The Johns Hopkins Hope at Hopkins Clinic: Supporting the comprehensive needs of individuals with metastatic breast cancer.

Vered Stearns, Ruizhe Chen,Amanda L. Blackford, Elizabeth Saylor, A. N. J. Reinders Folmer, Jessica Jelinek, Christine Hodgdon, Jacqueline Bacon,Jessica Engle,Mirat Shah, Rosanne Sheinberg, Sandra Pedraza-Cardozo,Mary Wilkinson, Melissa Alvendia,Claire Snyder,Karen L. Smith

JCO oncology practice(2023)

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摘要
452 Background: Individuals with metastatic breast cancer (MBC) may live with their disease for many years. We initiated the Johns Hopkins Hope at Hopkins Clinic, a multi-pronged quality improvement initiative that aims to optimize care for individuals with MBC. Methods: Individuals with MBC were offered participation in the Clinic, in addition to their usual care. Participants completed baseline patient reported outcome (PRO) surveys through REDCap. They were offered a menu of services, including cancer rehabilitation, supportive oncology, social work, nutrition, navigation, and access to optional services based on baseline PRO data and preferences. A medical oncologist assembled and delivered a comprehensive Care Plan synthesizing recommendations from all consultants with a focus on optimizing treatment, managing symptoms, and promoting wellness. Patients were asked to complete an evaluation survey 3 days after the clinic session, and follow-up PRO surveys at 3 and 6 months after the Care Plan was delivered. We report summary statistics of baseline demographics, tumor characteristics, and PRO scores at the pre-clinic visit. Results: From 11/2020 to 6/2022, 53 patients were referred, and 44 (83%) completed baseline surveys and participated in the Hope at Hopkins Clinic. Median age (N=44) was 58 (32-86); 32 (73%) were white, and 6 (14%) were Black; 24 (55%) had BMI>25. Tumors were mostly estrogen receptor-positive (85%) and HER2-negative (68%). Physical and mental health was not good for ≥14 days for 9/44 (20%) and 4/44 (9%), respectively. PROMIS measure scores were >1 standard deviation below average for 14/44 (32%) for Physical Health, 7/44 (16%) for Mental Health, and 10/44 (23%) for Physical Function. PHQ8 scores indicated depression for 10/44 (23%); GAD7 scores indicated anxiety for 3/44 (7%). 37 (84%) participants received an individualized Care Plan and educational materials based on identified symptoms, concerns, and interests. We will report the number and types recommendations by domain. Follow-up PRO data are available for 10 and 4 patients at 3- and 6-months, respectively. Conclusions: We have provided individualized assessment, education, and recommendations and created a comprehensive Care Plan to guide patients living with MBC. We have used the experience to implement a new multidisciplinary model, and to extend support services to patients living with MBC and their care teams.
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关键词
metastatic breast cancer,johns hopkins hope,breast cancer,hopkins clinic
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