Stearns Vered, Chen Ruizhe, Blackford Amanda L, Saylor Elizabeth, Mull Jill, Folmer Ann, Jelinek Jessica, Hodgdon Christine, Bacon Jacqueline, Engle Jessica, Shah Mirat, Sheinberg Rosanne, Pedraza-Cardozo Sandra, Wilkinson Mary, Alvendia Melissa, Snyder Claire, Smith Karen L
Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA.
Meyer Cancer Center, Weill Cornell Medicine (VS), 420 East 70 Street, 2 Floor, New York, NY, 10021, USA.
Breast Cancer Res Treat. 2025 Apr;210(3):551-562. doi: 10.1007/s10549-024-07591-5. Epub 2025 Jan 27.
Individuals with metastatic breast cancer (MBC) may live with their disease for many years. We initiated the Johns Hopkins Hope at Hopkins Clinic to assess the needs and optimize the care of these patients.
Patients with MBC who agreed to participate in the Clinic in addition to usual care completed patient-reported outcome (PRO) surveys. They met with a navigator and underwent core consults (cancer rehabilitation, integrative medicine, supportive and palliative care, social work, and nutrition), clinical trial eligibility assessment, and optional services based on PRO responses and selection from a Clinic Menu. A medical oncologist provided a Care Plan during a final consult. Participants were asked to complete 3- and 6-month follow-up PRO surveys. We report on initial Clinic implementation, participant characteristics, and baseline PROs.
From 11/2020 to 6/2022, 45 patients completed baseline surveys and participated in the Clinic. Median age was 58 (32-86); the majority (71%) were white and had estrogen receptor-positive (84%) tumors. Baseline physical and mental health were not good for ≥ 14 days of the past month for 22 and 10%, respectively. PROMIS measure scores were > 1 standard deviation worse than average for 32% for Physical Health, 16% for Mental Health, and 23% for Physical Function. PHQ-8 and GAD-7 scores suggested depression and anxiety for 22 and 7%, respectively. More than 80% of participants received specific recommendations from the core consultants. Only 20% of participants completed follow-up surveys.
Patients living with MBC have multiple needs. We used our results to implement routine PRO assessments and to expand services for patients with MBC. Our experience can serve as a model for coordinated care in other systems.
转移性乳腺癌（MBC）患者可能会与疾病共存多年。我们在约翰霍普金斯诊所启动了“约翰霍普金斯希望项目”，以评估这些患者的需求并优化其护理。
除常规护理外，同意参加该诊所项目的MBC患者完成了患者报告结局（PRO）调查。他们与一名导航员会面，并接受了核心咨询（癌症康复、综合医学、支持性和姑息性护理、社会工作以及营养）、临床试验资格评估，以及根据PRO反应和从诊所菜单中选择的可选服务。一名医学肿瘤学家在最后一次咨询时提供了护理计划。参与者被要求完成3个月和6个月的随访PRO调查。我们报告了诊所的初始实施情况、参与者特征和基线PROs。
从2020年11月到2022年6月，45名患者完成了基线调查并参加了该诊所项目。中位年龄为58岁（32 - 86岁）；大多数（71%）为白人，肿瘤为雌激素受体阳性（84%）。在过去一个月中，分别有22%和10%的患者基线身体和心理健康状况不佳持续≥14天。在身体健康方面，32%的患者PROMIS测量得分比平均水平差>1个标准差；在心理健康方面，16%的患者得分如此；在身体功能方面，23%的患者得分如此。PHQ - 8和GAD - 7得分分别表明22%的患者有抑郁症状，7%的患者有焦虑症状。超过80%的参与者收到了核心顾问的具体建议。只有20%的参与者完成了随访调查。
MBC患者有多种需求。我们利用研究结果实施常规PRO评估，并为MBC患者扩展服务。我们的经验可作为其他系统中协调护理的典范。
