in the current career structure and opportunities for AH clinician researchers in Australian health services. In particular, while there are strong intrinsic drivers to pursue this dual career, extrinsic drivers are poorly developed, including a lack of job opportunities, an unstable career pathway and a lack of valuing or incentivizing this career choice within health services. This often means that clinician researchers feel compelled to choose between a research or clinical career, leading to loss of this valuable combined skill set. The findings of this research may assist health services in developing and supporting improved clinician researcher career pathways.

Incidence and Factors Related to Endodontic Flare Up - A 1-year Retrospective Study

Background: Endodontic flare up is a common complication of endodontic treatment that results from acute exacerbation of pulpal and peri-radicular pathosis; leading to unscheduled emergency visits that is disturbing for both clinicians and patients. Flare up causes are multifactorial that includes microbial, host, chemical and mechanical factors. Objective: The aim of this retrospective study was to evaluate the incidence and identify risk factors of flare up in a multispecialty dental and maxillofacial center over a period of one year from February 2019 to February 2020. Methods: Data was collected from 323 teeth belonging to 272 patients that completed their root canal treatment on multiple sessions during the evaluation period. The samples were classified based on inclusion criteria and variables according to teeth type; age; sex; pulpal and periapical pathosis; presence of intracanal medication between visits; and absence of coronal seal. Results: The incidence of flare up was 122(38%), the evaluated variables did not show statistical significance in any of the evaluated parameters. Conclusion: The incidence of flare up is widely diverse and may be due to a variety of reasons; and therefore, the management of flare up in each dental facility is different and varies according to their setup; number of clinicians and specialists available. Continuous training and skills improvement for clinician in charge of managing emergency patients with flare up is highly recommended. Keywords: Dental Emergencies; Flare up; Infection; Inflammation; Risk factors; Root canal treatment

A Review of the Clinician's Role in Women's Weight Management and Implications for Women's Health and Pregnancy Outcomes.

Ten years have passed since the Institute of Medicine (IOM) released its recommendations for gestational weight gain (GWG), based on a woman's prepregnancy body mass index. Despite this, the majority of women do not gain the appropriate gestational weight; most women gain too much weight, and a small but substantial number gain too little. We review the literature concerning GWG, the opinions and practices of clinicians in managing their patients' weight, and how these practices are perceived by patients. We also review several randomized control trials that investigate the efficacy of clinical intervention in managing GWG. A literature review search was conducted with no limitations on the number of years searched. The number of clinicians who are aware of and use the IOM recommendations has increased, but the prevalence of inappropriate GWG has not decreased. Clinicians report feeling less than confident in their ability to have an impact on their patients' weight gain, and there are discrepancies between what clinicians and patients report regarding counseling. Many randomized control trials demonstrate a beneficial impact of clinical intervention, highlighting the importance of collaboration and technology to provide educational information and support throughout a pregnancy. Pregnancy provides an opportunity for clinicians to have open and direct conversations with their patients about their weight. Providing clinicians with the tools, skillset, and confidence to assist in the management of GWG is essential to the health of women and their children, and warrants further investigation.

Minimal Residual Disease in Myeloma: Application for Clinical Care and New Drug Registration.

The development of novel agents has transformed the treatment paradigm for multiple myeloma, with minimal residual disease (MRD) negativity now achievable across the entire disease spectrum. Bone marrow-based technologies to assess MRD, including approaches using next-generation flow and next-generation sequencing, have provided real-time clinical tools for the sensitive detection and monitoring of MRD in patients with multiple myeloma. Complementary liquid biopsy-based assays are now quickly progressing with some, such as mass spectrometry methods, being very close to clinical use, while others utilizing nucleic acid-based technologies are still developing and will prove important to further our understanding of the biology of MRD. On the regulatory front, multiple retrospective individual patient and clinical trial level meta-analyses have already shown and will continue to assess the potential of MRD as a surrogate for patient outcome. Given all this progress, it is not surprising that a number of clinicians are now considering using MRD to inform real-world clinical care of patients across the spectrum from smoldering myeloma to relapsed refractory multiple myeloma, with each disease setting presenting key challenges and questions that will need to be addressed through clinical trials. The pace of advances in targeted and immune therapies in multiple myeloma is unprecedented, and novel MRD-driven biomarker strategies are essential to accelerate innovative clinical trials leading to regulatory approval of novel treatments and continued improvement in patient outcomes.

P007 Service evaluation of the nurse-led telephone advice line in the wake of COVID-19: a report of audit and staff satisfaction

Background/Aims The Rheumatology nurse advice line (NAL) at the Royal National Hospital for Rheumatic Diseases (RNHRD, Bath) provides a vital service for direct patient access to specialist advice via a designated voicemail system. Increasing numbers and difficulty connecting call returns have increased staff workload, reduced efficiency and impacted on staff satisfaction. An audit was therefore undertaken to evaluate service use and efficiency, paired with formal assessment of staff satisfaction in order to identify areas for improvement. Methods The total number of monthly calls through the NAL during 2020 were counted. A subset of consecutive calls were audited in detail, documenting temporal parameters in relation to the call being logged, returned and concluded. The number of clinicians and attempts required to contact the patient was noted. An anonymised staff satisfaction questionnaire was completed by NAL nurses and administrators. Data was analysed using Excel. Results An average 653 calls per month (range 340-894) came through the NAL between January and September 2020. 97 consecutive patient contacts were audited from August 2020. Multiple attempts were required to successfully return the call in 19.6% of cases (n = 19/97). Of those, 68.4% (n = 13/19) of calls needed ≥ 2 nurses to contact the patient. In general, the first attempt to return the call was prompt (average 7.6 hours, range 0.1-27.7). However, the time to conclude the call from the patient’s first call log ranged from 0.1 - 142.6 hours (average 12.7 hours) with increased time associated with difficulties contacting the patient or when further advice was required from a Rheumatology doctor (18.5%, n = 18/97).Staff surveys revealed 67% of staff felt that the NAL is a good service to offer patients. However, 67% of staff did not feel the NAL in its current format was easy to manage. Specific comments included that the lack of rota'd responsibility, unpredictable workload and time inefficiencies were barriers to managing the service. Conclusion From this data, we conclude that patient calls are returned promptly, but utilising a system of voicemail and unscheduled call returns is inefficient and contributes to staff dissatisfaction. This data has driven change for service improvement. To improve efficiency, calls will be answered live by an administrator during working hours and patients given a call-back time. A doctor will be named as a single point of contact for the nurses to seek additional advice and a nurse rota will designate responsibility for NAL calls to reduce work-load uncertainty. Follow up service evaluation will include staff and patient satisfaction questionnaires, and repeat audit, with consideration of ways to support frequent service users. Disclosure J. Day: None. J. Ball: None. J. Down: None. R. Sengupta: None. V. Flower: None.

Utilization of biological variation data in the interpretation of laboratory test results - survey about clinicians' opinion and knowledge.

IntroductionTo interpret test results correctly, understanding of the variations that affect test results is essential. The aim of this study is: 1) to evaluate the clinicians’ knowledge and opinion concerning biological variation (BV), and 2) to investigate if clinicians use BV in the interpretation of test results.Materials and methodsThis study uses a questionnaire comprising open-ended and close-ended questions. Questions were selected from the real-life numerical examples of interpretation of test results, the knowledge about main sources of variations in laboratories and the opinion of clinicians on BV. A total of 399 clinicians were interviewed, and the answers were evaluated using a scoring system ranked from A (clinician has the highest level of knowledge and the ability of using BV data) to D (clinician has no knowledge about variations in laboratory). The results were presented as number (N) and percentage (%).ResultsAltogether, 60.4% of clinicians have knowledge of pre-analytical and analytical variations; but only 3.5% of them have knowledge related to BV. The number of clinicians using BV data or reference change value (RCV) to interpret measurements results was zero, while 79.4% of clinicians accepted that the difference between two measurements results located within the reference interval may be significant.ConclusionsClinicians do not use BV data or tools derived from BV such as RCV to interpret test results. It is recommended that BV should be included in the medical school curriculum, and clinicians should be encouraged to use BV data for safe and valid interpretation of test results.

Open Surgical Guides – A Novel Concept in Computer Guided Implantology

Dental implants have become so popular that more than 5 million implants are placed each year by dentists in the United States alone. However, it is generally observed that a majority of implants are placed in a less-than-ideal manner. Computer-guided surgeries are proven to have a positive impact on implant placement as well as implant treatment planning. But, despite the indisputable compensations, only a partial number of clinicians regularly practice directed transplant surgery nowadays. This article aims to examine the challenges in guided implant surgery and how a novel concept of the open guide is trying to solve these issues. The latter was used during a CT scan and was eventually converted into an actual surgical guide. However, using conventional guides is not a guarantee for proper implant placement. The reason for that was inherent in their design. Conventional guides take marvelous leeway in the drilling trajectory and no drilling depth control. Using them relies on several variables that may not be trustworthy, such as hand stability, patient immobility, and another person’s feedback on the drilling angle. Bone quality can also affect the osteotomy in situations of immediate implant placement, as the drills commonly bounce off dense bone affecting the angulation and point of entry. From a safety perspective, conventional guides do not consider the patient’s relevant anatomy.

Implementation of a Scholarly Activity Program in a Small Academic Medical Center Department.

Small departments within academic medical centers have fewer numbers of clinicians, less time devoted to research, and fewer staff with senior faculty academic ranks available as mentors. This report describes the rationale behind Mayo Clinic's Department of Dental Specialties' scholarly activity program, implemented to combine mentorship with scholarship provided in a variety of formats. Program objectives focused on providing mentorship, disseminating existing scholarship, and bringing a diversity of scholarly activities into departmental mainstream.

Practice level factors associated with enhanced engagement with practice facilitators; findings from the heart health now study

BackgroundPractice facilitation is a promising strategy to enhance care processes and outcomes in primary care settings. It requires that practices and their facilitators engage as teams to drive improvement. In this analysis, we explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month practice facilitation intervention focused on implementing cardiovascular prevention activities in practice. Understanding factors associated with greater engagement with facilitators in practice-based quality improvement can assist practice facilitation programs with planning and resource allocation.MethodsOne hundred thirty-six ambulatory care small to medium sized primary care practices that participated in the EvidenceNow initiative’s NC Cooperative, named Heart Health Now (HHN), fit the eligibility criteria for this analysis. We explored the practice and facilitator factors associated with greater team engagement at the mid-point of a 12-month intervention using a retrospective cohort design that included baseline survey data, monthly practice activity implementation data and information about facilitator’s experience. Generalized linear mixed-effects models (GLMMs) identified variables associated with greater odds of team engagement using an ordinal scale for level of team engagement.ResultsAmong our practice cohort, over half were clinician-owned and 27% were Federally Qualified Health Centers. The mean number of clinicians was 4.9 (SD 4.2) and approximately 40% of practices were in Medically Underserved Areas (MUA). GLMMs identified a best fit model. The Model presented as odd ratios and 95% confidence intervals suggests greater odds ratios of higher team engagement with greater practice QI leadership 17.31 (5.24–57.19), [0.00], and practice location in a MUA 7.25 (1.8–29.20), [0.005]. No facilitator characteristics were independently associated with greater engagement.ConclusionsOur analysis provides information for practice facilitation stakeholders to consider when considering which practices may be more amendable to embracing facilitation services.

Patients' perspectives on methods of assessing pain

Pain questionnaires often serve as an assessment tool for initial consultations in chronic pain clinics. The Pain Management Unit (PMU) is a tertiary care centre in Halifax, Nova Scotia. A number of clinicians in the PMU have noted that some patients express that questionnaires are time consuming to complete and believe they are not used in a manner that is helpful to their health care. The effectiveness of questionnaire-based pain evaluation is an area of active research. Text-heavy questionnaires have been criticized for their reliance on literacy and for the format’s inability to facilitate patient self-expression. Other methods of assessing pain have been suggested, including those that use pictograms, photographs and technology. This study was designed to gauge patients’ opinions on the current pain assessment method used in the PMU. In addition, it aimed to evaluate if incorporating art and technology appealed to current patients. The ultimate goal of this study was to evaluate if improvements could be made to patients’ pain assessment experience. Thirty patients were interviewed following their initial consultation appointments at the PMU. Interviews were transcribed verbatim and analyzed using NVivo Software to look for themes expressed by research participants. The study yielded a total of 20 different themes, such as repetition within the questionnaires, and the patient’s desire to incorporate different technologies such as an iPad or computer. Recommendations are proposed based on these themes to help guide the creation or modification of pain assessment tools.

Treatment patterns in pancreatic cancer: Differences between expert and community practitioners.

e19207 Background: Expanding systemic therapy options continue to improve outcomes for patients (pts) with pancreatic cancer (PCa) in both the unresectable and resectable disease settings. We developed an online treatment (Tx) decision support tool designed to provide community healthcare providers (HCPs) with case-specific recommendations from 5 PCa experts. Here, we report an analysis of cases entered into the tool by HCPs, comparing their planned Tx with expert recommendations and assessing the impact of those recommendations on intended HCP Tx decisions. Methods: In July 2019, 5 expert panelists provided Tx recommendations for numerous distinct PCa cases. To use the tool, HCPs entered specific pt/disease factors along with their intended Tx plan for the case, after which they received expert Tx recommendations followed by a survey asking if the recommendations had changed their planned Tx course. Results: 251 HCPs entered 347 pt cases into the tool (83% by physicians). 68% of respondents reported treating &lt; 15 pts with PCa per yr, and 60% sought recommendations for a specific pt. Variance was observed between experts and HCPs for cases in several Tx settings (Table); eg, although FOLFIRINOX was the primary panel recommendation for many younger, healthier pts requiring neoadjuvant or adjuvant therapy or first-line Tx for unresectable disease, most HCPs did not select this therapy for these pts at baseline. Among HCPs whose planned Tx differed from the experts, 51% indicated that they would change their Tx based on panel recommendations. Conclusions: Analysis of data from an online Tx decision support tool for PCa revealed variance between expert recommendations and the intended Tx of HCPs for numerous scenarios, with education provided by the tool potentially increasing the number of clinicians who made optimal Tx decisions. A full analysis of Tx trends will be presented. [Table: see text]