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dc.contributor.authorBradford, Natalie K
dc.contributor.authorWalker, Roderick
dc.contributor.authorHenney, Roslyn
dc.contributor.authorInglis, Po
dc.contributor.authorChan, Raymond J
dc.date.accessioned2020-08-11T03:14:28Z
dc.date.available2020-08-11T03:14:28Z
dc.date.issued2018
dc.identifier.issn2156-5333
dc.identifier.doi10.1089/jayao.2017.0042
dc.identifier.urihttp://hdl.handle.net/10072/390534
dc.description.abstractAims: The consequences of cancer and treatment on fertility can be a continuing source of distress for adolescents and young adults. The study aims were to assess the effects of bundled interventions on clinical practice concerning fertility in young people aged 14-25 years with cancer. Methods: Bundled interventions, including development of quality indicators, resources, and targeted education, were introduced during 2015 across five cancer centers. Data before interventions (2012-2014) were compared with data prospectively collected during 2015-2016. Relative risks (RR) with 95% confidence intervals (CI) were calculated to assess effects of interventions. Results: Compared with the pre-intervention cohort (n = 260), the post-intervention cohort (n = 216) was 1.47 times more likely to have documented discussion of risk of infertility (95% CI 1.12-1.63, p = <0.001). Similarly, documented referral to fertility specialists was more likely in the post-intervention cohort (RR 1.53, 95% CI 1.26-1.87, p = <0.001) as was documented fertility preservation outcomes (RR 2.56, 95% CI 1.91-3.44, p = <0.001). These differences were significant across age, gender, and diseases. Females had greater improvement in documented risk of infertility discussion between cohorts (RR 1.70, 95% CI 1.19-2.08, p = <0.001). Among diseases, the greatest improvements were seen in those with brain cancers (RR 2.15, 95% CI 1.28-3.62, p = 0.004) and soft tissue sarcoma (RR 2.60, 95% CI 1.17-5.78, p = 0.02). Conclusions: We have demonstrated the effects of bundled interventions to improve clinical practice associated with fertility preservation in young people with cancer. Interventions were successful for reducing disparities identified in the pre-intervention cohort associated with gender and certain diseases. Assessment of the quality of patient care is not possible without accurate, consistent documentation.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherMary Ann Liebert, Inc
dc.relation.ispartofpagefrom37
dc.relation.ispartofpageto45
dc.relation.ispartofissue1
dc.relation.ispartofjournalJournal of Adolescent and Young Adult Oncology
dc.relation.ispartofvolume7
dc.subject.fieldofresearchNursing
dc.subject.fieldofresearchOncology and carcinogenesis
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchcode4205
dc.subject.fieldofresearchcode3211
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsOncology
dc.subject.keywordsfertility preservation
dc.subject.keywordsoncofertility
dc.titleImprovements in Clinical Practice for Fertility Preservation Among Young Cancer Patients: Results from Bundled Interventions
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationBradford, NK; Walker, R; Henney, R; Inglis, P; Chan, RJ, Improvements in Clinical Practice for Fertility Preservation Among Young Cancer Patients: Results from Bundled Interventions, Journal of Adolescent and Young Adult Oncology, 2018, 7 (1), pp. 37-45
dc.date.updated2020-01-16T04:32:01Z
dc.description.versionAccepted Manuscript (AM)
gro.rights.copyrightThis is a copy of an article published in Journal of Adolescent and Young Adult Oncology. Copyright 2018 Mary Ann Liebert, Inc. Final publication is available from Mary Ann Liebert, Inc., publishers https://doi.org/10.1089/jayao.2017.0042
gro.hasfulltextFull Text
gro.griffith.authorChan, Ray


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