Briefs

On June 22-23, 2006, the Johns Hopkins Office of Continuing Education will present its annual endoscopy course, “The Fifth Annual Diagnostic and Therapeutic Technique in Endoscopy: A Symposium for GI Nurses and Associates.” The course will be held in Las Vegas at the Caesar’s Palace conference center. This annual conference will educate GI nurses, associates and other allied health professionals working in endoscopy suites. Through formal lecture, challenging case presentations and interactive breakout sessions, course participants will be introduced to cutting-edge developments.

Topics include GI neoplasm, inflammatory bowel disease (IBD), and stenting, as well as issues related to the latest trends in sedation and pharmacology, and recent malpractice issues in endoscopy. For further information, please contact the Johns Hopkins’ Office of Continuing Education at (410) 955-2959 or visit them on the Web at www.hopkinscme.net. 

BEIRUT, Lebanon — In the first study of its kind, researchers discovered that rifaximin, an antibiotic used to treat diarrhea, is an effective treatment for abdominal bloating and flatulence, including in irritable bowel syndrome (IBS) patients. This research was published in the February 2006 issue of The American Journal of Gastroenterology.

In this randomized, double-blind, placebo-controlled trial, researchers at the American University of Beirut in Lebanon treated 124 patients with rifaximin therapy and found that it was effective at relieving the symptoms of bloating and excess gaseousness by way of reducing the amount of hydrogen gas produced in the large intestine. And because rifaximin is non-absorbable, there are no side effects, making it suitable for chronic use.

Research has shown that these symptoms are common and often more disturbing to IBS patients, as well as being harder to treat, than the commonly associated diarrhea and constipation. Fortunately, among the patients with IBS in the trial, a favorable response was also noted, which lasted even through the post-treatment phase of the study.

Source: Blackwell Publishing

LOS GATOS, Calif. — NeoGuide Systems, Inc., a developer of technology to prevent and treat colorectal cancer, announced that it received FDA 510(k) clearance to market its NeoGuide Endoscopy System. The system is designed to enhance physician control of the colonoscope and to eliminate looping, the principle reason why conventional colonoscopy procedures are painful, time-consuming, and difficult.

In conventional colonoscopy, advancing the colonoscope displaces the colon and stretches the surrounding tissue, a phenomenon known as looping. Unlike conventional scopes, the NeoGuide colonoscope is built out of multiple segments that can be actively controlled. As the physician inserts the NeoGuide scope, the system automatically creates a three-dimensional map of the colon and then directs these segments to follow the path taken by the tip.

In September 2005, NeoGuide successfully completed its initial clinical study with the system at Klinikum der Stadt Ludwigshafen in Ludwigshafen, Germany. Results of the study will be presented at the 2006 Digestive Disease Week (DDW) meeting in May. The company has also conducted extensive studies demonstrating the safety of the system and the potential to reduce looping in various bench top models.

Source: NeoGuide Systems, Inc.

Colon Cancer Alliance Offers Clinical Trial Buddy Program

NEW YORK — Colon cancer patients considering participation in a clinical trial can now access a peer-to-peer support system, the Buddy Program, the Colon Cancer Alliance (CCA) announced. As a result of this innovation, an experienced mentor will provide guidance to newly diagnosed patients about how to prepare for clinical trials and understand the process.

Thousands of clinical trials are available for patients to try new, experimental and investigational drugs. But fewer than 5 percent of adult cancer patients currently choose to participate in them.

“For the first time, colorectal cancer patients will have the opportunity to be educated about clinical trials by someone who has just been in their shoes,” said Amy Kelly, co-founder and executive director of the CCA. “We expect that the intimacy of this experience will encourage more patients to join trials. As more people participate, we will develop the necessary research to find the best treatments for the disease.”

Since 1995, participation in clinical trials has declined due to long-standing fear, apprehension and skepticism. Doctors also may not mention trials as an option, and access problems still exist. To help maximize the CCA’s Buddy Program and address some of these problems, all potential mentors will undergo training to ensure that they can offer the most appropriate guidance. The clinical trial component will expand an existing program in which colon cancer survivors, their families and friends are able to speak to others who have “been there.” These buddies provide a personal perspective on coping with side effects, treatment options, life after a colostomy and many other emotional issues. Those interested in learning more about the buddy program can visit www.ccalliance.org. 

The CCA also has implemented additional educational initiatives as a result of feedback from patients and caregivers. This year, the nonprofit plans to add live operators to its help line, develop patient education materials in Spanish, distribute more free materials to doctors and hospitals, add more guest speakers to on-line chats, continue to grow its local chapter program, “Voices,” and expand colon cancer conference sites and locations throughout the United States. The alliance also will make press kits available via their Web site for local groups or individuals wishing to promote National Colorectal Awareness Month.

Source: Colon Cancer Alliance

PHILADELPHIA — The Coalition of Cancer Cooperative Groups announced the launch of QuickLink — www.cancertrialshelp.org/patientsCaregivers/colorectalTrials.jsp — a new resource designed to help patients, caregivers and people at risk learn more about major colorectal cancer clinical trials. QuickLink can be found by visiting www.CancerTrialsHelp.org. 

“The only way to move toward a cure for colon cancer is through research,” said Robert L. Comis, MD, president, Coalition of Cancer Cooperative Groups. “As a direct outcome from clinical trials, five new drugs have received FDA approval over the last five years, making new and better treatments more available to patients with colorectal cancer today than ever before.”

Patients who join cancer clinical trials are given the best available treatment or a new treatment that, based on early clinical data, could be an improvement over the current standard therapy. In addition, there are many trials available for prevention, screening and early detection of colorectal cancer or pre-cancerous polyps.

“Clinical trials are not just a vital source of information; they can be of great value to the individuals who participate in them,” said Comis. “A common misperception that some patients receive placebo has prevented some people from participating in clinical trials.” Placebos are rarely used in cancer clinical trials and are never used in place of treatment.

There are nearly 270 colorectal cancer studies currently available for patients in the U.S., out of over 4,500 cancer trials of all types.¹ Now, QuickLink provides information on 10 of the largest colorectal trials currently available, along with links to patient support services and quick access to the screening capabilities of TrialCheck®, the coalition’s signature database and navigator of thousands of cancer clinical trials. TrialCheck offers a fast and easy way for people to locate clinical trials. Results are displayed by proximity to the user’s ZIP Code.

Recently, a group of experts from the oncology research community, academia, cancer cooperative groups, patient advocacy, and industry identified 10 trials as high priority colorectal clinical studies that address important research opportunities and merit support for rapid completion. Combined, these 10 large studies will need to enroll more than 17,500 participants. The Coalition’s Scientific Leadership Council in Gastrointestinal Cancer presented these trials as part of their recommendations for the future direction of colorectal cancer research at a forum in Washington, D.C., in December 2005, and at a major GI cancer meeting in San Francisco in January 2006.

WILMETTE, Ill. — Staffing and scheduling practices, the amount of patient time spent in ambulatory healthcare centers, and billing and collection methods are key factors in the efficiency of healthcare centers performing colonoscopy, one of the most common outpatient care procedures. Overall, patient satisfaction was high across all centers.

These are among the findings from the first non-clinical study of colonoscopy in ambulatory healthcare centers conducted by the AAAHC Institute for Quality Improvement, a subsidiary of the Accreditation Association for Ambulatory Healthcare. The study assessed performance measures on key non-clinical aspects of performing colonoscopy, including administrative and financial processes and patient satisfaction outcomes. Study results are for quality improvement purposes, and are inappropriate for use in setting reimbursement rates.

The Colonoscopy Non-Clinical Study, involving 40 organizations that together perform more than 130,000 colonoscopies per year, was conducted by the AAAHC Institute. A center needed to have performed at least 15 procedures in order for its data to be included in the benchmark analyses. A total of 725 cases from 31 facilities were included in the benchmark analyses. Other findings include:

• Staff costs per procedure ranged from $15 to $1,065 (median $70). Factors cited for low costs included employing a primarily part-time staff, using a rotational “call-off” list for staff cutbacks when census is low, and having nurse managers who work alongside clinical staff.
• Supply costs per procedure ranged from $5 to $77 (median $37). The organization with the lowest cost cited “comparison shopping” for the best prices as the prime factor in keeping costs down.
• Staff Time. Time devoted to scheduling a procedure ranged from two to 22 minutes, and time spent registering patients ranged from 10 to 59 minutes. Factors that lowered scheduling time included efficient IT systems, using forms pre-printed with the CPT codes for the most commonly performed procedures, and working closely with physicians’ offices to schedule procedures. Time spent processing patients was lowest for a surgery center staff that worked closely with the endoscopist’s office staff, and that had patient consent forms completed at the physician’s office during the pre-procedure consultation.
• Facility Time. The time patients spent from arrival at the facility until they were ready for discharge ranged from 81 to 243 minutes. Factors contributing to reduced patient facility time were: giving patients HIPAA and insurance forms prior to the procedure, having one nurse admit and assist in the procedure and recovery of the patient, using pre-printed pre-, intra- and post-procedure forms with minimal narrative, and pre-arranging transportation for prompt discharge.
• Billing. Staff time spent for billing ranged from two to 30 minutes and billing days after procedure ranged from less than one to 11. Low billing time was attributed to charge sheets that included procedure codes. These sheets are checked off by the attending nurse and verified before entering into the system. Using billing software, staff familiarity with codes, and billing every day when procedures are finished also were associated with lower billing time.
• Collection. Average time spent on collection ranged from 0 to 40 minutes and average days to collection ranged from seven to 98. The least time spent on collection was attributed to careful coding, electronic filing, frequent checking of account status online, good rapport between facility staff and claims staff, having insurance contracts loaded into the IT system, prior verification of benefits, collecting patient co-pay prior to or at the time of the procedure, and patient pre-registration by business office staff to assure accurate information.

In general, patient satisfaction was high regardless of how the ambulatory healthcare centers ranked on the nonclinical outcomes measured.

• More than 97 percent of patients rated their overall experience as positive, 2 percent rated it as neutral and less than 1 percent rated it as negative.
• 94 percent of patients indicated their procedures were scheduled as soon as they wanted.
• 40 percent of patients had to wait past their scheduled procedure time, of these, 32 percent waited longer than expected and 26 percent waited less time than expected.
• 98 percent of patients said healthcare providers showed concern for their comfort.

The AAAHC Institute Colonoscopy Non-Clinical Study was conducted between July 2004 and January 2005, and included 40 organizations that together perform more than 130,000 colonoscopies per year. Real-time data on factors including scheduling, patient processing, staffing, facility time, billing, collection and other costs associated with the procedures were gathered. Data from organizations that completed study questionnaires for 15 or more procedures were used in the benchmark analyses. Included in the final analyses were 725 colonoscopy cases from 31 organizations.

The purpose of the AAAHC Institute Ambulatory Surgery Non-Clinical Studies is to provide opportunities to initiate performance measurements on key administrative and financial processes and outcomes. The studies were undertaken by the Performance Measurement Initiative (PMI) of the AAAHC Institute, which also has completed a non-clinical study of ambulatory healthcare centers that perform cataract surgery. Other AAAHC Institute studies of ambulatory healthcare organizations are under way, including studies of liposuction, medical events, asthma and myringotomy.

Source: AAAHC 

NEW YORK — Gilda’s Club Worldwide launched “Snapshot of Survival,” a national art contest for people living with colorectal cancer, their families and friends, designed to highlight the widespread impact of colorectal cancer and their hopeful outlook for survival. The contest invites people affected by colorectal cancer to illustrate their interpretation of survival through art, a powerful means of expression and considered by many to be an important component of the healing process.

Winning artwork will be part of the Snapshot of Survival exhibit, which will be launched in New York City in July, 2006. After its launch, the exhibit will travel around the country to select cancer centers.

Selected artwork will be chosen by a panel of judges. Winners will be notified in summer 2006 and the first, second and third prize winners and their guests will be invited to attend the exhibit launch in New York City. All participants will be recognized in a 2006 issue of Coping with Cancer magazine.

For more information about entry criteria, contact Gilda’s Club at 888-GILDA-4-U or visit www.gildasclub.org. The Snapshot of Survival program is sponsored by sanofi-aventis.

Source: Gilda’s Club Worldwide

Share this article: Email, Slashdot, Digg, Del.icio.us, Yahoo!MyWeb, Windows Live Favorites, Furl
Add this article feed to: RSS, My Yahoo, Newsgator, Bloglines