Or Patient-Centered Cancer Care: IOM’s recommendations
Last week, we looked at the recent Institute of Medicine’s report and wrote the post about “How the US Got Its Cancer Care Crisis“.
This week we get more practical. With specific recommendations you can use!
The general recommendations include:
(1) becoming engaged patients.
(2) ensuring an adequately staffed, trained, and coordinated workforce.
(3) providing evidence-based care.
(4) learning health care information technology (IT).
(5) translation of evidence into clinical practice, quality measurement and performance improvement.
(6) addressing accessible and affordable care.
One of the most important sections of the report, from the patients’ perspective, relates to improving patient engagement and making cancer care more patient-centered and increasing the use of palliative care.
How does the report help with patient engagement? It provides a list of questions for the patient to ask of their physician. Here is a repost of this list.
Questions about Prognosis
- What is the goal of treatment? Is it directly treating the cancer or improving my symptoms or both?
- How long does the average person with this cancer live? (ask for a window and the most likely scenario)
- How ill I feel?
- What is my likelihood of a cure?
- If I cannot be cured, will I live longer with treatment? How much longers/
- Will I feel better or worse?
- Can I receive palliative care focused on the quality of my and my familiy’s life during my cancer treatment?
- What options do I have if I don’t want to continue my cancer treatment?
- When should I think about hospice? Can I meet with a hospice now, when I am well?
- How often should we check in about my care plan?
Questions about Treatment
- Why are my treatment options?
- Why do I need this treatment?
- How does this treatment compare with other treatment options?
- What things are likely to happen to me?
- Am I healthy enough to undergo the treatment?
- What are the risks and benefits of treatment?
- Are there any side effects?
- Will treatment make me feel better or worse?
- How many times have you done this procedure?
- What is the cost of this treatment?
- What clinical trials are available?
- What are the potential benefits of clinical trials?
- Am I eligible to participate?
- How do I enroll?
- Which hospital is best for my needs?
- Which clinicians will coordinate my care?
- How do you spell the name of that drug?
- Will this medicine interact with medicines that I’m already taking?
Questions About Advance Care Planning
- Are there things I should be doing to plan ahead?
- Draft a will?
- Participate in advance care planning and decide on my advance directives?
- Choose a healthcare proxy who can speak for me, if I am unable?
- Address financial or family legal issues?
- Appoint a durable power of attorney for financial affairs?
- Establish a trust?
Questions about family psychosocial, and spiritual needs
- Will you help me talk with my children?
- Who is available to help me cope with this situation?
According to the report these questions were actually adapted from three sources AHRQ, ASCO and Cancer.net, and Harrington and Smith (2008).
What do you think?
From your personal experience or expertise, what do you think about the IOM’s list of questions? Anything to add/remove/update in these lists?
So glad a spotlight is being directed towards some standardize care for those going through cancer. My co-author and I are also working hard to help People develop their “survival plan” after treatment is over.
Empowered patients are healthy patients!
Thank you so much. I’m glad that the IOM has been looking at Cancer care and happy that you are working to empower patients!
Apart from the questions about clinical treatments (which are available, what are their success rates, how much have you/this centre done?) the one question still not asked, but which makes much difference, is “What patient-led treatments should I do?
The answers should not be “I don’t know”
They should be:
no smoking
exercise – min 30’/day walking
little/no meat (especially processed meat)
little/no fish
Little/no sugar/fast carbs
Little/no alcohol
Vit.D3 supplement – 2,000-12,000IU/day
fresh veggies/berries each day, preferably organic (& especially cruciferrous – broccoli, Brussels sprouts, cauliflower)
Check your inflammation; if high, reduce
Check waist/height ratio; reduce to less than 0.5; if more, reduce
Good dental hygiene – floss, xylitol/non-fluorine toothpaste after breakfast/last meal; no rinse
This will extend your survival time.
Thank you for sharing your ideas!
This article left out one, MAJOR issue: DOCTORS STILL DO NOT LISTEN TO PATIENTS. I have a Ph. D., I am much more concerned about MY disease than my doctors, I do directed research on my disease at its current stage, BUT MY DOCTORS STILL IGNORE ME AND MY QUESTIONS. I SEE THE LOOK WHEN I COME IN WITH MY SHEAF OF PAPERS.
I agree with you. I’m grateful that Medivizor is around to help patients and caregivers with personalized information.