The Association between Oxaliplatin-Induced Peripheral Neuropathy, Sociodemographic, and Clinical Characteristics with Falls in Older Adults with Colorectal Cancer.

Our purpose was to investigate the associations between oxaliplatin-induced peripheral neuropathy (OIPN), sociodemographic, and clinical characteristics of older colorectal cancer patients with falls. The study population consisted of older adults diagnosed with colorectal cancer obtained from the Surveillance, Epidemiology, and End Results database combined with Medicare claims. OIPN was defined using specific (OIPN 1) and broader (OIPN 2) definitions of OIPN, based on diagnosis codes. Extensions of the Cox regression model to accommodate repeated events were used to obtain overall hazard ratios (HR) with 95% confidence intervals and the cumulative hazard of fall. The unadjusted risk of fall for colorectal cancer survivors with vs. without OIPN 1 at 36 months of follow-up was 19.6% vs. 14.3%, respectively. The association of OIPN with time to fall was moderate (OIPN 1, HR = 1.37, 95% CI: 1.04, 1.79) to small (OIPN 2, HR = 1.24, 95% CI: 1.01, 1.53). Memantine, opioids, cannabinoids, prior history of fall, female sex, advanced age and disease stage, chronic liver disease, diabetes, and chronic obstructive pulmonary disease all increased the hazard rate of fall. Incorporating fall prevention in cancer care is essential to minimize morbidity and mortality of this serious event in older colorectal cancer survivors.

The association between sociodemographic, clinical, and potentially preventive therapies with oxaliplatin-induced peripheral neuropathy in colorectal cancer patients.

PURPOSE: The purpose of this retrospective cohort study was to evaluate whether several potentially preventive therapies reduced the rate of oxaliplatin-induced peripheral neuropathy (OIPN) in colorectal cancer patients and to assess the relationship of sociodemographic/clinical factors with OIPN diagnosis. METHODS: Data were obtained from the Surveillance, Epidemiology, and End Results database combined with Medicare claims. Eligible patients were diagnosed with colorectal cancer between 2007 and 2015, ≥ 66 years of age, and treated with oxaliplatin. Two definitions were used to denote diagnosis of OIPN based on diagnosis codes: OIPN 1 (specific definition, drug-induced polyneuropathy) and OIPN 2 (broader definition, additional codes for peripheral neuropathy). Cox regression was used to obtain hazard ratios (HR) with 95% confidence intervals (CI) for the relative rate of OIPN within 2 years of oxaliplatin initiation. RESULTS: There were 4792 subjects available for analysis. At 2 years, the unadjusted cumulative incidence of OIPN 1 was 13.1% and 27.1% for OIPN 2. For both outcomes, no therapies reduced the rate of OIPN diagnosis. The anticonvulsants gabapentin and oxcarbazepine/carbamazepine were associated with an increased rate of OIPN (both definitions) as were increasing cycles of oxaliplatin. Compared to younger patients, those 75-84 years of age experienced a 15% decreased rate of OIPN. For OIPN 2, prior peripheral neuropathy and moderate/severe liver disease were also associated with an increased hazard rate. For OIPN 1, state buy-in health insurance coverage was associated with a decreased hazard rate. CONCLUSION: Additional studies are needed to identify preventive therapeutics for OIPN in cancer patients treated with oxaliplatin.

How do Students Involved with a Campus Support Program for Students with a History of Foster Care, Relative Care, or Homelessness Fare After Graduation?

Background: Postsecondary education can provide opportunities for students from traditionally hidden populations like those who have experienced foster care or homelessness. To assist these students, campus support programs (CSPs) provide a wide range of services and activities. Objective: Evidence of the impact of CSPs is limited, and little is known about how students who were involved in CSPs fare at or after graduation. This study seeks to address these gaps in knowledge. Methods: This mixed-methods study surveyed 56 young people involved in a CSP for college students who have experienced foster care, relative care, or homelessness. Participants completed surveys at graduation, 6 months post-graduation, and one-year post-graduation. Results: At graduation, over two-thirds of the students felt completely (20.4%) or fairly (46.3%) prepared for life after graduation. Most felt completely (37.0%) or fairly confident (25.9%) that they would get a job after graduation. Six months after graduation, 85.0% of the graduates were employed, with 82.2% working at least full-time. 45% of the graduates were enrolled in graduate school. These numbers were similar a year after graduation. Post-graduation, participants described areas of their lives that were going well, obstacles and hardships faced, changes they would like to see in their lives, and post-graduation needs. Across these areas themes were present in the areas of finances, work, relationships, and resilience. Conclusions: Institutions of higher education and CSP should assist students with a history of foster care, relative care, and homelessness to ensure that after graduation, they have adequate money, employment, and support.