ABSTRACT
Global oncology research and training are crucial to address the growing global burden of cancer, which largely and increasingly occurs in low-income and middle-income countries. To better understand global oncology activities at the 71 National Cancer Institute (NCI)-designated cancer centres, the US NCI Centre for Global Health regularly surveys cancer centre directors, global oncology leads, and principal investigators in 36 US states and the District of Columbia. The survey results complement internal and publicly available data about global oncology research funded directly by the US National Institutes of Health to provide a comprehensive catalogue of global oncology research, training, and activities led by NCI-designated cancer centres. 91% (61 of 67) of responding cancer centres reported global oncology activities not directly funded by the National Institutes of Health. The survey results indicate that global oncology is an important priority at cancer centres and provide a valuable resource for these centres, researchers, collaborators, trainees, and the NCI and other funders.
Subject(s)
Medical Oncology , Neoplasms , United States , Humans , National Cancer Institute (U.S.) , Surveys and Questionnaires , Neoplasms/epidemiology , Neoplasms/therapy , National Institutes of Health (U.S.)ABSTRACT
BACKGROUND: Nonadherence to medication is a burden to the US health care system and is associated with poor clinical outcomes. Data on outpatient parenteral antimicrobial therapy (OPAT) treatment plan adherence are lacking. The purpose of this study is to determine the rate of nonadherence and factors associated with it. METHODS: We surveyed patients discharged from a tertiary hospital on OPAT between February and August 2019 about their baseline characteristics, OPAT regimen, adherence, and experience with OPAT. RESULTS: Sixty-five patients responded to the survey. The median age was 62 years, and 56% were male. The rate of reported nonadherence to intravenous (IV) antibiotics was 10%. Factors associated with nonadherence to IV antibiotics included younger age, household income of <$20â 000, and lack of time for administering IV antibiotics (30 vs 64 years, Pâ <â .01; 83% vs 20%, Pâ <â .01, and 33% vs 4%, Pâ =â .04, in the nonadherent vs adherent groups, respectively), while less frequent administration (once or twice daily) and having friend or family support during IV antibiotic administration were associated with better adherence (17% vs 76%, Pâ <â .01, and 17% vs 66%, Pâ =â .03, in the nonadherent vs adherent groups, respectively). Most patients attended their infectious diseases clinic visits (nâ =â 44, 71%), and the most commonly cited reasons for missing an appointment were lacking transportation (nâ =â 12, 60%), not feeling well (nâ =â 8, 40%), and being unaware of the appointment (nâ =â 6, 30%). CONCLUSIONS: Less frequent antibiotic dosing and better social support were associated with improved adherence to OPAT. In contrast, younger age, lower income, and lack of time were associated with nonadherence.
