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  1. Article: The potential for deprescribing in a palliative oncology patient population: a cross-sectional study.

    van Merendonk, Lisanne N / Peters, Bas J M / Möhlmann, Julia E / Hunting, Cornelis B / Kastelijn, Elisabeth A / van den Broek, Marcel P H

    European journal of hospital pharmacy : science and practice

    2023  Volume 31, Issue 1, Page(s) 10–15

    Abstract: Objectives: The use of preventive medication in palliative oncology patients may be inappropriate due to limited life expectancy. Deprescribing tools are available but time-consuming and not always tailored to this specific population. Our primary goal ... ...

    Abstract Objectives: The use of preventive medication in palliative oncology patients may be inappropriate due to limited life expectancy. Deprescribing tools are available but time-consuming and not always tailored to this specific population. Our primary goal was to identify potentially inappropriate medications (PIMs) in palliative oncology patients with a life expectancy of up to 2 years using an adapted deprescribing tool. Our secondary aim was to identify patient characteristics associated with the presence of PIMs.
    Methods: Oncology patients with a life expectancy of up to 2 years were included cross-sectionally. An adapted deprescribing tool was developed to identify PIMs. Logistic regression was used to identify factors associated with having PIMs.
    Results: A total of 218 patients were included in this study of which 56% had at least one PIM with a population mean of 1.1 PIM per patient. Most frequently defined PIMs were antihypertensive drugs and gastric acid inhibitors. Identification of PIMs by review took an estimated 5-10 min per patient. Polypharmacy, age >65 years and inpatient/outpatient status were found to be associated with having at least one PIM.
    Conclusions: Deprescribing is possible in more than half of palliative oncology patients with a life expectancy of up to 2 years. The adapted deprescribing tool used is non-time consuming and suitable for palliative oncology patients, regardless of age.
    MeSH term(s) Humans ; Aged ; Deprescriptions ; Inappropriate Prescribing/prevention & control ; Cross-Sectional Studies ; Potentially Inappropriate Medication List ; Neoplasms/drug therapy ; Neoplasms/epidemiology
    Language English
    Publishing date 2023-12-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2650179-X
    ISSN 2047-9964 ; 2047-9956
    ISSN (online) 2047-9964
    ISSN 2047-9956
    DOI 10.1136/ejhpharm-2021-003143
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Implementation, participation and satisfaction rates of a web-based decision support tool for patients with metastatic colorectal cancer.

    Keikes, Lotte / de Vos-Geelen, Judith / de Groot, Jan Willem B / Punt, Cornelis J A / Simkens, Lieke H J / Trajkovic-Vidakovic, Marija / Portielje, Johanneke E A / Vos, Allert H / Beerepoot, Laurens V / Hunting, Cornelis B / Koopman, Miriam / van Oijen, Martijn G H

    Patient education and counseling

    2019  Volume 102, Issue 7, Page(s) 1331–1335

    Abstract: Objective: To examine implementation and patients' and providers' participation and satisfaction of a newly developed decision support tool (DST) for patients with metastatic colorectal cancer (mCRC) in palliative setting.: Methods: Our DST consisted ...

    Abstract Objective: To examine implementation and patients' and providers' participation and satisfaction of a newly developed decision support tool (DST) for patients with metastatic colorectal cancer (mCRC) in palliative setting.
    Methods: Our DST consisted of a consultation sheet and web-based tailored information for mCRC treatment options. We conducted an implementation trajectory in 11 Dutch hospitals and evaluated implementation, participation and satisfaction rates.
    Results: Implementation rates fluctuated between 3 and 72 handed out (median:23) consultation sheets per hospital with patients' login rates between 36% and 83% (median:57%). The majority of patients (68%) had (intermediate)-high participation scores. The median time spent using the DST was 38 min (IQR:18-56) and was highest for questions concerning patients' perspective (5 min). Seventy-six% of patients were (very) satisfied. The provider DST rating was 7.8 (scale 1-10) and participation ranged between 25 and 100%. Remaining implementation thresholds included providers' treatment preferences, resistance against shared decision-making and (over)confidence in shared decision-making concepts already in use.
    Conclusion: We implemented a DST with sufficient patient and oncologist satisfaction and high patient participation, but participation differed considerably between hospitals suggesting unequal adoption of our tool.
    Practice implications: Requirements for structural implementation are to overcome remaining thresholds and increase awareness for additional decision support.
    MeSH term(s) Aged ; Colorectal Neoplasms/therapy ; Decision Support Techniques ; Female ; Humans ; Internet ; Male ; Middle Aged ; Neoplasm Metastasis ; Netherlands ; Palliative Care ; Patient Satisfaction
    Language English
    Publishing date 2019-02-22
    Publishing country Ireland
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 605590-4
    ISSN 1873-5134 ; 0738-3991
    ISSN (online) 1873-5134
    ISSN 0738-3991
    DOI 10.1016/j.pec.2019.02.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Perioperative systemic therapy and cytoreductive surgery with HIPEC versus upfront cytoreductive surgery with HIPEC alone for isolated resectable colorectal peritoneal metastases: protocol of a multicentre, open-label, parallel-group, phase II-III, randomised, superiority study (CAIRO6)

    Rovers, Koen P / Bakkers, Checca / Simkens, Geert A A M / Burger, Jacobus W A / Nienhuijs, Simon W / Creemers, Geert-Jan M / Thijs, Anna M J / Brandt-Kerkhof, Alexandra R M / Madsen, Eva V E / Ayez, Ninos / de Boer, Nadine L / van Meerten, Esther / Tuynman, Jurriaan B / Kusters, Miranda / Sluiter, Nina R / Verheul, Henk M W / van der Vliet, Hans J / Wiezer, Marinus J / Boerma, Djamila /
    Wassenaar, Emma C E / Los, Maartje / Hunting, Cornelis B / Aalbers, Arend G J / Kok, Niels F M / Kuhlmann, Koert F D / Boot, Henk / Chalabi, Myriam / Kruijff, Schelto / Been, Lukas B / van Ginkel, Robert J / de Groot, Derk Jan A / Fehrmann, Rudolf S N / de Wilt, Johannes H W / Bremers, Andreas J A / de Reuver, Philip R / Radema, Sandra A / Herbschleb, Karin H / van Grevenstein, Wilhelmina M U / Witkamp, Arjen J / Koopman, Miriam / Haj Mohammad, Nadia / van Duyn, Eino B / Mastboom, Walter J B / Mekenkamp, Leonie J M / Nederend, Joost / Lahaye, Max J / Snaebjornsson, Petur / Verhoef, Cornelis / van Laarhoven, Hanneke W M / Zwinderman, Aeilko H / Bouma, Jeanette M / Kranenburg, Onno / van 't Erve, Iris / Fijneman, Remond J A / Dijkgraaf, Marcel G W / Hemmer, Patrick H J / Punt, Cornelis J A / Tanis, Pieter J / de Hingh, Ignace H J T

    BMC cancer

    2019  Volume 19, Issue 1, Page(s) 390

    Abstract: Background: Upfront cytoreductive surgery with HIPEC (CRS-HIPEC) is the standard treatment for isolated resectable colorectal peritoneal metastases (PM) in the Netherlands. This study investigates whether addition of perioperative systemic therapy to ... ...

    Abstract Background: Upfront cytoreductive surgery with HIPEC (CRS-HIPEC) is the standard treatment for isolated resectable colorectal peritoneal metastases (PM) in the Netherlands. This study investigates whether addition of perioperative systemic therapy to CRS-HIPEC improves oncological outcomes.
    Methods: This open-label, parallel-group, phase II-III, randomised, superiority study is performed in nine Dutch tertiary referral centres. Eligible patients are adults who have a good performance status, histologically or cytologically proven resectable PM of a colorectal adenocarcinoma, no systemic colorectal metastases, no systemic therapy for colorectal cancer within six months prior to enrolment, and no previous CRS-HIPEC. Eligible patients are randomised (1:1) to perioperative systemic therapy and CRS-HIPEC (experimental arm) or upfront CRS-HIPEC alone (control arm) by using central randomisation software with minimisation stratified by a peritoneal cancer index of 0-10 or 11-20, metachronous or synchronous PM, previous systemic therapy for colorectal cancer, and HIPEC with oxaliplatin or mitomycin C. At the treating physician's discretion, perioperative systemic therapy consists of either four 3-weekly neoadjuvant and adjuvant cycles of capecitabine with oxaliplatin (CAPOX), six 2-weekly neoadjuvant and adjuvant cycles of 5-fluorouracil/leucovorin with oxaliplatin (FOLFOX), or six 2-weekly neoadjuvant cycles of 5-fluorouracil/leucovorin with irinotecan (FOLFIRI) followed by four 3-weekly (capecitabine) or six 2-weekly (5-fluorouracil/leucovorin) adjuvant cycles of fluoropyrimidine monotherapy. Bevacizumab is added to the first three (CAPOX) or four (FOLFOX/FOLFIRI) neoadjuvant cycles. The first 80 patients are enrolled in a phase II study to explore the feasibility of accrual and the feasibility, safety, and tolerance of perioperative systemic therapy. If predefined criteria of feasibility and safety are met, the study continues as a phase III study with 3-year overall survival as primary endpoint. A total of 358 patients is needed to detect the hypothesised 15% increase in 3-year overall survival (control arm 50%; experimental arm 65%). Secondary endpoints are surgical characteristics, major postoperative morbidity, progression-free survival, disease-free survival, health-related quality of life, costs, major systemic therapy related toxicity, and objective radiological and histopathological response rates.
    Discussion: This is the first randomised study that prospectively compares oncological outcomes of perioperative systemic therapy and CRS-HIPEC with upfront CRS-HIPEC alone for isolated resectable colorectal PM.
    Trial registration: Clinicaltrials.gov/ NCT02758951 , NTR/ NTR6301 , ISRCTN/ ISRCTN15977568 , EudraCT/ 2016-001865-99 .
    MeSH term(s) Adult ; Bevacizumab/administration & dosage ; Chemotherapy, Adjuvant/adverse effects ; Colorectal Neoplasms/drug therapy ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/surgery ; Combined Modality Therapy ; Cytoreduction Surgical Procedures/adverse effects ; Disease-Free Survival ; Female ; Fluorouracil/administration & dosage ; Fluorouracil/adverse effects ; Humans ; Leucovorin/administration & dosage ; Leucovorin/adverse effects ; Male ; Middle Aged ; Neoplasm Metastasis ; Oxaliplatin/administration & dosage ; Oxaliplatin/adverse effects ; Perioperative Period ; Peritoneal Neoplasms/drug therapy ; Peritoneal Neoplasms/pathology ; Peritoneal Neoplasms/secondary ; Peritoneal Neoplasms/surgery ; Peritoneum/drug effects ; Peritoneum/pathology ; Peritoneum/surgery ; Progression-Free Survival ; Quality of Life
    Chemical Substances Oxaliplatin (04ZR38536J) ; Bevacizumab (2S9ZZM9Q9V) ; Leucovorin (Q573I9DVLP) ; Fluorouracil (U3P01618RT)
    Language English
    Publishing date 2019-04-25
    Publishing country England
    Document type Clinical Trial, Phase II ; Clinical Trial, Phase III ; Journal Article ; Randomized Controlled Trial
    ISSN 1471-2407
    ISSN (online) 1471-2407
    DOI 10.1186/s12885-019-5545-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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