Shelburne Nonniekaye, Simonds Naoko Ishibe, Jensen Roxanne E, Brown Jeremy
Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20850 USA.
The Scientific Consulting Group, Inc., Gaithersburg, USA.
Emerg Cancer Care. 2022;1(1):4. doi: 10.1186/s44201-022-00005-6. Epub 2022 Jun 14.
Cancer-related emergency department (ED) visits often result in higher hospital admission rates than non-cancer visits. It has been estimated many of these costly hospital admissions can be prevented, yet urgent care clinics and EDs lack cancer-specific care resources to support the needs of this complex population. Implementing effective approaches across different care settings and populations to minimize ED and urgent care visits improves oncologic complication management, and coordinating follow-up care will be particularly important as the population of cancer patients and survivors continues to increase. The National Cancer Institute (NCI) and the Office of Emergency Care (OECR) convened a workshop in December 2021, "Cancer-related Emergency and Urgent Care: Prevention, Management, and Care Coordination" to highlight progress, knowledge gaps, and research opportunities. This report describes the current landscape of cancer-related urgent and emergency care and includes research recommendations from workshop participants to decrease the risk of oncologic complications, improve their management, and enhance coordination of care.
Since 2014, NCI and OECR have collaborated to support research in cancer-related emergency care. Workshop participants recommended a number of promising research opportunities, as well as key considerations for designing and conducting research in this area. Opportunities included better characterizing unscheduled care services, identifying those at higher risk for such care, developing care delivery models to minimize unplanned events and enhance their care, recognizing cancer prevention and screening opportunities in the ED, improving management of specific cancer-related presentations, and conducting goals of care conversations.
Significant progress has been made over the past 7 years with the creation of the Comprehensive Oncologic Emergency Research Network, broad involvement of the emergency medicine and oncology communities, establishing a proof-of-concept observational study, and NCI and OECR's efforts to support this area of research. However, critical gaps remain.
与癌症相关的急诊科就诊往往比非癌症就诊导致更高的住院率。据估计，许多此类昂贵的住院治疗是可以避免的，但紧急护理诊所和急诊科缺乏针对癌症患者的护理资源，无法满足这一复杂人群的需求。在不同的护理环境和人群中实施有效的方法以尽量减少急诊科和紧急护理就诊，可改善肿瘤并发症的管理，并且随着癌症患者和幸存者数量的持续增加，协调后续护理将尤为重要。美国国立癌症研究所（NCI）和紧急护理办公室（OECR）于2021年12月召开了一次研讨会，主题为“与癌症相关的紧急和紧急护理：预防、管理和护理协调”，以突出进展、知识差距和研究机会。本报告描述了与癌症相关的紧急和紧急护理的现状，并包括研讨会参与者提出的研究建议，以降低肿瘤并发症的风险、改善其管理并加强护理协调。
自2014年以来，NCI和OECR合作支持与癌症相关的紧急护理研究。研讨会参与者推荐了一些有前景的研究机会，以及在该领域设计和开展研究的关键考虑因素。机会包括更好地描述非计划护理服务、识别此类护理风险较高的人群、开发护理模式以尽量减少意外事件并加强护理、在急诊科识别癌症预防和筛查机会、改善特定癌症相关症状的管理以及进行护理目标对话。
在过去7年中取得了重大进展，创建了综合肿瘤紧急研究网络，急诊医学和肿瘤学界广泛参与，开展了一项概念验证观察性研究，以及NCI和OECR在支持这一研究领域所做的努力。然而，关键差距仍然存在。
