Early integration of palliative care has been shown to improve the quality of life and decrease aggressive end-of-life measures for patients with cancer. However, data is limited in patients receiving immunotherapy who experience treatment-related complications. This single-center retrospective cohort study examined the effect of palliative care evaluation among all lung cancer patients who received at least one dose of immune checkpoint inhibitor between 6/1/18 and 2/1/20 (n=210) and who were subsequently hospitalized and started on steroids (n=97). We evaluated the rates of ICU admissions, intubation, CPR, hospice referrals and code status changes. In our high-risk cohort of 97 patients, median follow-up was 23 months with progression in 54 patients (56%) at median 11 months (IQR 6-26) and death in 67 patients (69%) at median 14mo (IQR 9-29). Primary outcomes are described in Table 1. Thirty-one patients (32%) were referred and 25 (26%) were seen by palliative care. Patients who initially presented with cancer as an incidental, asymptomatic finding were less likely to be referred to palliative care (OR 0.07, 95% CI 0.01-0.55). Patients who were first seen by palliative care as an outpatient (n=9) were seen earlier in their disease course at median 146 days (IQR 104-469) compared to those who were first seen while hospitalized (n=15) at median 610 days (IQR 287-944, p 0.03). Involvement of palliative care was associated with a lower rate of ICU admission and increased rate of referral to hospice for end of life care. Code status changes were not associated with palliative care consultation. Intubation and CPR were uncommon events even in this high-risk cohort. Prospective evaluation is needed for validation of these findings.

potential benefit in selecting candidates for PD-1/PDL-1 targeted immunotherapy in metastatic NSCLC and in this limited dataset were associated with the development of some autoimmune adverse events.Further studies are ongoing.

Electronic PROMs have many potential uses in orthopaedic practice. The primary objective of this three-phase pilot study was to measure uptake using a web-based ePROM system following the introduction of two separate process improvements.80 consecutive new elective orthopaedic patients in a single surgeon's practice were recruited. Group 1 (n=26) received a reminder letter, Group 2 (n=31) also received a SMS message via mobile or home telephone and Group 3 (n=23) also had access to Tablet Computer in clinic.Overall 79% of patients had Internet access. 35% of Group 1, 55% of Group 2 and 74% of Group 3 recorded an ePROM score (p=0.02). There was no significant age difference between groups. In Group 3, 94% of patients listed for an operation completed an ePROM score (p=0.006).Collecting PROM data effectively in everyday clinical practice is challenging. Electronic collection should improve healthcare delivery, but is in its infancy. This pilot study shows that the combination of SMS reminder and access to T...

I1: Trauma, Pre-hospital and Cardiac Arrest Care 2015

Musculoskeletal CareVolume 14, Issue 2 p. 116-120 Short Report The Cost of Improving Hip Replacement Follow-Up in the UK N. Roberts, N. Roberts Royal Cornwall Hospital, Truro, UKSearch for more papers by this authorR. Mujica-Mota, R. Mujica-Mota University of Exeter, Exeter, UKSearch for more papers by this authorD. Williams, Corresponding Author D. Williams Royal Cornwall Hospital, Truro, UK Correspondence Dan Williams, Consultant in Trauma and Orthopaedics, Royal Cornwall Hospital, Truro, Cornwall, TR1 3LJ, UK. Tel: +44 (0)1872 250000. Email: danwilliams@doctors.org.ukSearch for more papers by this author N. Roberts, N. Roberts Royal Cornwall Hospital, Truro, UKSearch for more papers by this authorR. Mujica-Mota, R. Mujica-Mota University of Exeter, Exeter, UKSearch for more papers by this authorD. Williams, Corresponding Author D. Williams Royal Cornwall Hospital, Truro, UK Correspondence Dan Williams, Consultant in Trauma and Orthopaedics, Royal Cornwall Hospital, Truro, Cornwall, TR1 3LJ, UK. Tel: +44 (0)1872 250000. Email: danwilliams@doctors.org.ukSearch for more papers by this author First published: 07 August 2015 https://doi.org/10.1002/msc.1117Citations: 6Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume14, Issue2June 2016Pages 116-120 RelatedInformation

Method Semi-structured interviews were conducted with 10 participants from a single hospital prior to MTC designation including clinicians, nursing and management staff. A topic guide was designed using the TDF. Interview transcripts were analysed following a framework analysis approach and coded according to TDF domains. Themes were analysed for relevance according to prevalence, expressed importance, discordance and underlying evidence base.

INTRODUCTION Electronic patient reported outcome measures (PROMs) enable real time reporting back to the patient and medical team, comparison between similar patient cohorts and long-term cost effective outcome measurement. The primary objective of this three-phase pilot study was to measure uptake using a web-based PROM system following the introduction of two separate process improvements. METHODS Eighty consecutive new elective orthopaedic patients in a single surgeon's practice were recruited for the study. Patients in Group 1 (n=26) received only a letter reminding them to complete a symptom score. Those in Group 2 (n=31) also received a reminder SMS (short message service) message via their mobile or home telephone and those in Group 3 (n=23) also had access to a tablet computer in clinic. RESULTS The mean patient age in Group 1 was 55 years (range: 24-80 years), in Group 2 it was 60 years (range: 23-85 years) and in Group 3 it was 58 years (range: 37-78 years) (p>0.05). Overall, 79% of patients had internet access, and 35% of Group 1, 55% of Group 2 and 74% of Group 3 recorded an electronic PROM score (p=0.02). In Group 3, 94% of patients listed for an operation completed an electronic PROM score (p=0.006). CONCLUSIONS Collecting PROM data effectively in everyday clinical practice is challenging. Electronic collection should meet that challenge and improve healthcare delivery but it is in its infancy. This pilot study shows that the combination of an SMS reminder and access to a Wi-Fi enabled tablet computer in the clinic setting enabled 94% of patients listed for an operation to complete a score on a web-based clinical outcomes system. Additional staff training and telephone call reminders may further improve uptake.

Background Up to 62% of severe injuries in British patients include Traumatic Brain Injury (TBI) [1]. 48% of these severe TBIs have unfavourable 6-month outcome with large variations in mortality and morbidity between centres [2]. Most deaths occur from brainstem herniation [3]. This project aimed to evaluate current best-practice for gaps in knowledge, care, and research, to determine what changes could best improve TBI care, and to project optimum treatment for 2020.

A 68-year-old woman presented to the acute general practitioner service with a 7-day history of worsening shortness of breath and cough, nausea and vomiting of any oral intake, and for the past 3 days severe left-sided abdominal pain radiating through to the back. Past medical history was significant for chronic obstructive pulmonary …