Papers by Melinda Gevorgian
Transplantation and Cellular Therapy, Mar 1, 2022
s / Transplant Cell Ther 28 3S (2021) S1–S509 S335 transplantation (HCT), sharing care is particu... more s / Transplant Cell Ther 28 3S (2021) S1–S509 S335 transplantation (HCT), sharing care is particularly relevant because patients often transfer between community practices and transplant centers (TCs). This study aimed to examine how community physicians evaluated their relationship with the nearest TC and how it affects their perceptions and attitudes regarding early treatment and post-HCT care. Methods: An online survey was conducted from Nov. 24, 2020 – Jan. 3, 2021 among 131 recruited, board-certified US hematologists/oncologists who had seen at least 2 acute myeloid leukemia (AML) patients in the past year. Pediatric-only physicians, those who perform HCT, and those self-identifying as “attached to or part of a dedicated BMT program within the same system” were excluded. TC relationship strength was measured by agreement with “I/my practice has a strong relationship with the nearest TC” on a 7-point scale (1 Completely disagree – 7 Completely agree). Physicians reporting ratings of 6-7 were defined as the Strong group, and ratings of 1-5 were defined as the Low/Neutral group. Agreement with statements about early treatment and post-HCT care was defined as ratings of 6-7. Chi-square tests were used to examine associations of TC relationship strength with treatment perspectives. Results: Fifty-two physicians (39.7%) were classified in the Low/Neutral group, and 79 (60.3%) were classified in the Strong group. No significant demographic differences were observed between the groups. Compared to the Strong group, the Low/ Neutral group had lower agreement with statements supporting early treatment behaviors, such as agreeing that receiving HCT in early-stage disease leads to improved patient outcomes (p=0.0012) (Table 1). The Low/Neutral group also had lower agreement with statements indicating confidence in providing post-HCT care, such as agreeing that they have had adequate training in post-HCT care (p<0.001) (Table 1). Discussion: While this study cannot prove a causal impact and the classification of relationship group is arbitrary, this research reveals that community physicians with lower-rated relationship strength with TCs indicate lower support for early treatment behaviors and lower confidence in managing post-transplant patients. A limitation of this study may be the definitions of “attachment” to a TC and the “nearest” TC varying due to self-reported data. Further research should investigate how to enhance the relationship between community practices and TC teams, which could potentially improve early treatment behaviors and quality of post-HCT care among community physicians. 431 Social Work Integration into Transplant and Cellular Therapy Program Andrea Rector, MSW1; Allison Farley, LMSW1 and DenEllen Sutherland, RN, MSN2. 1 HCA/TriStar Centennial Medical Center/ Sarah Cannon Transplant & Cellular Therapy Program, Nashville, TN; 2 Sarah Cannon Transplant and Cellular Therapy Program, TriStar Centennial Medical Center, Nashville, TN Background: Two full time positions for our adult population were integrated in to Sarah Cannon’s Transplant and Cellular Therapy Program. The program previously utilized Social Workers from the hospital’s case management department to provide transplant psychosocial evaluations and discharge planning needs. Our goal is to optimize meeting the complex psychosocial needs of the patient and their caregivers all the way along their survivorship journey. By our integration into the program, we are better positioned to identify and address psychosocial problems and intervene when beneficial. Discussion: Our program’s patient population consists of individuals 18 and older, who have a formal diagnosis of a blood cancer, or meet criteria for transplant and cellular therapy treatment. When social workers were first integrated fulltime into the program, in April 2020, census was low due to the onset of COVID +19 pandemic. From April through June of 2020 there were a total 23 patients who had a transplant or CAR-T, compared one year later those same months had 43 patients. Within the past year and a half, we have assisted 304 patients across both inpatient and outpatient service lines. Having the social workers integrated into the care team, we are observing that our patients and their support systems are benefitting from improved availability and expertise, which help to improve patient outcomes. As specialized providers with a broad spectrum of skills, we are flexible team members that collaborate and can be easily integrated into the treatment of the “whole person”. We add a unique position to assist with culturally inclusive services, participate in psychoeducation for both patient, family, and interdisciplinary team members. Other benefits to the patient include finding community resources that specifically meet the needs of our transplant population, assisting with patient FMLA and disability processes, increased emphasis on building healthy coping skills, and…
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Neuron, 2019
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Transplantation and Cellular Therapy, 2022
s / Transplant Cell Ther 28 3S (2021) S1–S509 S335 transplantation (HCT), sharing care is particu... more s / Transplant Cell Ther 28 3S (2021) S1–S509 S335 transplantation (HCT), sharing care is particularly relevant because patients often transfer between community practices and transplant centers (TCs). This study aimed to examine how community physicians evaluated their relationship with the nearest TC and how it affects their perceptions and attitudes regarding early treatment and post-HCT care. Methods: An online survey was conducted from Nov. 24, 2020 – Jan. 3, 2021 among 131 recruited, board-certified US hematologists/oncologists who had seen at least 2 acute myeloid leukemia (AML) patients in the past year. Pediatric-only physicians, those who perform HCT, and those self-identifying as “attached to or part of a dedicated BMT program within the same system” were excluded. TC relationship strength was measured by agreement with “I/my practice has a strong relationship with the nearest TC” on a 7-point scale (1 Completely disagree – 7 Completely agree). Physicians reporting ratings of 6-7 were defined as the Strong group, and ratings of 1-5 were defined as the Low/Neutral group. Agreement with statements about early treatment and post-HCT care was defined as ratings of 6-7. Chi-square tests were used to examine associations of TC relationship strength with treatment perspectives. Results: Fifty-two physicians (39.7%) were classified in the Low/Neutral group, and 79 (60.3%) were classified in the Strong group. No significant demographic differences were observed between the groups. Compared to the Strong group, the Low/ Neutral group had lower agreement with statements supporting early treatment behaviors, such as agreeing that receiving HCT in early-stage disease leads to improved patient outcomes (p=0.0012) (Table 1). The Low/Neutral group also had lower agreement with statements indicating confidence in providing post-HCT care, such as agreeing that they have had adequate training in post-HCT care (p<0.001) (Table 1). Discussion: While this study cannot prove a causal impact and the classification of relationship group is arbitrary, this research reveals that community physicians with lower-rated relationship strength with TCs indicate lower support for early treatment behaviors and lower confidence in managing post-transplant patients. A limitation of this study may be the definitions of “attachment” to a TC and the “nearest” TC varying due to self-reported data. Further research should investigate how to enhance the relationship between community practices and TC teams, which could potentially improve early treatment behaviors and quality of post-HCT care among community physicians. 431 Social Work Integration into Transplant and Cellular Therapy Program Andrea Rector, MSW1; Allison Farley, LMSW1 and DenEllen Sutherland, RN, MSN2. 1 HCA/TriStar Centennial Medical Center/ Sarah Cannon Transplant & Cellular Therapy Program, Nashville, TN; 2 Sarah Cannon Transplant and Cellular Therapy Program, TriStar Centennial Medical Center, Nashville, TN Background: Two full time positions for our adult population were integrated in to Sarah Cannon’s Transplant and Cellular Therapy Program. The program previously utilized Social Workers from the hospital’s case management department to provide transplant psychosocial evaluations and discharge planning needs. Our goal is to optimize meeting the complex psychosocial needs of the patient and their caregivers all the way along their survivorship journey. By our integration into the program, we are better positioned to identify and address psychosocial problems and intervene when beneficial. Discussion: Our program’s patient population consists of individuals 18 and older, who have a formal diagnosis of a blood cancer, or meet criteria for transplant and cellular therapy treatment. When social workers were first integrated fulltime into the program, in April 2020, census was low due to the onset of COVID +19 pandemic. From April through June of 2020 there were a total 23 patients who had a transplant or CAR-T, compared one year later those same months had 43 patients. Within the past year and a half, we have assisted 304 patients across both inpatient and outpatient service lines. Having the social workers integrated into the care team, we are observing that our patients and their support systems are benefitting from improved availability and expertise, which help to improve patient outcomes. As specialized providers with a broad spectrum of skills, we are flexible team members that collaborate and can be easily integrated into the treatment of the “whole person”. We add a unique position to assist with culturally inclusive services, participate in psychoeducation for both patient, family, and interdisciplinary team members. Other benefits to the patient include finding community resources that specifically meet the needs of our transplant population, assisting with patient FMLA and disability processes, increased emphasis on building healthy coping skills, and…
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Papers by Melinda Gevorgian