US Organizations Research Articles

1077-P: A Multicenter Initiative to Improve Care in Cardiometabolic Disease—Initial Report From Cardiometabolic Center Alliance (CMCA)

Background: Despite high risk, minority of individuals with Type 2 diabetes (T2D) and cardiovascular or chronic kidney disease (CVD/CKD) receives optimal guideline directed medical therapy (GDMT). Professional societies advocate for collaborative, team-based models to improve care in this group but successful multicenter implementation efforts are lacking. Methods: CMCA is a non for profit organization that seeks to transform care and outcomes in individuals with cardiometabolic disease. CMCA assists members in implementing team-based, coordinated care models (Cardiometabolic Centers) and GDMT driven pathways. Quality of care and outcomes are monitored via multicenter registry. Since launch in 2020, 14 US organizations joined CMCA. This initial report includes sites with data reported for ≥30 participants (each with ≥ 2 visits). Results: In total 606 individuals with T2D and CVD/CKD from 6 sites were evaluated (age 64 years, 44% women, 78% white, median follow up 6 months). After initiation of care at CMCA sites, large improvements in GDMT and reductions in weight, HbA1c, blood pressure, total/LDL cholesterol, triglycerides, and insulin requirements were observed (Figure panels 1 and 2; p< 0.001 for all). Conclusion: CMCA directed implementation of coordinated team-based care produced rapid and large improvements in GDMT and quality of care across multiple sites. Disclosure M.N.Kosiborod: Consultant; Alnylam Pharmaceuticals, Inc., Amgen Inc., Applied Therapeutics Inc., AstraZeneca, Bayer Inc., Boehringer Ingelheim Inc., Cytokinetics Inc., Dexcom, Inc., Eli Lilly and Company, ESPERION Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk, Pharmacosmos A/S, Pfizer Inc., Sanofi, Vifor Pharma Management Ltd., Youngene Therapeutics, Other Relationship; AstraZeneca, Research Support; AstraZeneca, Boehringer Ingelheim Inc. E.Fryoux: None. L.Harness: None. R.Heath: None. K.A.Miller: None. I.Neeland: Consultant; Nestlé Health Science, Speaker's Bureau; Boehringer Ingelheim and Eli Lilly Alliance, Bayer Inc. S.Patel: None. J.Plutzky: Advisory Panel; ESPERION Therapeutics, Inc., Consultant; Amgen Inc., Merck & Co., Inc., Novo Nordisk, Research Support; Boehringer Ingelheim Inc. R.K.Saalfeld: None. A.Stafos: None. S.Rajagopalan: Advisory Panel; Novartis, Novo Nordisk, Speaker's Bureau; Novo Nordisk. M.L.Magwire: Consultant; AstraZeneca, Novo Nordisk. D.S.Aistrope: None. E.Andaya: None. J.Butler: Consultant; Abbott,, Amgen, Applied Therapeutics, Array, Astra Zeneca, Bayer,, Boehringer Ingelheim, Bristol Myers Squibb, CVRx, G3 Pharma,, Impulse Dynamics, Innolife, Janssen, LivaNova, Luitpold, Medtronic, Merck, Novartis, NovoNordisk, Relypsa, Roche, Sequana Medical, Vifor, Speaker's Bureau; Novartis, Boehringer Ingelheim-Lilly, Astra Zeneca, Janssen. K.Cummings: None. L.Davis: Speaker's Bureau; Amgen Inc. R.H.Eckel: Advisory Panel; Amarin Corporation, 89bio, Inc., Novo Nordisk, Weight Watchers International, Board Member; Lexicon Pharmaceuticals, Inc., Consultant; Amgen Inc., Better Therapeutics, Inc, The Healthy Aging Company, Other Relationship; Arrowhead Pharmaceuticals, Inc. J.A.Fialkow: Speaker's Bureau; Amgen Inc., ESPERION Therapeutics, Inc., Amarin Corporation. Funding AstraZeneca; Boehringer Ingelheim; Novo Nordisk, Amgen Inc.; Eli Lilly and Company; Novartis

RWD156 The Impact of the Sars-Cov-2 Pandemic (COVID-19) on the Incidence of Newly Diagnosed Multiple Myeloma Patients Using a Federated Network of Real-World Evidence in US and Germany

COVID-19 had an impact on health care, including diagnostics. Early diagnosis of MM is a critical factor for prognosis. We examined the impact of COVID-19 on incidence of NDMM patients and on characteristics in NDMM patients in US and in Germany. 44,164 NDMM patients were identified in TriNetX federated network across 55 healthcare organizations in US between January 2018 and December 2021. A bivariate analysis examined changes in patient characteristics in two cohorts before (Cohort 1; n=25513) and after (Cohort 2; n=18.651) the start of the COVID-19 pandemic in March 2020. 4172 NDMM patients were identified in the German database in a sample of across >100 healthcare organizations in the same time period. Similarly, bivariate analysis examined changes in patient characteristics before (Cohort 1; n=2252) and after (Cohort 2; n=1920) the start of pandemic. Analysis of US data showed a significant decrease in incidence of NDMM. Bivariate analysis revealed that NDMM patients in Cohort 2 have a significantly higher risk profile compared with patients in Cohort 1, higher incidence of renal failure (13.5% v. 15.43%), heart failure (10.3% v 11.26%), bone lesions (12.6% v. 13.05%) and anemia (26.8% v. 29.75%). The German data indicated an increased risk profile in Cohort 2, with higher reporting of renal impairment (12.3% v. 15.5%) and cardiac impairment (8.3% v. 10.9%). The higher risk profile was reflected in a significant increase of all SLiM-CRAB criteria, notably hypercalcemia (24.1 % v. 36.9%), bone marrow plasma cell infiltration (28.1% v. 36.8%) and free light chain involvement (27.3% v. 41.3%). The results provide real-world evidence of a change in risk profile for patients with NDMM during COVID-19. This higher risk profile is observed in both the US and Germany, and may negatively impact outcomes such as progression-free and five-year overall survival.

Psychological caring climate at work, mental health, well-being, and work-related outcomes: Evidence from a longitudinal study and health insurance data

Psychological climate for caring (PCC) is a psychosocial factor associated with individual work outcomes and employee well-being. Evidence on the impacts of various psychological climates at work is based mostly on self-reported health measures and cross-sectional data. We provide longitudinal evidence on the associations of PCC with subsequent diagnosed depression and anxiety, subjective well-being, and self-reported work outcomes. Employees of a US organization with a worker well-being program provided data for the analysis. Longitudinal survey data merged with data from personnel files and health insurance claims records comprising medical information on diagnosis of depression and anxiety were used to regress each outcome on PCC at baseline, adjusting for prior values of all outcomes and other covariates. PCC was found to be associated with lower odds of subsequent diagnosed depression, an increase in overall well-being, mental health, physical health, social connectedness, and financial security, as well as a decrease in distraction at work, an increase in productivity/engagement and possibly in job satisfaction. There was little evidence of associations between PCC and subsequent diagnosed anxiety, character strengths, and work-family conflict. Work policies focused on improving PCC may create a promising pathway to promoting employee health and well-being as well as improving work-related outcomes.

Building Public Health Emergency Preparedness, Response, and Recovery Capabilities Through Disaster Citizen Science: Perspectives From Local Health Department, Academic, and Community Representatives.

Disaster citizen is the use of scientific methods by the public to address preparedness, response, or recovery needs. Disaster citizen science applications with public health relevance are growing in academic and community sectors, but integration with public health emergency preparedness, response, and recovery (PHEPRR) agencies is limited. We examined how local health departments (LHDs) and community-based organizations have used citizen science to build public health preparedness and response (PHEP) capabilities. The purpose of this study is to help LHDs make use of citizen science to support PHEPRR. We conducted semistructured telephone interviews (n = 55) with LHD, academic, and community representatives engaged or interested in citizen science. We used inductive and deductive methods to code and analyze interview transcripts. US and international community-based organizations and US LHDs. Participants included 18 LHD representatives reflecting diversity in geographic regions and population sizes served and 31 disaster citizen science project leaders and 6 citizen science thought leaders. We identified challenges LHDs and academic and community partners face in using citizen science for PHEPRR as well as strategies to facilitate implementation. Academic and community-led disaster citizen science activities aligned with many PHEP capabilities including community preparedness, community recovery, public health surveillance and epidemiological investigation, and volunteer management. All participant groups discussed challenges related to resources, volunteer management, collaborations, research quality, and institutional acceptance of citizen science. The LHD representatives noted unique barriers due to legal and regulatory constraints and their role in using citizen science data to inform public health decisions. Strategies to increase institutional acceptance included enhancing policy support for citizen science, increasing volunteer management support, developing best practices for research quality, strengthening collaborations, and adopting lessons learned from relevant PHEPRR activities. There are challenges to overcome in building PHEPRR capacity for disaster citizen science but also opportunities for LHDs to leverage the growing body of work, knowledge, and resources in academic and community sectors.

STRisk: A Socio-Technical Approach to Assess Hacking Breaches Risk

Data breaches have begun to take on new dimensions and their prediction is becoming of great importance to organizations. Prior work has addressed this issue mainly from a technical perspective and neglected other interfering aspects such as the social media dimension. To fill this gap, we propose STRisk which is a predictive system where we expand the scope of the prediction task by bringing into play the social media dimension. We study over 3800 US organizations including both victim and non-victim organizations. For each organization, we design a profile composed of a variety of externally measured technical indicators and social factors. In addition, to account for unreported incidents, we consider the non-victim sample to be noisy and propose a noise correction approach to correct mislabeled organizations. We then build several machine learning models to predict whether an organization is exposed to experience a hacking breach. By exploiting both technical and social features, we achieve a Area Under Curve (AUC) score exceeding 98%, which is 12% higher than the AUC achieved using only technical features. Furthermore, our feature importance analysis reveals that open ports and expired certificates are the best technical predictors, while spreadability and agreeability are the best social predictors.

Landscape Review of Mail-in Self-Collection, Programs for Sexually Transmitted Infections.

Mail-in self-collection of samples with centralized reference laboratory sexually transmitted infection (STI) testing has been shown to be feasible with equivalent performance. Commercial, fee-for-service mail-in testing Web sites seem to be popular. These sites are currently unregulated by the US Food and Drug Administration. To compile a list of US organizations offering mail-in testing for STIs/HIV, the phrases "mail-in STI testing" and "home STI testing" were entered into search engines. Supplementary information was collected by organization email or "Contact Us" submission. Information was collected from 20 programs in the United States offering STI mail-in, self-collection testing services. Five programs (25%) were free to consumers. Six organizations (30%) only offered prefixed kits (STIs tested could not be selected). Half of the organizations provided extragenital testing, 2 (10%) did not provide extragenital testing, and the 8 others (40%) did not clarify. Three organizations (15%) used their own laboratory, 11 (55%) did not provide laboratory information. One commercial laboratory provided services to 5 organizations. Mail-in self-collection services are ubiquitous and exist in all states except 2; STI testing public health programs that offer testing at no cost to the consumer are only in 46% of states. Mail-in testing is likely a permanent fixture in sexual health services and will be an important component of a hybrid approach that complements that of static clinic services.

Investigating the effects of online communication apprehension and digital technology anxiety on organizational dissent in virtual teams

Working in virtual teams has become increasingly common in contemporary workplaces with technology that allows teams to collaborate online without being present in the same physical space. For some employees, communicating via virtual technologies such as email, phone, video conferences or applications to work in teams can cause anxiety, which in turn may influence their decision to engage in organizational dissent. This study examines the impact of two forms of online anxiety on employees' virtual organizational dissent: online communication apprehension and digital technology anxiety. The effects of age, technical skills, the portion of workload done virtually, and previous experience in virtual teamwork were included in the study as control variables. Using factorial analysis and structural equation modeling, the results from 321 volunteer employees of various US organizations (males = 135, females = 184, others = 2) were analyzed. The results show that the two forms of online anxiety and technical skills generally increase organizational dissent and aging significantly decreases virtual latent dissent. The study's findings support the social compensation hypothesis of online media use.

Can Industry 4.0 Assist Lean Manufacturing in Attaining Sustainability over Time? Evidence from the US Organizations

Recent research asserts that Industry 4.0 technologies have positively impacted Lean Manufacturing and sustainable performance. Although the combined impact of Industry 4.0 and Lean Manufacturing on sustainable performance has been scientifically studied, no study has shown how Lean duration moderates the relationship between Industry 4.0 and Lean Manufacturing in US manufacturing firms. This research aims to close this gap by evaluating whether Lean duration moderates the association between Industry 4.0 and Lean Manufacturing, which in turn affects sustainability performance. The Structural Equation Modeling (SEM) method was used to formulate and examine proposed relationships. The study used data collected from 126 managers who worked in 65 different manufacturing organizations. The data demonstrated a moderating effect of Lean duration on the relationship between Industry 4.0 and Lean Manufacturing and a significant and direct effect of Lean Manufacturing on sustainable performance. However, Industry 4.0 had a positive indirect effect on sustainable performance through the moderating effect of Lean Manufacturing and a negative direct impact on sustainable performance. The study’s findings add to the body of knowledge on the impact of Industry 4.0 on the Lean Manufacturing philosophy by identifying Lean duration as a moderator of this relationship. Theoretically, this research empirically validated the association between Lean duration, Industry 4.0, Lean Manufacturing, and sustainable performance in US Manufacturing organizations. The results showed that industry practitioners should consider the effect of Lean duration when adopting and managing Industry 4.0 technologies for better sustainable performance.

Alternatives to the quality-adjusted life year: How well do they address common criticisms?

To analyze whether other outcome measures used in health technology assessment (HTA) address the criticisms of quality-adjusted life years (QALYs). HTA methods guidance from 11 US comparator countries (the G10 and Australia) and six value frameworks from US organizations were reviewed to identify health outcome measures currently used to evaluate the benefits of a drug. The study involved a documentary analysis of guidelines to identify outcome measures used by the sampled HTA organizations. Similar outcomes were grouped together into outcome types. Each type was analyzed to determine the extent to which it replicates key advantages and responds to criticisms of QALYs extracted from the literature. Outcomes were included if guidance from at least one HTA organization identified the outcome as acceptable for HTA. Outcomes measuring or evaluating the benefit, clinical effect, or impact of a drug or health technology was included; methods of calculating costs were excluded. Seven types of outcome measures were identified falling into three groups: preference-based, single-dimension outcomes, and outcomes using non-health perspectives. Among the seven QALY alternative outcome measures currently used for HTA by the sampled countries, no one outcome measure addresses all the QALY criticisms while retaining the advantageous features of the QALY. Proposals to adopt health technology assessment (HTA) to support value-based pricing of prescription drugs in the US have faced pushback over the use of the QALY. There is no single "right" outcome measure, and the criticisms of QALYs apply to other outcome measures used to evaluate health. The measures identified have different features and strengths, which may be appropriate for specific decision making goals, but the QALY remains the best option for decision making that requires comparisons of the overall societal value of health gains.

Editor's Choice Articles for December.

Editor's Choice Articles for December.

(Bounded) Exit, voice, and politics: pandemic education in US and South Korea

ABSTRACT This article theorizes how crises and markets shape the responses of consumers and producer organizations. We advance four propositions: 1) if a crisis requires major revisions in operational rules, less-exit sensitive (i.e., monopoly-like) organizations shall revise to aggregate preferences of organized producers; and more-exit sensitive (market-oriented) organizations, to the preferences of individual consumers; 2) if a sustained crisis widens the gap between incumbent organizations and consumer preferences, more consumers shall exit to alternative organizations; 3) if the incumbent organization controls valued resources, consumers shall select more-bounded exit options, which retain formal-legal ties with the incumbent; and 4) compared to less-bounded exit, more-bounded exit options shall enhance consumers’ collective voice about incumbent organizations. We inductively derive our theory from an exploratory analysis of educational organizations in US and South Korea during the Covid-19 pandemic in 2020. Many consumers were dissatisfied with regular-public schools and considered various exit alternatives, including non-regular schools (e.g., private, charter [US], homeschooling [US], special-purpose [Korea]) and private supplemental education. Compared to less-bounded exit (e.g., private schools), more-bounded exit options (e.g., charter, PSE) grew more, and contributed more to consumer voice about regular-public schools, during the pandemic.

An evaluation of nine culturally tailored interventions designed to enhance engagement in HIV care among transgender women of colour in the United States.

IntroductionTransgender women (TW) worldwide have a high prevalence of HIV, and TW with HIV encounter numerous healthcare barriers. It is critical to develop evidence‐informed interventions to improve their engagement in healthcare to achieve durable viral suppression (VS). We evaluated whether participation in one of nine interventions designed specifically for TW was associated with improved engagement in HIV care among transgender women of colour (TWC).MethodsBetween 2013 and 2017, nine US organizations implemented nine distinct and innovative HIV care engagement interventions with diverse strategies, including: individual and group sessions, case management and navigation, outreach, drop‐in spaces, peer support and/or incentives to engage TWC with HIV in care. The organizations enrolled 858 TWC, conducted surveys, captured intervention exposure data and extracted medical record data. Our evaluation of the interventions employed a pre‐post design and examined four outcomes—any HIV care visit, antiretroviral therapy (ART) prescription, retention in HIV care and VS (both overall and among those with a clinic visit and viral load test), at baseline and every 6 months for 24 months. We employed logistic generalized estimating equations to assess the relative odds of each outcome at 12 and 24 months compared to baseline.ResultsOverall, 79% of participants were exposed to at least one intervention activity. Over 24 months of follow‐up, participants received services for a median of over 6 hours (range: 3–69 hours/participant). Compared to baseline, significantly (p<0.05) greater odds were demonstrated at both 12 and 24 months for three outcomes: prescription of ART (ORs: 1.42 at 12 months, 1.49 at 24 months), VS among all participants (ORs: 1.49, 1.54) and VS among those with a clinic visit and viral load test (ORs: 1.53, 1.98). The outcomes of any HIV care visit and retention in HIV care had significantly greater odds (ORs: 1.38 and 1.58, respectively) only at 12 months compared to baseline.ConclusionsThese evaluation results illustrate promising approaches to improve engagement in HIV care and VS among TWC with HIV. Continued development, adaptation and scale‐up of culturally tailored HIV care interventions for this key population are necessary to meet the UNAIDS 95‐95‐95 goals.

Comments, Shares, or Likes: What Makes News Posts Engaging in Different Ways

In a digital media environment where content distribution is shaped by technology companies’ algorithms and user behaviors, news organizations try to post content that can prompt user engagement in forms such as comments, shares, and likes or reactions. This study employs a content analysis of 1,600 messages and analyses of engagement metrics for 157,962 messages to examine to what extent and how Facebook messages of US and Israeli news organizations differ in the engagement modes they generate: commenting versus sharing versus liking/reacting. Drawing on the participation paradigm in audience research, news value theory, and literature on engagement enhancers, the study shows that certain content characteristics are associated with each of the examined engagement modes in more than one country while other content characteristics are associated with particular modes, but not with all of them. It offers a nuanced understanding of user interaction with news-related content and helps think about content units as more engaging or less engaging than others, or as engaging in different ways.

Universities claim to value community-engaged scholarship: So why do they discourage it?

With current crises of academic relevance and legitimacy, there is a need for epistemic equity inherent to community-engaged research. Scholars in science communication and science and technology studies have analyzed, advocated for, and conducted public engagement in pursuit of this goal. However, despite desires to celebrate public engagement, US academic institutions and organizations often present barriers to meaningful community-engaged research. From tenure and promotion requirements, to lack of recognition and resources, universities in the American academic landscape are not currently organized to support such work. In this article, we offer a conceptual framework to examine the complex structural dimensions of academic institutions that have systematically discouraged and devalued faculty participation in community-engaged scholarship. We outline four such structural dimensions: interrogating epistemic biases, neoliberalist tendencies, gendered norms, and colonial-racist defaults. Our goal is to illuminate processes that could inform interventions to bridge the gap between academic aspirations for community-engaged work and current actions in the academy that undermine it.

Fight Outcomes In Mixed Martial Arts (mma) From 1991-2021: An Analysis Of 107,227 Competitions

Although MMA rules and regulations are similar around the world, they can vary by state, country, and organization. State athletic commissions sanction US-based events, while a governing body of the host nation typically sanctions international events. Accordingly, MMA athletes may have a differential injury risk based on where they fight or the organization for whom they fight. PURPOSE: To determine the distribution of fight outcomes, if outcome distribution varies among US and international organizations, and if major rule changes in US-based organizations have changed the distribution of fight outcomes. METHODS: We extracted data from the ESPN MMA database for fights that occurred between September 1991 and October 2021, capturing 115,512 fights. Fights that did not have a time (7045), round number (147), had rounds greater than five min (1091), or had more than five rounds (2) were removed, leaving 107,227 fights for analysis. When comparing organizations, we used four US (UFC, Bellator, Strikeforce, Invicta) and six international (ONE, Pride, Rizin, Pancrase, M-1 Global, Fight Night) organizations (30,510) and three US-based organizations when comparing pre- and post-adoption of the Unified Rules of MMA (UFC, Bellator, Strikeforce; 18,238). RESULTS: Fights were stopped due to submission (32.5%) or ended in decision (30.5%) most frequently, with knockout (6.3%), technical KO (19.0%), and KO/TKO (9.9%) comprising 35.2% of fight stoppages. When comparing US and international organizations, US fights were more likely to go to Decision (43.6% vs. 38.8%) or end in KO/TKO (23.8% vs. 17.6%), while international organizations had higher rates of Submission (24.6% vs. 21.9%), TKO (12% vs. 6.3%), and KO (3.2% vs. 2.0%). When comparing outcomes pre- and post-Unified Rules, we identified a 51.3% increase in the proportion of fights going to decision and a reduction in the proportion of fights ending in KO/TKO (33.3%) or Submission (28.4%), respectively. CONCLUSIONS: Despite varying rules and regulations across organizations and locations, historical MMA fight outcomes have been similar for US and international competition. Furthermore, implementation of the Unified Rules by US-based organizations is associated with a lower proportion of fights ending by KO/TKO, implying a positive impact on MMA athlete safety.

Linear Non-Threshold (LNT) historical discovery milestones.

The present paper provides a summarized identification of critical historical milestones in the discovery of the flawed and corrupt foundations of cancer risk assessment, with particular focus on the LNT Dose Response model. The milestone sequence presented herein is based on a large body of published findings by the author. The history of LNT and cancer response represents what may be the most significant case of scientific misconduct reported in the US, with its revelation severely damaging the scientific credibility and moral authority of leading US regulatory agencies and organizations such as the National Academy of Sciences (NAS) and the journal Science. The consequences of this corrupt history are substantial, affecting cancer risk assessment throughout the world, critical aspects of national economies, the development of critical technologies and public health practices.

Social capital, human capital, tacit knowledge, and innovations, A Polish-US cross-country study

This study measures the relationship between human and social capital (internal and external) and tacit knowledge sharing's influence on innovativeness among knowledge workers employed in Polish (n=1050) and US (n=1118) organizations. The structural equation modeling method revealed that internal social capital matters more for organizational innovativeness in the US. In Poland, both external and internal were important. Specifically, in the US, external social capital supports internal innovativeness directly and external - indirectly. On the contrary, in Poland, social capital directly influences internal and external innovativeness.&#x0D; These differences are partially due to country differences regarding public and private financing. Also apparent is the need for strong social bonds between employees in innovative companies. Furthermore, this study confirms that internal innovativeness is vital for external innovativeness and reveals that social capital is a structural enabler for innovativeness, given its critical role in the distribution of tacit knowledge.&#x0D;

Rallying women: activism, archives and affect

ABSTRACT In January 2017 over 400,000 women marched in Washington DC—while others marched in cities across the world—to protest the election of a misogynistic president and to draw attention to gendered and racialised inequality. Since then, operating as Women’s March the US organisation has staged subsequent marches which both extend the group’s activism and commemorate the original event. Activists have referenced the historical precedents that they believe will help them to successfully construct the group’s memory culture and identity and produce the emotion and affect needed to sustain their movement. Cognisant that they are making history through mobilising year after year, they have also developed strategies for archiving that history for greater acessibility. In this article, we examine the place of history and historical literacy—both knowledge of history and the skills to interpret its significance—in the nexus between memory, affect and activism. A lack of historical literacy has the potential to create an exclusive memory culture which risks inflicting trauma on those already traumatised by current and historic events; while attention to preserving and making available history as it is being made helps to build pride and solidarity and ensure the intergenerational transmission of feminist knowledge.

España en la OTAN: una relación mediatizada por EEUU

NATO has been perceived mainly as a US organization and, consequently, with a great capacity of influence in Spain since its entry into the Atlantic Alliance. This article analyzes to what extent this stereotype has been fulfilled over the 40 years since Spain's entry in the organisation and how Spain has simultaneously managed and dealt with its Atlantic membership and its bilateral relationship with the US.

National Survey on the Effect of Oncology Drug Shortages in Clinical Practice: A Hematology Oncology Pharmacy Association Survey.

Drug shortages are a clear and growing challenge. Prominent shortages included oncology medications and supportive care products essential for the care of patients with cancer. Oncology drug shortages often result in disruptions in the timing of chemotherapy treatments, alterations in the dose or regimen administered, or even missed doses when alternative agents are unavailable. The purpose of this survey was to characterize the impact of oncology drug shortages across the United States, including the experiences of health care organizations, resource implications, and the impact on patient safety, patient care, and clinical trials. A 36-item online survey was distributed to membership of the Hematology/Oncology Pharmacy Association to gather information on shortages of oncology drugs (ie, all drugs essential in the care of patients with cancer, including supportive care agents). Sixty-eight US organizations participated in the survey between December 2019 and July 2020. Sixty-three percent of institutions reported one or more drug shortages per month, with a 34% increase in 2019 from 2018. Treatment delays, reduced doses, or alternative regimens were reported by 75% of respondents. The most difficult agents to obtain were vincristine, vinblastine, intravenous immunoglobulin, leucovorin, and Bacillus Calmette-Guerin. A survey of US oncology pharmacists indicated that oncology drug shortages occurred frequently in 2020. Shortages led to delays in chemotherapy and changes in treatment or omission, complicated clinical research, and increased risk of medication errors and adverse outcomes.