Scholars@Duke
Devon Karnes Check

Devon Karnes Check

Assistant Professor in Population Health Sciences
Population Health Sciences
devon.check@duke.edu
215 Morris Street, Suite 210, Durham, NC 27708

Selected Publications

Misuse of Prescribed and Nonprescribed Substances Among U.S. Cancer Survivors.

Journal Article J Gen Intern Med · November 2024 BACKGROUND: Substance misuse is common among cancer survivors and can negatively impact cancer outcomes. METHODS: We conducted a cross-sectional study using National Survey on Drug Use and Health data for 2015 to 2020. We included adult respondents with a ... Full text Link to item Cite

Association of race and ethnicity with genomic testing at a comprehensive cancer center in North Carolina.

Journal Article Cancer Res Commun · October 23, 2024 Genomic testing, which analyzes tumor cells or circulating tumor DNA to guide cancer treatment, is increasingly used in precision oncology. However, data on racial and ethnic disparities in its use are limited. This retrospective cohort study included pati ... Full text Link to item Cite

Creating a Palliative Care Clinic for Patients with Cancer Pain and Substance Use Disorder.

Journal Article J Pain Symptom Manage · August 2024 BACKGROUND: Opioids are a first-line treatment for severe cancer pain. However, clinicians may be reluctant to prescribe opioids for patients with concurrent substance use disorders (SUD) or clinical concerns about non-prescribed substance use. MEASURES: P ... Full text Link to item Cite

Post-trial responsibilities in pragmatic clinical trials: Fulfilling the promise of research to drive real-world change.

Journal Article Learn Health Syst · July 2024 While considerable scholarship has explored responsibilities owed to research participants at the conclusion of explanatory clinical trials, no guidance exists regarding responsibilities owed at the conclusion of a pragmatic clinical trial (PCT). Yet post- ... Full text Open Access Link to item Cite

Similarities and Differences Between Pragmatic Trials and Hybrid Effectiveness-Implementation Trials.

Journal Article J Gen Intern Med · July 2024 Pragmatism in clinical trials is focused on increasing the generalizability of research findings for routine clinical care settings. Hybridism in clinical trials (i.e., assessing both clinical effectiveness and implementation success) is focused on speedin ... Full text Link to item Cite

Racial and ethnic disparities in genomic testing among lung cancer patients: a systematic review.

Journal Article J Natl Cancer Inst · June 7, 2024 BACKGROUND: Racial and ethnic disparities in genomic testing could exacerbate disparities in access to precision cancer therapies and survival-particularly in the context of lung cancer where genomic testing has been recommended for the past decade. Howeve ... Full text Open Access Link to item Cite

Factors Affecting Post-trial Sustainment or De-implementation of Study Interventions: A Narrative Review.

Journal Article J Gen Intern Med · May 2024 In contrast to traditional randomized controlled trials, embedded pragmatic clinical trials (ePCTs) are conducted within healthcare settings with real-world patient populations. ePCTs are intentionally designed to align with health system priorities levera ... Full text Open Access Link to item Cite

Substance Use Disorders Among US Adult Cancer Survivors.

Journal Article JAMA Oncol · March 1, 2024 IMPORTANCE: Some individuals are predisposed to cancer based on their substance use history, and others may use substances to manage cancer-related symptoms. Yet the intersection of substance use disorder (SUD) and cancer is understudied. Because SUD may a ... Full text Link to item Cite

Embedding implementation science in the research pipeline.

Journal Article Transl Behav Med · February 7, 2024 Clinical and health services researchers seek to discover effective programs, practices, and interventions to improve people's health. The current paradigm for evidence generation is incremental and misaligned to translate evidence-based discoveries into r ... Full text Link to item Cite

Managing Chronic Pain in Cancer Survivorship: Communication Challenges and Opportunities as Described by Cancer Survivors.

Journal Article Am J Hosp Palliat Care · January 2024 OBJECTIVES: Many cancer survivors experience chronic pain after completing curative-intent treatment. Based on available data, chronic pain may be undertreated in this context; however, little is known about cancer survivors' experiences with clinical mana ... Full text Link to item Cite

Characteristics, healthcare utilization, and outcomes of patients with HER2-low breast cancer.

Journal Article Breast Cancer Res Treat · January 2024 PURPOSE: Treatment for HER2-low [defined as ImmunoHistoChemistry (IHC) 1 + or 2 + and negative/normal in Situ Hybridization (ISH)] breast cancer patients is rapidly evolving, yet we lack critical information about the HER2-low population. METHODS: We condu ... Full text Link to item Cite

Meaning-centered pain coping skills training for patients with metastatic cancer: Protocol for a randomized controlled efficacy trial.

Journal Article Contemp Clin Trials · December 2023 BACKGROUND: Many patients with advanced cancer describe pain as a debilitating symptom that greatly interferes with daily activities and enjoyment of life. Psychosocial interventions can improve cancer-related pain but rarely address spiritual concerns (e. ... Full text Link to item Cite

"It Is So Easy For Them to Dismiss": A Phenomenological Study of Cancer Survivors With Chronic Cancer-Related Pain.

Journal Article J Palliat Med · August 2023 Background: For many cancer survivors post-cure, chronic pain is a devastating complication of cancer treatment. The prevalence of chronic pain among cancer survivors is double that of the general population. However, little is known about the pain experie ... Full text Link to item Cite

The Use of Templates for Documenting Advance Care Planning Conversations: A Descriptive Analysis.

Journal Article J Pain Symptom Manage · August 2023 CONTEXT: While professional societies and expert panels have recommended quality indicators related to advance care planning (ACP) documentation, including using structured documentation templates, it is unclear how clinicians document these conversations. ... Full text Link to item Cite

Meaning-centered pain coping skills training for patients with metastatic cancer: Results of a randomized controlled pilot trial.

Journal Article Psychooncology · July 2023 OBJECTIVE: For patients with advanced cancer, pain is a common and debilitating symptom that can negatively impact physical, emotional, and spiritual well-being. This trial examined the feasibility and initial effects of Meaning-Centered Pain Coping Skills ... Full text Link to item Cite

Factors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer.

Journal Article Clin Lung Cancer · June 2023 BACKGROUND: Despite recommendations for molecular testing irrespective of patient characteristics, differences exist in receipt of molecular testing for oncogenic drivers amongst metastatic non-small cell lung cancer (mNSCLC) patients. Exploration into the ... Full text Link to item Cite

Clinician Perspectives on Managing Chronic Pain After Curative-Intent Cancer Treatment.

Journal Article JCO Oncol Pract · April 2023 PURPOSE: Among cancer survivors who have completed curative-intent treatment, the high prevalence and adverse consequences of chronic pain are well documented. Yet, research on clinicians' experiences with and perspectives on managing chronic pain among ca ... Full text Link to item Cite

Intervention delivery for embedded pragmatic clinical trials: Development of a tool to measure complexity.

Journal Article Contemp Clin Trials · March 2023 BACKGROUND: Conducting an embedded pragmatic clinical trial in the workflow of a healthcare system is a complex endeavor. The complexity of the intervention delivery can have implications for study planning, ability to maintain fidelity to the intervention ... Full text Link to item Cite

Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis.

Journal Article Support Care Cancer · December 2022 PURPOSE: Cancer is a major reason for concurrent prescription of opioids with other sedating medications-particularly benzodiazepines and gabapentinoids-yet population-based assessments of the extent and predictors of concurrent prescribing among clinicall ... Full text Link to item Cite

Evaluating a couple communication skills training (CCST) intervention for advanced cancer: study protocol for a randomized controlled trial.

Journal Article Trials · August 26, 2022 BACKGROUND: For patients and their intimate partners, advanced cancer poses significant challenges that can negatively impact both individuals and their relationship. Prior studies have found evidence that couple-based communication skills interventions ca ... Full text Link to item Cite

Opioid Prescribing and Use Among Cancer Survivors: A Mapping Review of Observational and Intervention Studies.

Journal Article J Pain Symptom Manage · April 2022 CONTEXT: Recent years show a sharp increase in research on opioid use among cancer survivors, but evidence syntheses are lacking, leaving knowledge gaps. Corresponding research needs are unclear. OBJECTIVES: To provide an evidence synthesis. METHODS: We se ... Full text Link to item Cite

Accountable and Transparent Palliative Quality Measures Will Improve Care.

Journal Article J Palliat Med · April 2022 How do we build on the proven successes of hospice and palliative care and build clinical programs to serve those who need it in the context of real-world health care? Experiences with glide pathways have clearly shown that changes in financial incentives ... Full text Link to item Cite

Use of Theoretical Frameworks in the Development and Testing of Palliative Care Interventions.

Journal Article J Pain Symptom Manage · March 2022 CONTEXT: Palliative care (PC) research has grown over the last 20 years. Yet, the causal components and pathways of PC interventions remain unclear. OBJECTIVES: To document the prevalence and application of theoretical frameworks in developing and testing ... Full text Link to item Cite

Financial Burden of Drugs Prescribed for Cancer-Associated Symptoms.

Journal Article JCO Oncol Pract · February 2022 PURPOSE: The financial toxicity of anticancer drugs is well-documented, but little is known about the costs of drugs used to manage cancer-associated symptoms. METHODS: We reviewed relevant guidelines and compiled drugs used to manage seven cancer-associat ... Full text Link to item Cite

Predictors of Chronic Opioid Use: A Population-Level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims.

Journal Article J Natl Cancer Inst · November 2, 2021 BACKGROUND: No population-based studies have examined chronic opioid use among cancer survivors who are diverse with respect to diagnosis, age group, and insurance status. METHODS: We conducted a retrospective cohort study using North Carolina cancer regis ... Full text Link to item Cite

Predictors of Response to an Evidence-Based Behavioral Cancer Pain Management Intervention: An Exploratory Analysis From a Clinical Trial.

Journal Article J Pain Symptom Manage · August 2021 CONTEXT: Interventions that teach patients cognitive and behavioral strategies for managing cancer pain have demonstrated effectiveness. Systematic reviews of such interventions call for research to inform their implementation in practice, including invest ... Full text Link to item Cite

Inpatient palliative care utilization for patients with brain metastases.

Journal Article Neurooncol Pract · August 2021 INTRODUCTION: Given the high symptom burden and complex clinical decision making associated with a diagnosis of brain metastases (BM), specialty palliative care (PC) can meaningfully improve patient quality of life. However, no prior study has formally eva ... Full text Link to item Cite

Integration of Improvement and Implementation Science in Practice-Based Research Networks: a Longitudinal, Comparative Case Study.

Journal Article J Gen Intern Med · June 2021 BACKGROUND: Implementation science (IS) and quality improvement (QI) inhabit distinct areas of scholarly literature, but are often blended in practice. Because practice-based research networks (PBRNs) draw from both traditions, their experience could infor ... Full text Link to item Cite

Opioid Use Disorder and Overdose in Older Adults With Breast, Colorectal, or Prostate Cancer.

Journal Article J Natl Cancer Inst · April 6, 2021 BACKGROUND: Despite high rates of opioid therapy, evidence about the risk of preventable opioid harms among cancer survivors is underdeveloped. Our objective was to estimate the odds of opioid use disorder (OUD) and overdose following breast, colorectal, o ... Full text Link to item Cite

Implementation and Impact of a Risk-Stratified Prostate Cancer Screening Algorithm as a Clinical Decision Support Tool in a Primary Care Network.

Conference J Gen Intern Med · January 2021 BACKGROUND: Implementation methods of risk-stratified cancer screening guidance throughout a health care system remains understudied. OBJECTIVE: Conduct a preliminary analysis of the implementation of a risk-stratified prostate cancer screening algorithm i ... Full text Link to item Cite

Associations of Patient Characteristics and Care Setting with Complexity of Specialty Palliative Care Visits.

Journal Article J Palliat Med · January 2021 Background: Information routinely collected during a palliative care consultation request may help predict the level of complexity of that patient encounter. Objectives: We examined whether patient and consultation characteristics, as captured in consultat ... Full text Link to item Cite

Improvement Science and Implementation Science in Cancer Care: Identifying Areas of Synergy and Opportunities for Further Integration.

Journal Article J Gen Intern Med · January 2021 Efforts to improve cancer care primarily come from two fields: improvement science and implementation science. The two fields have developed independently, yet they have potential for synergy. Leveraging that synergy to enhance alignment could both reduce ... Full text Link to item Cite

Persistent Breast Pain

Chapter · January 1, 2021 Persistent breast pain (PBP) following a cancer diagnosis and treatment is common and can be highly distressing, interfering with daily activities, and leading to decreases in overall quality of life. PBP can result from breast surgeries, radiation, chemot ... Full text Cite

Response to Strassels and Durham.

Journal Article J Natl Cancer Inst · December 14, 2020 Full text Link to item Cite

Association of Current Opioid Use With Serious Adverse Events Among Older Adult Survivors of Breast Cancer.

Journal Article JAMA Netw Open · September 1, 2020 IMPORTANCE: National efforts to improve safe opioid prescribing focus on preventing misuse, overdose, and opioid use disorder. This approach overlooks opportunities to better prevent other serious opioid-related harms in complex populations, such as older ... Full text Link to item Cite

Concurrent Opioid and Benzodiazepine Prescriptions Among Older Women Diagnosed With Breast Cancer.

Journal Article J Natl Cancer Inst · July 1, 2020 Guidelines recommend using caution in co-prescribing opioids with benzodiazepines, yet, in practice, the extent of concurrent prescribing is poorly understood. Notably, no population-based studies, to our knowledge, have investigated concurrent prescribing ... Full text Link to item Cite

Top Ten Tips Palliative Care Clinicians Should Know About Integrating Population Health Principles into Practice.

Journal Article J Palliat Med · April 2020 The field of palliative care (PC) has spent the past decade demonstrating that it improves outcomes for patients, clinicians, and health systems. Forward-thinking organizations preparing for a reimbursement system rooted in value have built robust inpatien ... Full text Link to item Cite

Comparing Specialty and Primary Palliative Care Interventions: Analysis of a Systematic Review.

Journal Article J Palliat Med · March 2020 Background: Investigators have tested interventions delivered by specialty palliative care (SPC) clinicians, or by clinicians without palliative care specialization (primary palliative care, PPC). Objective: To compare the characteristics and outcomes of r ... Full text Link to item Cite

Adjuvant endocrine therapy for breast cancer patients: impact of a health system outreach program to improve adherence.

Journal Article Breast Cancer Res Treat · February 2020 PURPOSE: Reports suggest that up to 50% of women with hormone receptor-positive (HR+) breast cancer (BC) do not complete the recommended 5 years of adjuvant endocrine therapy (AET). We examined the impact of an outreach program at Kaiser Permanente Norther ... Full text Link to item Cite

Decision Regret Related to Urinary Diversion Choice among Patients Treated with Cystectomy.

Journal Article J Urol · January 2020 PURPOSE: Patients who undergo cystectomy due to bladder cancer can elect an ileal conduit or a neobladder for urinary diversion. Decision regret related to this choice is an important and undesirable patient reported outcome. Our objective was to compare t ... Full text Link to item Cite

Factors associated with employment discontinuation among older and working age survivors of oropharyngeal cancer.

Journal Article Head Neck · November 2019 BACKGROUND: Oropharyngeal cancer survivors experience difficulty returning to work after treatment. To better understand specific barriers to returning to work, we investigated factors associated with discontinuing employment among older and working-age su ... Full text Link to item Cite

Examining potential gaps in supportive medication use for US and foreign-born Hispanic women with breast cancer.

Journal Article Support Care Cancer · May 2019 BACKGROUND: Compared to non-Hispanic Whites, Hispanic women are more likely to report pain, depression, and other mental health concerns. However, little is known about Hispanic women's use of supportive medications, and whether use differs depending on na ... Full text Link to item Cite

Opportunities to Improve Detection and Treatment of Depression Among Patients With Breast Cancer Treated in an Integrated Delivery System.

Journal Article J Pain Symptom Manage · March 2019 CONTEXT: Patients with cancer commonly experience depression. If not addressed, depression can lead to reduced quality of life and survival. OBJECTIVE: Given the introduction of national initiatives to improve management of psychiatric symptoms among patie ... Full text Link to item Cite

Perioperative Intravesical Chemotherapy for Patients WithNon-Muscle-invasive Bladder Cancer: Understanding the Extent of and Sources of Variation in Guideline-recommended Use.

Journal Article Urology · February 2019 OBJECTIVE: To examine intravesical chemotherapy (IVC) use according to non-muscle-invasive bladder cancer patient disease risk, and the contributions of multilevel factors to variation in proficient use among patients with low-intermediate disease. METHODS ... Full text Link to item Cite

Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members.

Journal Article Lung Cancer · November 2018 OBJECTIVES: To examine the role of uniform access to care in reducing racial/ethnic disparities in receipt of resection for early stage non-small cell lung cancer (NSCLC) by comparing integrated health system member patients to demographically similar non- ... Full text Link to item Cite

Understanding racial/ethnic differences in breast cancer-related physical well-being: the role of patient-provider interactions.

Journal Article Breast Cancer Res Treat · August 2018 PURPOSE: Racial/ethnic differences in cancer symptom burden are well documented, but limited research has evaluated modifiable factors underlying these differences. Our objective was to examine the role of patient-provider interactions to help explain the ... Full text Link to item Cite

Concerns underlying treatment preferences of advanced cancer patients with children.

Journal Article Psychooncology · October 2017 BACKGROUND: Decision-making about advanced cancer treatment is complex and may be influenced by patients' family context, including the presence of children. We explored how parental values and concerns motivate patients' preferences about aggressiveness o ... Full text Link to item Cite

Parenting while living with advanced cancer: A qualitative study.

Journal Article Palliat Med · March 2017 BACKGROUND: Patients with advanced cancer who have dependent children are an important population with a life-limiting illness and high levels of psychological distress. Few studies have addressed the experience of being a parent with advanced cancer and t ... Full text Link to item Cite

Examining racial variation in antiemetic use and post-chemotherapy health care utilization for nausea and vomiting among breast cancer patients.

Journal Article Support Care Cancer · December 2016 PURPOSE: Racial minority cancer patients may experience underuse of antiemetic medications to prevent chemotherapy-induced nausea and vomiting (CINV). In addition to its adverse implications for quality of life, antiemetic underuse may contribute to observ ... Full text Link to item Cite

Early supportive medication use and end-of-life care among Medicare beneficiaries with advanced breast cancer.

Journal Article Support Care Cancer · August 2016 PURPOSE: A randomized controlled trial of cancer patients has linked early supportive care with improved hospice use and less-aggressive end-of-life care. In practice, the early use of supportive interventions and potential impact on end-of-life care are p ... Full text Link to item Cite

Parenting concerns, quality of life, and psychological distress in patients with advanced cancer.

Journal Article Psychooncology · August 2016 OBJECTIVE: Parents with life-limiting illness anticipate the loss of their parental role and the long-term consequences of their illness on their children. The purpose of this study was to examine relationships between parenting concerns, quality of life ( ... Full text Link to item Cite

Investigation of Racial Disparities in Early Supportive Medication Use and End-of-Life Care Among Medicare Beneficiaries With Stage IV Breast Cancer.

Journal Article J Clin Oncol · July 1, 2016 PURPOSE: Early supportive care may improve quality of life and end-of-life care among patients with cancer. We assessed racial disparities in early use of medications for common cancer symptoms (depression, anxiety, insomnia) and whether these potential di ... Full text Link to item Cite

Investigating racial disparities in use of NK1 receptor antagonists to prevent chemotherapy-induced nausea and vomiting among women with breast cancer.

Journal Article Breast Cancer Res Treat · April 2016 Chemotherapy-induced nausea and vomiting (CINV) is a major concern for cancer patients and, if uncontrolled, can seriously compromise quality of life (QOL) and other treatment outcomes. Because of the expense of antiemetic medications used to prevent CINV ... Full text Link to item Cite

An exploratory study of end-of-life prognostic communication needs as reported by widowed fathers due to cancer.

Journal Article Psychooncology · November 2015 OBJECTIVE: Effective physician communication about prognosis is a critical aspect of quality care for families affected by terminal illness. This is particularly important for spousal caregivers of terminally ill parents of dependent children, who may have ... Full text Link to item Cite

Is there a role for survivorship care plans in advanced cancer?

Journal Article Support Care Cancer · August 2015 PURPOSE: The Institute of Medicine (2006) has recommended that cancer survivors completing treatment receive a survivorship care plan (SCP). The survivorship needs in advanced cancer have been overlooked and understudied. The potential role of SCPs for sur ... Full text Link to item Cite

Guidelines for the use of survivorship care plans: a systematic quality appraisal using the AGREE II instrument.

Journal Article Implement Sci · May 3, 2015 BACKGROUND: Survivorship care plans (SCPs) are written treatment summaries and follow-up care plans that are intended to facilitate communication and coordination of care among survivors, cancer care providers, and primary care providers. A growing number ... Full text Link to item Cite

Summing it up: an integrative review of studies of cancer survivorship care plans (2006-2013).

Journal Article Cancer · April 1, 2015 In 2006, the Institute of Medicine recommended that cancer survivors who are completing primary treatment receive a survivorship care plan (SCP) based on face validity. The state of scientific knowledge regarding the SCP is unclear. The authors conducted a ... Full text Link to item Cite

Research Participants' Understanding of and Reactions to Certificates of Confidentiality.

Journal Article AJOB Prim Res · January 1, 2014 BACKGROUND: Certificates of Confidentiality are intended to facilitate participation in critical public health research by protecting against forced disclosure of identifying data in legal proceedings, but little is known about the effect of Certificate de ... Full text Link to item Cite

Use of central institutional review boards for multicenter clinical trials in the United States: a review of the literature.

Journal Article Clin Trials · August 2013 BACKGROUND: To improve the efficiency of conducting multicenter clinical trials, the Food and Drug Administration, the Office of Human Research Protections, and the Department of Health and Human Services have expressed support for using a centralized inst ... Full text Link to item Cite

Transitional adherence and persistence in the use of aldosterone antagonist therapy in patients with heart failure.

Journal Article Am Heart J · June 2013 BACKGROUND: Aldosterone antagonist therapy is recommended for selected patients with heart failure and reduced ejection fraction. Adherence to therapy in the transition from hospital to home is not well understood. METHODS: We identified patients with hear ... Full text Link to item Cite

Using central IRBs for multicenter clinical trials in the United States.

Journal Article PLoS One · 2013 Research institutions differ in their willingness to defer to a single, central institutional review board (IRB) for multicenter clinical trials, despite statements from the FDA, OHRP, and NIH in support of using central IRBs to improve the efficiency of c ... Full text Link to item Cite

Institutional review boards' use and understanding of certificates of confidentiality.

Journal Article PLoS One · 2012 Certificates of Confidentiality, issued by agencies of the U.S. government, are regarded as an important tool for meeting ethical and legal obligations to safeguard research participants' privacy and confidentiality. By shielding against forced disclosure ... Full text Open Access Link to item Cite