CDRP Program UpdateUPMC McKeesport

Program Steering CommitteeRTOG Meeting

Toronto, CanadaJune 23rd, 2006

Overview

Multi-modality & RT trials clinical trialsUPMC Cancer Center InitiativesClinical trials accrualNavigators updateTELESYNERGY updateMentors update

Multi-modality Clinical Trials Tracking Mechanisms

UPMC Health System sites (UPMC McKeesport, New Castle, Murtha Cancer Pavilion)

Scan UPMC Cancer Centers protocol listings on monthly basis to identify service area patients

Navigators will work with on-site department nurses and med-onc protocol nurses to identify patients as they are put on trials

Mercy Cancer InstituteNo multi-modality trials offered

Somerset Oncology CenterNo trials offered at this site to dateRemains a challenge 20 to infrastructure but progress being made

UPMC Cancer Centers Initiative

African American Cancer Care Partnership (AACCP)$750,000 provided by UPMC Health System

4 UPMC sites designated – including UPMC McKeesportProvides payment for initial consult for newly

diagnosed breast, colorectal, lung or prostate cancerOn consult patients are evaluated for clinical trials as well

as needs for resource programs such as Patient NavigatorTo date 8 of 38 patients at the four sites have been entered

on clinical trials!!

All Clinical Trials Distributionby ethnicity (A/A = 14%) May 2006

0

1

2

3

4

5

6

7

8

2004 2005 2006

BlackWhiteHispanicOther

Population by Race* White Black Other Total

Allegheny County 1,069,111 159,112 43,389 1,271,61284% 13% 3% 100%

PA DOH 2001 Estimates

All Clinical TrialsComparison of multi-modality to RT enrollment

0123456789

10

Combo RT

Patients

All Clinical TrialsBy age: A/A (2004 – 2005)

0

1

2

3

4

5

6

7

8

A/A Non A/A

<65=/> 65

All Clinical Trialsby gender – May 2006

0

1

2

3

4

5

6

7

8

2004 2005 2006

MaleFemale

Other Clinical Trials

Patient NavigatorTotal patients: 195African American: 48 (25% over all 5 sites) Hispanic: 2 Asian: 1

ASTRO-Sponsored StudyHow Can Radiation Oncologists Better Serve Their

Patients? A Randomized Study to Determine Whether Radiation Oncologists Can Improve Patient Satisfaction by Attempting to Meet Their Patients’ Preferences (anticipated accrual = 500)

Patient NavigatorMay 2006

0

10

20

30

40

50

60

70

80

Jameson McKeesport Mercy

A/AWhiteHispanicAsian

14% A/A 18% A/A 32% A/A

Evaluation of the Tailored Patient Navigator Programs

for the Underserved Populations with Cancer is a “process” evaluation of a PNPstudy has enrolled 44 African Americans and

130 non-African Americans from the target areas who have a confirmed diagnosis of cancer

174 participants enrolled from January 2005 through May 2006, 32.1% of enrollees within the urban facility were African Americans versus 14.7% at the non-urban facility

52.9%

64.1%

47.1%

35.9%

0%

20%

40%

60%

80%

Under 65 65 and Older

Age

Distribution of Patient Age by Facility

Rural Facility Urban Facility

14.7%

32.1%

82.4%

67.0%

2.9% 0.9%

0%

20%

40%

60%

80%

100%

Black White Other

Distribution of Patient Race/Ethnicity by Facility Type

Rural Facility Urban Facility

26.5%23.6%

14.7%

23.6%

8.8%6.6%

0%

10%

20%

30%

Breast Cancer Lung Cancer Prostate

Distribution of Primary Type of Cancers among Patients Participating in Navigator Programs

Rural Facility Urban Facility

20.6%

16.0% 16.2%

35.8%

7.4%8.5%

0%

10%

20%

30%

Insurance Approval Transportation Co-payment

Primary Barriers to Cancer Treatment by Facility Type

Rural Facility Urban Facility

80

49

57

27

48

32

47

30

25

17

23

16 15

26

15

10

72

63

0

20

40

60

80

Min

utes

Finance Transportation Socialservices

Child services AmericanCancerSociety

Schedule End of life Reach toRecovery

Average timeper patient

Type of Services

Average Time Spent in Various Services by Patient Navigators

Rural Facility Urban Facility

TELESYNERGY®

Continue to formulate ways to integrate its use with mentors, esp. for professional development

System is integral to tumor board @ McKeesport

Streaming video capabilities allows for wider audience participation with teleconferencing

Demo at this meeting

Abstracts Publications Abstracts accepted for ASTRO 2006

A Comprehensive Outcomes-Based Planning and Evaluation Program for Implementing TELESYNERGY® and Other Videoconferencing Approaches in Radiation Oncology –Ed Ricci, PhD

Analysis of “Best Practice” Treatment Patterns for a Radiation Oncology Community Outreach Group (ROCOG) Engaged in Cancer Disparities Outcome-Julian Proctor, MD

Cancer Health Disparities symposium 2006 UPMC McKeesport Radiation Oncology Minorities Community

Outreach Group- Dwight Heron, MD International Intercultural Council 2006

Breaking Barriers: A Navigator Program of Cancer Care for the Underserved Populations-Karen Schwaderer, RN

Academy Health Symposium Evaluation of the Tailored Patient Navigator Programs for the

Underserved Populations with Cancer-Cho Cho Lin, PhD American Telemedicine Association

A Multi-institutional Mobility Initiative for TELESYNERGY® and other Teleconferencing Systems”-Larry Schenken, PhD

4 Manuscripts in preparation at various stages