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Los datos del mundo real identifican las necesidades de atención en pacientes adolescentes y adultos jóvenes con
John Mariano1, Myla Strawderman2, Eric Snyder1
1Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.
Journal of adolescent and young adult oncology
|September 3, 2025
Resumen
Los pacientes con cáncer de adolescentes y adultos jóvenes (AYA), en particular aquellos con linfoma, experimentan importantes necesidades no cubiertas de atención oncológica. Los registros médicos electrónicos (EMR) pueden identificar de manera factible estos desafíos, informando sobre las intervenciones específicas y las encuestas a los pacientes.
Área de la Ciencia:
- En el campo de la oncología
- Medicina para adolescentes y adultos jóvenes (AYA)
- Informática de la salud
Sus antecedentes:
- Los pacientes con cáncer de adolescentes y adultos jóvenes (AYA) se enfrentan a desafíos no oncológicos únicos distintos de las poblaciones pediátricas y adultas.
- Las directrices nacionales hacen hincapié en las necesidades no satisfechas significativas en salud mental, física y sexual/reproductiva para las AYAs con cáncer.
- La identificación de estas brechas de atención es crucial para el desarrollo de sistemas de apoyo específicos.
Objetivo del estudio:
- Explorar la viabilidad del uso de registros médicos electrónicos (EMR) para identificar los dominios de atención no oncológica en pacientes con linfoma AYA.
- Comparar la prevalencia y la incidencia de estos dominios no oncológicos en pacientes con linfoma AYA frente a controles emparejados.
- Establecer un enfoque basado en datos para abordar las brechas de atención en la atención del cáncer de AYA.
Principales métodos:
- Un estudio retrospectivo de cohorte emparejado que compara a los pacientes con AYA con linfoma (2014-2020) con controles emparejados por edad y sexo sin cáncer.
- Utilizó una nueva herramienta de evaluación EMR para consultar dominios no oncológicos antes del diagnóstico y durante el primer año posterior al diagnóstico.
- Se comparó la prevalencia y la incidencia de los dominios no oncológicos identificados entre los grupos de linfoma y de control.
Principales resultados:
- Los pacientes con linfoma presentaron tasas más altas de dolor crónico, uso de analgésicos y citas de preservación de la fertilidad antes del diagnóstico en comparación con los controles.
- Un año después del diagnóstico, los pacientes con linfoma mostraron mayores tasas de ansiedad, uso de antidepresivos, abuso de opiáceos, dolor crónico y citas de endocrinología reproductiva / infertilidad.
- Se observaron diferencias significativas (p < 0,0001) en el dolor crónico y el uso de analgésicos tanto antes como después del diagnóstico.
Conclusiones:
- Los registros médicos electrónicos (EMR) ofrecen un método factible para el seguimiento de los dominios de atención no oncológica institucional en pacientes con cáncer de AYA.
- Los datos de la EMR pueden orientar el desarrollo de estudios de intervención específicos de la institución para abordar las brechas de atención identificadas.
- Se pueden diseñar encuestas prospectivas de pacientes para correlacionar los hallazgos de EMR con las preocupaciones reportadas por los pacientes, mejorando la atención holística.
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