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4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes

OBJECTIVES/GOALS: Achieving therapy for hepatocellular carcinoma (HCC) involves navigating through a complex cascade of care. Non-HCC cancer mortality has been associated with social determinants of health outside of cancer specific risk. Our objective is to explore the impact of social determinants...

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Autores principales: Nephew, Lauren Devore, Rawl, Susan, Desai, Archita, Orman, Eric, Ghabril, Marwan, Patidar, Kavish, Chalasani, Naga
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8822909/
http://dx.doi.org/10.1017/cts.2020.281
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author Nephew, Lauren Devore
Rawl, Susan
Desai, Archita
Orman, Eric
Ghabril, Marwan
Patidar, Kavish
Chalasani, Naga
author_facet Nephew, Lauren Devore
Rawl, Susan
Desai, Archita
Orman, Eric
Ghabril, Marwan
Patidar, Kavish
Chalasani, Naga
author_sort Nephew, Lauren Devore
collection PubMed
description OBJECTIVES/GOALS: Achieving therapy for hepatocellular carcinoma (HCC) involves navigating through a complex cascade of care. Non-HCC cancer mortality has been associated with social determinants of health outside of cancer specific risk. Our objective is to explore the impact of social determinants on HCC outcomes. METHODS/STUDY POPULATION: Patients with HCC were enrolled from 3 hospitals form June, 1 2019 to December 1, 2019. A chart review was done to collect information on liver disease severity and cancer stage. Patients were interviewed to collect information on the following: 1) socioeconomic status (income, education, insurance status, and employment status), 2) literacy (Rapid Estimate of Adult Literacy in Medicine (REALM-R) and Brief Health Literacy Screening Tool (BREIF)), 3) social support (Patent Reported Outcome Measurement Information System (PROMIS) instrumental and information support tool), 4) quality of life (PROMIS global and mental health tool), 5) substance abuse, and 6) linkage to care. RESULTS/ANTICIPATED RESULTS: Data compiled on the social determinants of health revealed (n = 35): 1) 60.0% of patients had incomes below $30,000 per year, 60.0% of patients had not gone past high school for education, and 8.6% had full time employment, 2) the average BREIF score was 10.3 (range 3-15)(4-12 indicate limited literacy). The average REALM-R score was 5.5 (range 0-8) (<6 indicate at risk for poor literacy), 3) patients had strong instrumental (T score 61.4±7.1) and information social support (T score 64.6±4.7) (mean T scores calibrated to a general population mean of 50), 4) patients had poor mental (T score 43.7 ±6.5) and physical quality of life (T score 46.6 ±9.9), 5) 25.7% of patients reported alcohol use in the past 90 days 6) 80.0% of patients reported that their doctor had spoken to them about liver transplantation. DISCUSSION/SIGNIFICANCE OF IMPACT: This patient population was well linked to care with good social support. However their literacy, socioeconomic status, mental and global health was poor and substance use history complex. Continued follow up of this cohort is planned to determine how these factors might impact their ability to navigate through the care cascade as well as survival.
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spelling pubmed-88229092022-02-18 4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes Nephew, Lauren Devore Rawl, Susan Desai, Archita Orman, Eric Ghabril, Marwan Patidar, Kavish Chalasani, Naga J Clin Transl Sci Health Equity & Community Engagement OBJECTIVES/GOALS: Achieving therapy for hepatocellular carcinoma (HCC) involves navigating through a complex cascade of care. Non-HCC cancer mortality has been associated with social determinants of health outside of cancer specific risk. Our objective is to explore the impact of social determinants on HCC outcomes. METHODS/STUDY POPULATION: Patients with HCC were enrolled from 3 hospitals form June, 1 2019 to December 1, 2019. A chart review was done to collect information on liver disease severity and cancer stage. Patients were interviewed to collect information on the following: 1) socioeconomic status (income, education, insurance status, and employment status), 2) literacy (Rapid Estimate of Adult Literacy in Medicine (REALM-R) and Brief Health Literacy Screening Tool (BREIF)), 3) social support (Patent Reported Outcome Measurement Information System (PROMIS) instrumental and information support tool), 4) quality of life (PROMIS global and mental health tool), 5) substance abuse, and 6) linkage to care. RESULTS/ANTICIPATED RESULTS: Data compiled on the social determinants of health revealed (n = 35): 1) 60.0% of patients had incomes below $30,000 per year, 60.0% of patients had not gone past high school for education, and 8.6% had full time employment, 2) the average BREIF score was 10.3 (range 3-15)(4-12 indicate limited literacy). The average REALM-R score was 5.5 (range 0-8) (<6 indicate at risk for poor literacy), 3) patients had strong instrumental (T score 61.4±7.1) and information social support (T score 64.6±4.7) (mean T scores calibrated to a general population mean of 50), 4) patients had poor mental (T score 43.7 ±6.5) and physical quality of life (T score 46.6 ±9.9), 5) 25.7% of patients reported alcohol use in the past 90 days 6) 80.0% of patients reported that their doctor had spoken to them about liver transplantation. DISCUSSION/SIGNIFICANCE OF IMPACT: This patient population was well linked to care with good social support. However their literacy, socioeconomic status, mental and global health was poor and substance use history complex. Continued follow up of this cohort is planned to determine how these factors might impact their ability to navigate through the care cascade as well as survival. Cambridge University Press 2020-07-29 /pmc/articles/PMC8822909/ http://dx.doi.org/10.1017/cts.2020.281 Text en © The Association for Clinical and Translational Science 2020 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Health Equity & Community Engagement
Nephew, Lauren Devore
Rawl, Susan
Desai, Archita
Orman, Eric
Ghabril, Marwan
Patidar, Kavish
Chalasani, Naga
4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes
title 4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes
title_full 4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes
title_fullStr 4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes
title_full_unstemmed 4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes
title_short 4295 The Impact of Social Determinants of Health on Hepatocellular Carcinoma Outcomes
title_sort 4295 the impact of social determinants of health on hepatocellular carcinoma outcomes
topic Health Equity & Community Engagement
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8822909/
http://dx.doi.org/10.1017/cts.2020.281
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