The Cancer Health Empowerment For Living Without Pain Study May Benefit Mesothelioma Patients

Cancer-related pain is common and under-treated. This article describes a study designed to test the effectiveness of a theory-driven, patient-centered coaching intervention to improve cancer pain processes and outcomes.

Methods: The Cancer Health Empowerment for Living without Pain (Ca-HELP) Study is an American Cancer Society sponsored randomized trial conducted in Sacramento, California.

A total of 265 cancer patients with at least moderate pain severity (Worst Pain Numerical Analog Score >=4 out of 10) or pain-related impairment (Likert score >= 3 out of 5) were randomly assigned to receive tailored education and coaching (TEC) or educationally-enhanced usual care (EUC); 258 received at least one follow-up assessment. The TEC intervention is based on social-cognitive theory and consists of 6 components (assess, correct, teach, prepare, rehearse, portray).

Both interventions were delivered over approximately 30 minutes just prior to a scheduled oncology visit. The majority of visits (56%) were audio-recorded for later communication coding.

Follow-up data including outcomes related to pain severity and impairment, self-efficacy for pain control and for patient-physician communication, functional status and well-being, and anxiety were collected at 2, 6, and 12 weeks.DiscussionBuilding on social cognitive theory and pilot work, this study aims to test the hypothesis that a brief, tailored patient activation intervention will promote better cancer pain care and outcomes. Analyses will focus on the effects of the experimental intervention on pain severity and impairment (primary outcomes); self-efficacy and quality of life (secondary outcomes); and relationships among processes and outcomes of cancer pain care.

If this model of coaching by lay health educators proves successful, it could potentially be implemented widely at modest cost. [Clinical Trials Identifier: NCT00283166]

Author: Richard KravitzDaniel TancrediRichard StreetDonna KalauokalaniTim GrennanTed WunChristina SleeDionne Evans DeanLinda LewisNaomi SaitoPeter Franks
Credits/Source: BMC Cancer 2009, 9:319

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Foundation Announces Grant To Help Hospitals Create Palliative Care Programs

The most fragile patients often receive the most intensive medical care, and research shows their comfort too often takes a back seat to curative treatment or intervention. Unveiling its signature philanthropic program, Sojourns, The Regence Foundation aims to foster best practices, leadership and collaboration that help people with life-threatening and incurable illness to access quality palliative care in their own community.

Palliative care is a holistic approach that treats the whole person, including management of pain and other discomfort, at any stage of disease while supporting caregivers and families. Depending on a patient’s needs and goals for care, palliative care may be combined with or supplant curative therapies.

“Increasingly, research shows that patients’ treatment desires and comfort are overlooked,” said Michael Alexander, Regence Foundation board chair. “The Regence Foundation seeks to identify best practices in which treatment and care meet with patient and family desires, and to extend those practices to our members, whether they are suffering years with a life-threatening illness or facing a limited prognosis.”

The Regence Foundation’s Sojourns Pathway grants will promote hospital- and community-based palliative care services that help patients, families, and medical and other health professionals get a clear understanding of effective treatment options and patient desires, increasing patient engagement in treatment decisions.

Grants target three phases: Hospitals that need to plan a palliative care program; those that seek to implement a plan for a program and those with a program that seek to expand it through partnerships with other community organizations. Deadlines vary, but the Foundation began accepting proposals for “Innovation” grants on July 20, 2009.

Through an arrangement with the University of California San Francisco Palliative Care Service and Palliative Care Leadership Center, hospitals that receive planning grants will receive training in how to build and sustain an effective palliative care program. Palliative Care Leadership Centers (PCLC) is a national training and mentoring initiative, with direction and technical assistance provided by the Center to Advance Palliative Care (CAPC).

To learn more about Sojourns and to download the Requests for Proposals (RFPs), visit the Regence Foundation Web site.

The Regence Foundation is the corporate foundation of The Regence Group, the largest health insurer in the Northwest/Intermountain region and a not-for-profit independent licensee of the Blue Cross and Blue Shield Association. A 501(c)3 grantmaking organization, the Foundation partners with organizations driving significant change in health care delivery and accessibility in Idaho, Oregon, Utah and Washington.

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Mesothelioma Aid : Financial Plan For Mesothelioma Patients - III

Compensation from Asbestos Industry

Mesothelioma is a rare form of cancer which is associated with exposure to asbestos. Those who are diagnosed most often worked in construction trades, or at industrial sites such as shipyards, power plants, refineries, paper mills, manufacturing plants, and foundries. Many Navy retirees who served their country proudly aboard ships in World War II and Korea were exposed to asbestos as machinist mates, firemen, and boiler tenders. Wives were exposed when they did the laundry of husbands who brought asbestos fibers into the home on work clothing. Because of the long latency period involved in asbestos cancer (mesothelioma), those exposed to products in the 1940s, 50s, 60s, and early 70s, are just now being diagnosed.

People are often surprised to find out that compensation may be available to mesothelioma victims from the asbestos industry. This compensation can provide financial security and allow for peace of mind while families try to come to terms with the results of a mesothelioma diagnosis.

It has been proven in part through internal company documents, in part through the testimony of company employees, and in part through medical literature compiled by these companies, that product manufacturers were aware of the dangers of asbestos as early as the 1920s. For over 50 years, until the government stepped in the1970s, manufacturers actively conspired to keep their knowledge of the hazards of asbestos secret. Now, many of these manufacturers are willingly negotiating settlements.

Filing for Compensation Early

Taking care of your medical needs is always the most important matter to consider when you have been diagnosed with mesothelioma, but sometimes financial pressures can make treatment decisions more difficult. Compensation from the asbestos manufacturers is one way to help ease financial concerns over the cost of treatment as well as seeing that your family’s future is made more secure. It is generally a good idea to look at compensation in the same way that you approach your medical decisions – as an option you have to maintain control over your life.

Filing your claim early on is important for several reasons:

• Freedom of Choice for Treatment - Mesothelioma is still considered a relatively rare cancer, and therefore, it is sometimes important to seek a second opinion or surgical option from a mesothelioma specialist. Unfortunately, these doctors may be located some distance from where you live, and there may be costs for transportation and lodging as well as for medical services. You may also wish to participate in a clinical trial which are normally offered only at a limited number of cancer facilities. In short, not every medical option may be available locally, and having the financial freedom to consider every option soon after diagnosis is important.

• Statute of Limitations - Every state has a Statute of Limitations, or a time period in which you may file a claim. Once the Statute of Limitations has expired, you forfeit the right to compensation. The rules governing when statues go into effect may vary from state to state.
  
• Information Necessary for the Claims Process - There is information relative to your work history and asbestos exposure that you can supply better than anyone else. If you become too ill or pass away before filing a claim, it will be that much more difficult to establish how, when, where and to what products you may have been exposed.
  

For more information on state statutes of limitations or information related to the claims process, contact a mesothelioma attorney.

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Mesothelioma Aid : Financial Plan For Mesothelioma Patients - II

Type of Insurance and Care Provider for Mesothelioma Patients:

Conventional insurance allows a patient to choose any doctor, and go to virtually any hospital anywhere in the country. You have the assurance that your doctor's medical recommendations are made entirely in your best interest. Managed Care plans are corporations serving large groups of people through a method of financing and delivering health care for a set fee using a network of physicians and other health care providers. The network coordinates and refers patients to its health providers and hospitals, and monitors the amount and patterns of care delivered. Managed care plans usually limit which services patients may receive by using "gatekeepers", or primary care physicians, to make sure services considered unnecessary, or referrals outside the network are kept to a minimum.

An HMO (Health Maintenance Organization) is the most common form of "managed care". It is a group that contracts with medical facilities, physicians, employers and sometimes individual patients to provide medical care to a group of individuals. This care is usually paid for by an employer at a fixed price per patient. Patients generally do not have any significant "out-of-pocket" expenses. An HMO may, however, control the amount of health care the doctor is allowed to provide. Many HMOs require that you choose a primary care doctor from their list. Unless this practitioner decides your medical problem is outside his expertise, you may not receive approval to see a specialist. Likewise, many HMOs limit patients to selected hospitals.

A PPO (Preferred Provider Organization) is a managed care organization that contracts with a network of doctors, hospitals and other health care providers who deliver services for set fees, usually at a discount to the managed care organization. In a PPO, consumers must choose primary health providers from an approved list and must pay extra for specialty services received outside the PPO group.

A POS (Point of Service Plan) is a health plan whose members can choose their services when they need them, either in the HMO or from a provider outside the HMO, at some cost to the member, or a plan in which the primary provider directs services and referrals.

Medicare is a health insurance program for people 65 years of age and older, some people with disabilities under age 65 and people with end-stage renal disease requiring dialysis or transplant. Medicare has two parts, Part A and Part B.

Part A covers hospital insurance; most people do not have to pay for Part A. This helps pay for care in hospitals as an inpatient, critical access hospitals (small facilities in rural areas with limited inpatient and outpatient services), skilled nursing facilities, hospice care and some home health care.

Part B covers medical insurance; most people pay monthly for Part B. This helps pay for doctors, services, outpatient hospital care and some other medical services that Part A does not cover, such as physical and occupational therapy and some home health care. Part B helps pay for these services when they are medically necessary.

Medicaid is a jointly funded federal/state health insurance program for certain low-income and needy people. It covers approximately 36 million individuals including children, the elderly, the blind and/or disabled and people who are eligible to receive federally assisted income maintenance payments.

to be continued....

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Mesothelioma Aid : Financial Plan For Mesothelioma Patients

Being diagnosed with mesothelioma can impose a heavy financial burden on both the patient and their family. Few patients can afford to completely pay their own way when it comes to treatment, relying on medical insurance to cover at least a portion of the cost; individuals who are uninsured or under insured, generally need to seek financial assistance from other sources. Although there is no typical cost for cancer care, it is not unusual for medical bills to escalate quickly beyond six figures.

Having the knowledge that resources are available, is the first step in coping financially with a diagnosis of mesothelioma. There are organizations and programs on the local, state and federal levels that can help, and compensation is also available to those diagnosed with mesothelioma through the manufacturers of the products that caused their illness. Making sound financial decisions for the future of your family is important, and addressing these issues early on will give you the peace of mind to concentrate fully on your medical care.

Paying For Your Treatment

Part of dealing with mesothelioma realistically involves thinking through how you will pay for your treatment, and ultimately, how your family will be taken care of. Diagnosis, treatment and sometimes support services are expensive, and you may not be able to work full-time during this period, or you may be retired.

Without insurance it may be difficult to obtain the medical treatment of your choice, and even people who have medical insurance will need to do some finanical planning at this time. Resolving financial issues early on will lift the burden of worrying about your medical care and the well-being of your family.

If you are covered under an individual or group health plan, you should talk with your claims representative to find out exactly what your plan will cover. Plans can vary greatly on what types of treatment are covered, on the length of hospital stays and on the amount you must pay before your coverage begins. Some plans cover home care services, others do not.

If you are over the age of 65 or are disabled, the Medicare program may provide some health care benefits. Many people on Medicare have supplemental insurance policies to cover what Medicare does not. You can inquire about your eligibility for Medicare by contacting your local Social Security Office or the Medicare Hotline,1-800-MEDICARE (1-800-633-4227). Some people on Medicare are also eligible for Medicaid. You can find out about eligibility requirements for their services by contacting your state or local department of social services or through the federal government's Centers for Medicare and Medicaid Services (formerly known as the Health Care Financing Administration) website at http://www.cms.hhs.gov/

Financial compensation may also be available to mesothelioma patients and their families through claims against the manufacturers of products which contained asbestos. It is widely acknowledged that asbestos is the cause of mesothelioma. For more information on your legal rights, legal services and compensation for which you may be eligible, contact a mesothelioma lawyer.

to be continued...

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