ASH News Daily - Tuesday, December 13, 2011 - (Page A-7)
Tuesday, December 13, 2011
OUTCOMES
Patient Communication: It Matters to Them – And You
By Julie panepinto, Md, MSph,
and aManda BRandow, do, MS
many factors including patient and
provider behavior. Oral sessions
that will be presented today and one
that was presented Sunday highlight
patient-provider communication,
adherence to medications, and
the use of a decision support tool to
improve physician compliance with
recommended therapy.
Dr. Amy Sullivan, Harvard Med-
E
ical School, will present results from
the HEMA-COMM study involving
40 physicians and more than 200 patients.
The HEMA-COMM study is
an observational study evaluating
physician-patient communication
in patients with cancer. Through
the use of surveys, patient interviews,
and audiotaping with coding
of the consultation sessions, this
study sought to determine the level
of agreement between patient and
physician regarding patient prognosis.
The investigators proposed
that patients would more accurately
understand their prognosis if physicians
used unambiguous quantitative
communication. Be sure to attend
the session today at 7:30 a.m. in
Elizabeth Ballroom FG, Manchester
Grand Hyatt, to learn about their interesting
findings and the questions
that remain to be answered.
In a study being presented today
by Dr. Fabio Efficace, Italian Group
Abstracts
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approach harnesses the immune
system to direct a systemic antitumor
response despite injecting only
one local site. This may pave the way
for an entirely new modality of therapy
in hematologic malignancies.
Knowing how long to treat fol-
licular lymphoma in patients with
low tumor burden with rituximab
remains challenging for the clinician.
Mixed results have caused
some to treat with a single course
of therapy followed by “watch and
wait,” while others have opted to
continue treatment for longer. Dr.
Brad Kahl, University of Wisconsin,
will reveal the results of the
RESORT study, which seeks to help
answer the optimal strategy for patients
who are initially treated with
rituximab monotherapy. It is a randomized
phase III trial comparing
two rituximab-dosing strategies in
low tumor burden follicular lymphoma.
This study was designed
ffectiveness of care for patients
with hematologic illnesses
is dependent upon
for Adult Hematologic Diseases
(GIMEMA), Rome, Italy, at 8:45 a.m.
in the same location, the focus will
again be on the patient. Specifically,
the investigators will present results
of work examining adherence behavior
in patients with chronic myeloid
leukemia (CML) who are receiving
long-term imatinib therapy.
Dr. Efficace stated, “We now know
that optimal adherence to treatment
is crucial to maximize clinical outcomes
in patients with CML; however,
targeted therapies like imatinib
are to be taken on a daily basis
for years, thus ensuring that all patients
are fully compliant with the
treatment schedule over the long
run in ‘real life’ is a great challenge.”
The study examined the association
of personal, sociodemographic, and
treatment-related factors on patient
adherence to therapy. More than
400 patients participated and completed
the Morisky scale to measure
adherence. Almost half of patients
were found to have suboptimal adherence
thus jeopardizing the maximum
effectiveness of therapy. Attend
today’s session to learn about
the unique patient-related characteristics
that are associated with
worse adherence to therapy.
Work presented by Dr. Amer
Zeidan, Johns Hopkins University,
on Sunday focused on provider compliance
as he presented results of using
a “smart orderset” to improve
compliance with the American College
of Chest Physicians recommendations
for venous thromboembo-
to evaluate the difference in time
to treatment failure (TTTF) of using
maintenance rituximab (single
dose every three months) versus
Late-Breaking Abstracts
7:30 a.m.
Hall AB, SDCC
rituximab retreatment at time of relapse.
In an era when more therapy
seems to be universally better, the
results may surprise you.
Other late-breaking data to be
presented include a better understanding
of the pathophysiology
of sickle cell disease by virtue of
the discovery of a signaling molecule
known as S1P, a new target
for IDH1-mutant and TET2-mutant
myeloid leukemias, and a “novel
view” of the aging of the bone marrow.
Don’t be late to this hot-offthe-press
session!
Dr. Mikhael indicated no relevant
conflicts of interest.
lism (VTE) prophylaxis. To increase
institutional compliance, a computer
decision support tool using “smart
ordersets” was implemented and
compliance pre- and post-implementation
of the tool was examined.
Supporting the premise that decision
support for physicians decreases
variability in care, the investigators
demonstrated that compliance
with the recommended guidelines
for VTE prophylaxis increased significantly
from 68.3 percent to 85.9
percent. Successful implementation
of the tool also resulted in a decrease
in symptomatic VTE confirmed by
radiograph by day 90 post-hospital
discharge (2.8-0.7%).
These exciting and timely studies
highlight the importance of studying
physician-patient behavior and
its impact on effectiveness of care, a
research area of greater importance
in today’s health-care field. Understanding
physician-patient communication
has the potential to improve
patients’ understanding of their illness
and may impact downstream
patient outcomes such as survival
and health-related quality of life.
Furthermore, understanding reasons
patients do not adhere to recommended
therapy presents unique
opportunities for improving patient
adherence, which may ultimately be
linked to improved outcomes and
improved effectiveness. Lastly, providing
decision support tools to physicians
to assist with implementation
of recommended evidence-based
care provides a simple method to decrease
variability in patient care and
ultimately improve health outcomes.
Drs. Panepinto and Brandow indicated
no relevant conflicts of interest.
ASH NEWS DAILY
Page A–7
®
E. Donnall Thomas
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stem cells and personalized induced
pluripotent stem cells (iPS) derived
from patients by somatic cell reprogramming.
Most importantly, he
brought us balanced and clear perspectives
on where the field is heading
and addressed the future challenges
and true potential of applying
stem cells to the treatment of a variety
of diseases.
Dr. Daley once described his re-
search on iPS as a “fishing expedition”
relative to his efforts to study
all of the genes and molecular pathways
that enable pluripotency,
when he was announced as the inaugural
winner of the NIH Director’s
Pioneer Award in 2004, which
is just one of the numerous, well-deserved
awards bestowed upon this
outstanding investigator.
Dr. Daley, who holds the Samuel
E. Lux, IV, chair in hematology/
oncology and directs the stem cell
transplantation program at Children’s
Hospital Boston, has been
a pioneer and paradigm changer
throughout his career. His early
work on hematopoietic cell development
provided crucial insights
into the mechanisms of disease
initiation and progression. Working
with Rudolf Jaenisch, MD, he
subsequently reported on the first
successful application of somatic
cell nuclear transfer to create customized
embryonic stem cells to
treat genetic disease in a murine
model of immune deficiency. He is
also credited with the first creation
of functional sperm cells from embryonic
stem cells, which was cited
Dr. George Q. Daley presents the E.
Donnall Thomas Lecture.
by Science magazine as a “top ten”
breakthrough for 2003. Science subsequently
cited Dr. Daley’s creation
of disease-specific pluripotent stem
cells from patients using reprogramming
technology in its 2008
“Breakthrough of the Year” issue.
As we learned yesterday, Dr.
Daley believes that, “there is still so
much more to learn and so much
more promise to deliver.” Having
listened to Dr. Daley’s lecture, you
can still sense his great passion for
his work and appreciation for his
colleagues and trainees.
Dr. Bishop indicated no relevant
conflicts of interest.
Table of Contents for the Digital Edition of ASH News Daily - Tuesday, December 13, 2011
ASH News Daily - Tuesday, December 13, 2011
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