TY - JOUR
T1 - Characteristics of Health Care Settings Where Adolescents and Young Adults Receive Care for ALL
AU - Wolfson, Julie A.
AU - Grimes, Allison C.
AU - Nuno, Michelle
AU - Kerber, Charlotte L.
AU - Ramakrishnan, Subhash
AU - Beauchemin, Melissa
AU - Dickens, David
AU - Levine, Jennifer M.
AU - Roth, Michael E.
AU - Scialla, Michele
AU - Woods, Wendy
AU - Vargas, Sarah
AU - Boayue, Koh B.
AU - Chang, George J.
AU - Stock, Wendy
AU - Hershman, Dawn
AU - Curran, Emily
AU - Advani, Anjali
AU - O'Dwyer, Kristen
AU - Luger, Selina
AU - Liu, Jane Jijun
AU - Freyer, David R.
AU - Sung, Lillian
AU - Parsons, Susan K.
N1 - Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - PURPOSE: Individuals diagnosed with cancer between 15 and 39 years (adolescent and young adult [AYA]) face unique vulnerability. Detail is lacking about care delivery for these patients, especially those with ALL. We address these knowledge gaps by describing AYA ALL care delivery details at National Cancer Institute Community Oncology Research Program (NCORP) (sub)affiliates by model of care.METHODS: Participating institutions treated at least one AYA with ALL from 2012 to 2016. Study-specific criteria were used to determine the number of unique clinical facilities (CFs) per NCORP and their model of care (adult/internal medicine [IM], pediatric, mixed [both]). Surveys completed by NCORPs for each CF by model of care captured size, resources, services, and communication.RESULTS: Among 84 participating CFs (adult/IM, n=47; pediatric, n=15; mixed, n=24), 34% treated 5-10 AYAs with ALL annually; adult/IM CFs more often treated <5 (adult/IM, 60%; pediatric, 40%; mixed, 29%). Referral decisions were commonly driven by an age/diagnosis combination (58%), with frequent ALL-specific age minimums (87%) or maximums (80%). Medical, navigational, and social work services were similar across models while psychology was available at more pediatric CFs (pediatric, 80%; adult/IM, 40%; mixed, 46%-54%). More pediatric or mixed CFs reported oncologists interacting with pediatric/adult counterparts via tumor boards (pediatric, 93%; adult/IM, 26%; mixed, 96%) or initiating contact (pediatric, 100%; adult/IM, 77%; mixed 96%); more pediatric CFs reported an affiliated counterpart (pediatric, 53%; adult, 19%). Most CFs reported no AYA-specific resources (79%) or meetings (83%-98%).CONCLUSION: System-level aspects of AYA ALL care delivery have not been examined previously. At NCORPs, these characteristics differ by models of care. Additional work is ongoing to investigate the impact of these facility-level factors on guideline-concordant care in this population. Together, these findings can inform a system-level intervention for diverse practice settings.
AB - PURPOSE: Individuals diagnosed with cancer between 15 and 39 years (adolescent and young adult [AYA]) face unique vulnerability. Detail is lacking about care delivery for these patients, especially those with ALL. We address these knowledge gaps by describing AYA ALL care delivery details at National Cancer Institute Community Oncology Research Program (NCORP) (sub)affiliates by model of care.METHODS: Participating institutions treated at least one AYA with ALL from 2012 to 2016. Study-specific criteria were used to determine the number of unique clinical facilities (CFs) per NCORP and their model of care (adult/internal medicine [IM], pediatric, mixed [both]). Surveys completed by NCORPs for each CF by model of care captured size, resources, services, and communication.RESULTS: Among 84 participating CFs (adult/IM, n=47; pediatric, n=15; mixed, n=24), 34% treated 5-10 AYAs with ALL annually; adult/IM CFs more often treated <5 (adult/IM, 60%; pediatric, 40%; mixed, 29%). Referral decisions were commonly driven by an age/diagnosis combination (58%), with frequent ALL-specific age minimums (87%) or maximums (80%). Medical, navigational, and social work services were similar across models while psychology was available at more pediatric CFs (pediatric, 80%; adult/IM, 40%; mixed, 46%-54%). More pediatric or mixed CFs reported oncologists interacting with pediatric/adult counterparts via tumor boards (pediatric, 93%; adult/IM, 26%; mixed, 96%) or initiating contact (pediatric, 100%; adult/IM, 77%; mixed 96%); more pediatric CFs reported an affiliated counterpart (pediatric, 53%; adult, 19%). Most CFs reported no AYA-specific resources (79%) or meetings (83%-98%).CONCLUSION: System-level aspects of AYA ALL care delivery have not been examined previously. At NCORPs, these characteristics differ by models of care. Additional work is ongoing to investigate the impact of these facility-level factors on guideline-concordant care in this population. Together, these findings can inform a system-level intervention for diverse practice settings.
KW - Adolescent
KW - Child
KW - Delivery of Health Care
KW - Humans
KW - Neoplasms/epidemiology
KW - Oncologists
KW - Surveys and Questionnaires
KW - Young Adult
UR - https://www.scopus.com/pages/publications/85190483382
U2 - 10.1200/OP.23.00328
DO - 10.1200/OP.23.00328
M3 - Article
C2 - 38252911
AN - SCOPUS:85190483382
SN - 2688-1527
VL - 20
SP - 491
EP - 502
JO - JCO Oncology Practice
JF - JCO Oncology Practice
IS - 4
ER -