Devon Check

Overview:

Devon Check, PhD is a health services researcher focused on understanding and overcoming barriers to the delivery of equitable, high-quality care for patients with cancer and other potentially life-limiting conditions.

Dr. Check received her PhD in Health Policy and Management from the Gillings School of Global Public Health at UNC-Chapel Hill. Prior to joining the Department of Population Health Sciences at Duke, she completed a postdoctoral fellowship in Delivery Science at Kaiser Permanente Northern California.

Areas of Expertise: Implementation Science and Health Services Research

Positions:

Assistant Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Member of the

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2016

University of North Carolina - Chapel Hill

Grants:

Collaboratory Resource Coordinating Center for Pragmatic and Implementation Studies for the Management of Pain (PRISM) (U24)

Administered By
Duke Clinical Research Institute
Awarded By
National Institutes of Health
Role
Co Investigator
Start Date
End Date

Promotion of Prostate Cancer Screening Equity: A Quality Improvement Education Initiative

Administered By
Population Health Sciences
Awarded By
National Minority Quality Forum
Role
Principal Investigator
Start Date
End Date

Publications:

A Digital Population Tracking System Helps Improve Colorectal Cancer Survivorship Services

Authors
Liu, R; Flores, AD; Lee, J; Check, D; Sundaresan, T; Li, Y; Gong, IY; Nekhlyudov, L; Kline, RM; Manace, L
MLA Citation
Liu, R., et al. “A Digital Population Tracking System Helps Improve Colorectal Cancer Survivorship Services.” Oncology Issues, vol. 36, no. 6, Jan. 2021, pp. 18–24. Scopus, doi:10.1080/10463356.2021.1979851.
URI
https://scholars.duke.edu/individual/pub1502708
Source
scopus
Published In
Oncology Issues
Volume
36
Published Date
Start Page
18
End Page
24
DOI
10.1080/10463356.2021.1979851

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

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 searched PubMed and Embase, identifying articles related to cancer, and opioid prescribing/use published through September 2020. We screened resulting titles/abstracts. Relevant studies underwent full-text review. Inclusion criteria were quantitative examination of and primary focus on opioid prescribing or use, and explicit inclusion of cancer survivors. Exclusion criteria included end-of-life opioid use and opioid use as a secondary or downstream outcome (for intervention studies). We extracted information on the opioid-related outcome(s) examined (including definitions and terminology used), study design, and methods. RESULTS: Research returned 16,591 articles; 296 were included. Only 22 of 296 studies evaluated an intervention. There were 105 studies evaluating outcomes indicative of potentially high-risk, nonrecommended, or avoidable opioid use, e.g., continuous use-described as chronic use, prolonged use, and persistent use (n = 17); use after completion of curative-intent treatment-described as chronic opioid use, long-term opioid use, persistent opioid use, prolonged opioid use, continued opioid use, late opioid use, post-treatment opioid use (n = 27); use of opioids concurrent with other potentially high-risk medications (n = 13), and opioid misuse (n = 14). CONCLUSIONS: We found lack of consistency in the measurement of and terms used to describe similar opioid use outcomes, and a lack of interventional research targeting well-documented patterns of potentially nonrecommended, potentially avoidable, or potentially high-risk opioid prescribing or use.
Authors
Check, DK; Avecilla, RAV; Mills, C; Dinan, MA; Kamal, AH; Murphy, B; Rezk, S; Winn, A; Oeffinger, KC
MLA Citation
Check, Devon K., et al. “Opioid Prescribing and Use Among Cancer Survivors: A Mapping Review of Observational and Intervention Studies.J Pain Symptom Manage, vol. 63, no. 4, Apr. 2022, pp. e397–417. Pubmed, doi:10.1016/j.jpainsymman.2021.10.015.
URI
https://scholars.duke.edu/individual/pub1500605
PMID
34748896
Source
pubmed
Published In
J Pain Symptom Manage
Volume
63
Published Date
Start Page
e397
End Page
e417
DOI
10.1016/j.jpainsymman.2021.10.015

Accountable and Transparent Palliative Quality Measures Will Improve Care.

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 must always be implemented with counterbalancing measures that ensure that seriously ill patients are getting high-quality care consistent with their goals and values. There are quality measures for quality improvement and there are quality measures for accountability or transparency. We must balance any financial incentives with concrete quality measures that act as a check and balance to the care that is being provided. This area of investigation is rich in opportunity. Much research is needed to advance the craft of hospice and palliative care if the field is to move forward at scale in a timely manner. We need to democratize research and engage both "small r" and a "big R" researchers in the manner of other subspecialties such as oncology and cardiology. Future research should focus on building innovative systems and models of care to uncover needs of seriously ill patients and their caregivers and effectively cater to those needs.
Authors
Periyakoil, VS; Gunten, CFV; Check, D; Kaufman, B; Maxwell, TL; Teno, JM
MLA Citation
Periyakoil, Vyjeyanthi S., et al. “Accountable and Transparent Palliative Quality Measures Will Improve Care.J Palliat Med, vol. 25, no. 4, Apr. 2022, pp. 542–48. Pubmed, doi:10.1089/jpm.2022.0063.
URI
https://scholars.duke.edu/individual/pub1515363
PMID
35363070
Source
pubmed
Published In
Journal of Palliative Medicine
Volume
25
Published Date
Start Page
542
End Page
548
DOI
10.1089/jpm.2022.0063

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

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 PC interventions. METHODS: We conducted a secondary analysis of previously published systematic reviews of PC randomized clinical trials. Trials were evaluated for explicit mention of a theoretical framework, process or delivery model, or clinical practice guideline that supported the development of the intervention. We used a structured data extraction form to document study population, outcomes, and whether and how authors used a theoretical framework, process/delivery model, or clinical practice guideline. We applied an adapted coding scheme to evaluate use of theoretical frameworks. RESULTS: We reviewed 85 PC trials conducted between 1984 and 2021. Thirty-eight percent (n = 32) of trials explicitly mentioned a theoretical framework, process or delivery model, or clinical practice guideline as a foundation for the intervention design. Only nine trials included a theoretical framework, while the remaining 23 cited a process/delivery model or clinical practice guideline. CONCLUSION: Most PC trials do not cite a theoretical foundation for their intervention design. Future work should focus on developing and validating new theoretical frameworks and modifying existing theories and models to better explain the mechanisms of the variety of PC interventions.
Authors
Ingle, MP; Check, D; Slack, DH; Cross, SH; Ernecoff, NC; Matlock, DD; Kavalieratos, D
MLA Citation
Ingle, Mary Pilar, et al. “Use of Theoretical Frameworks in the Development and Testing of Palliative Care Interventions.J Pain Symptom Manage, vol. 63, no. 3, Mar. 2022, pp. e271–80. Pubmed, doi:10.1016/j.jpainsymman.2021.10.011.
URI
https://scholars.duke.edu/individual/pub1501375
PMID
34756957
Source
pubmed
Published In
J Pain Symptom Manage
Volume
63
Published Date
Start Page
e271
End Page
e280
DOI
10.1016/j.jpainsymman.2021.10.011

Inpatient palliative care utilization for patients with brain metastases.

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 evaluated patient-specific factors associated with PC consultation among BM patients. METHODS: We examined the rates of PC consults in a cohort of 1303 patients with BM admitted to three tertiary medical centers from October 2015 to December 2018. Patient demographics, surgical status, 30-day readmission, and death data were collected via retrospective chart review. PC utilization was assessed by identifying encounters for which an inpatient consult to PC was placed. Statistical analyses were performed to compare characteristics and outcomes between patients who did and did not receive PC consults. RESULTS: We analyzed 1303 patients admitted to the hospital with BM. The average overall rate of inpatient PC consultation was 19.6%. Rates of PC utilization differed significantly by patient race (17.5% in White/Caucasian vs 26.0% in Black/African American patients, P = .0014). Patients who received surgery during their admission had significantly lower rates of PC consultation (3.9% vs 22.4%, P < .0001). Patients who either died during their admission or were discharged to hospice had significantly higher rates of PC than those who were discharged home or to rehabilitation (P < .0001). CONCLUSIONS: In our dataset, PC consultation rates varied by patient demographic, surgical status, discharging service, and practice setting. Further work is needed to identify the specific barriers to optimally utilizing specialty PC in this population.
Authors
Price, M; Howell, EP; Dalton, T; Ramirez, L; Howell, C; Williamson, T; Fecci, PE; Anders, CK; Check, DK; Kamal, AH; Goodwin, CR
MLA Citation
Price, Meghan, et al. “Inpatient palliative care utilization for patients with brain metastases.Neurooncol Pract, vol. 8, no. 4, Aug. 2021, pp. 441–50. Pubmed, doi:10.1093/nop/npab016.
URI
https://scholars.duke.edu/individual/pub1488917
PMID
34277022
Source
pubmed
Published In
Neuro Oncology Practice
Volume
8
Published Date
Start Page
441
End Page
450
DOI
10.1093/nop/npab016

Research Areas:

Cancer
Communication
Decision Making
Delivery of Health Care
Diffusion of Innovation
Guideline Adherence
Health Services Research
Healthcare Disparities
Implementation Science
Palliative Care
Quality of Health Care
Survivorship