Laura Fish

Positions:

Assistant Professor in Family Medicine and Community Health

Family Medicine and Community Health, Prevention Research
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.P.H. 1992

University of North Carolina - Chapel Hill

Ph.D. 2006

University of North Carolina - Chapel Hill

Grants:

IPA - Laura Jane Fish

Administered By
Family Medicine and Community Health
Awarded By
Veterans Administration Medical Center
Role
Co Investigator
Start Date
End Date

IPA-Laura Fish

Administered By
Duke Cancer Institute
Awarded By
Veterans Administration Medical Center
Role
Clinical Research Manager
Start Date
End Date

Implement SmokeFreeTXT eReferral Program into the Duke Smoking Cessation Program

Administered By
Duke Cancer Institute
Awarded By
ICF International, Inc.
Role
Co Investigator
Start Date
End Date

Evaluating fitness-for-use of Electronic Health Records in Clinical Research

Administered By
Duke Clinical Research Institute
Awarded By
Food and Drug Administration
Role
Interviewer
Start Date
End Date

Publications:

Primary care provider perspectives on screening mammography in older women: A qualitative study

Objective: Guidelines informing screening mammography for older women are lacking. This study sought to characterize PCP perspectives on screening mammography for patients aged 75 and older. Methods: This was an exploratory, qualitative study based on semi-structured, one-on-one interviews with PCPs from six clinics affiliated with a tertiary medical center. Two independent coders analyzed interview transcripts and identified themes, subthemes, and representative quotes using inductive analysis methodology. Results: Ten providers completed interviews. The majority (90%) of providers reported insufficient evidence to suggest a best practice for screening in this population. Providers relied on shared decision-making with patients, a process facilitated by strong provider-patient relationships. Providers took into consideration factors such as functional status, personal risk of breast cancer, and patient preference. Time constraints disincentivized providers to engage in discussions. Conclusions: PCPs make decisions about screening mammography for older patients on an individualized basis, taking into account patient overall health status and desire for aggressive intervention. They often rely on shared decision-making given unclear clinical guidelines. Practice implications: These findings suggest that fostering strong provider-patient relationships, addressing patient knowledge gaps, and compensating providers for time spent on counseling may facilitate cost-efficient and patient-centered utilization of screening mammography.
Authors
Oshima, SM; Tait, SD; Fish, L; Greenup, RA; Grimm, LJ
MLA Citation
Oshima, S. M., et al. “Primary care provider perspectives on screening mammography in older women: A qualitative study (Accepted).” Preventive Medicine Reports, vol. 22, June 2021. Scopus, doi:10.1016/j.pmedr.2021.101380.
URI
https://scholars.duke.edu/individual/pub1481806
Source
scopus
Published In
Preventive Medicine Reports
Volume
22
Published Date
DOI
10.1016/j.pmedr.2021.101380

Patient Perspectives on the Financial Costs and Burdens of Breast Cancer Surgery.

Authors
Oshima, SM; Tait, SD; Rushing, C; Lane, W; Hyslop, T; Offodile, AC; Wheeler, SB; Zafar, SY; Greenup, R; Fish, LJ
MLA Citation
Oshima, Sachiko M., et al. “Patient Perspectives on the Financial Costs and Burdens of Breast Cancer Surgery.Jco Oncol Pract, Feb. 2021, p. OP2000780. Pubmed, doi:10.1200/OP.20.00780.
URI
https://scholars.duke.edu/individual/pub1473759
PMID
33566677
Source
pubmed
Published In
Jco Oncol Pract
Published Date
Start Page
OP2000780
DOI
10.1200/OP.20.00780

Assessing the Feasibility of a Novel mHealth App in Hematopoietic Stem Cell Transplant Patients.

Hematopoietic stem cell transplantation (HCT) is a curative treatment option for patients with hematologic conditions but presents many complications that must be managed as a complex, chronic condition. Mobile health applications (mHealth apps) may permit tracking of symptoms in HCT. In seeking strategies to manage the complexities of HCT, our team collaborated with Sicklesoft, Inc., to develop an mHealth app specifically for HCT patients to allow for daily evaluation of patient health, Technology Recordings to better Understand Bone Marrow Transplantation (TRU-BMT). The primary value of this application is that of potentially enhancing the monitoring of symptoms and general health of patients undergoing HCT, with the ultimate goal of allowing earlier detection of adverse events, earlier intervention, and improving outcomes. To first evaluate patient interest in mHealth apps, we designed and administered an interest survey to patients at the 2017 BMT-InfoNet reunion. As a follow-up to the positive feedback received, we began testing the TRU-BMT app in a Phase 1 pilot study. Thirty patients were enrolled in this single-arm study and were given the TRU-BMT mHealth app on a smartphone device in addition to a wearable activity tracker. Patients were followed for up to 180 days, all the while receiving daily app monitoring. Adherence to TRU-BMT was approximately 30% daily and 44% weekly, and greater adherence was associated with increased meal completion, decreased heart rate, and shorter hospital stay. TRU-BMT assessments of symptom severity were significantly associated with duration of hospital stay and development of chronic graft-versus-host disease. Our findings suggest that using TRU-BMT throughout HCT is feasible for patients and established a proof-of-concept for a future randomized control trial of the TRU-BMT application in HCT. © 2021 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Authors
Racioppi, A; Dalton, T; Ramalingam, S; Romero, K; Ren, Y; Bohannon, L; Arellano, C; Jonassaint, J; Miller, H; Barak, I; Fish, LJ; Choi, T; Gasparetto, C; Long, GD; Lopez, RD; Rizzieri, DA; Sarantopoulos, S; Horwitz, ME; Chao, NJ; Shah, NR; Sung, AD
MLA Citation
Racioppi, Alessandro, et al. “Assessing the Feasibility of a Novel mHealth App in Hematopoietic Stem Cell Transplant Patients.Transplant Cell Ther, vol. 27, no. 2, Feb. 2021, pp. 181.e1-181.e9. Pubmed, doi:10.1016/j.jtct.2020.10.017.
URI
https://scholars.duke.edu/individual/pub1475300
PMID
33830035
Source
pubmed
Published In
Transplant Cell Ther
Volume
27
Published Date
Start Page
181.e1
End Page
181.e9
DOI
10.1016/j.jtct.2020.10.017

Improving the Health of Public Housing Residents Through a Housing Authority and Nursing School Partnership.

The connection between health and housing is well-established. People who are precariously housed have worse health than those who have stable housing arrangements.- Persons moving into public housing have a higher illness burden than the general population, and public housing residents engage in less healthy behaviors, which contribute to public housing residents having poorer health than persons living in other housing situations. Public housing authorities and residents can benefit from authentic and constructive relationships with academic partners; academicians and students can benefit from engaging in partnerships with housing authorities and residents to better understand the connection between housing and health. This article describes the well-established relationship between the Duke University School of Nursing (DUSON) and the Durham Housing Authority (DHA), the evolution of that relationship, our collaborative work in improving the health of DHA residents while advancing nursing education and science, and lessons learned.
Authors
Biederman, DJ; Hartman, AM; Felsman, IC; Mountz, H; Jacobs, T; Rich, N; Fish, LJ; Noonan, D
MLA Citation
Biederman, Donna J., et al. “Improving the Health of Public Housing Residents Through a Housing Authority and Nursing School Partnership.Prog Community Health Partnersh, vol. 15, no. 1, 2021, pp. 59–64. Pubmed, doi:10.1353/cpr.2021.0005.
URI
https://scholars.duke.edu/individual/pub1477396
PMID
33775961
Source
pubmed
Published In
Prog Community Health Partnersh
Volume
15
Published Date
Start Page
59
End Page
64
DOI
10.1353/cpr.2021.0005

Adherence to Oral Anticancer Therapeutics in the Gynecologic Oncology Population.

INTRODUCTION: To gain a better understanding of gynecologic oncology patient adherence to oral anticancer agents through both a cross-sectional survey of adherence and qualitative interviews with patients and clinicians regarding their experience with these medications. METHODS: Eligible participants completed a survey for this cross-sectional study that included an assessment of adherence, distress, quality of life, and health literacy. Any woman taking an oral anticancer agent for a gynecologic malignancy at a tertiary academic medical center for 30 days or more was eligible. Semi-structured qualitative interviews (n=14) were then conducted to explore experiences with oral anticancer agents. We also conducted a qualitative group interview with physicians and nurse practitioners. RESULTS: One hundred women taking oral anticancer agents were enrolled. Fifty-four percent reported perfect adherence to their medication, 21% reported equivocal adherence (demonstrating at least one nonadherent behavior in the previous 7 days), and 25% reported nonadherence (demonstrating more than one nonadherent behavior in the previous 7 days). Qualitative analysis identified five major themes: ease of use compared with traditional therapy; the mental burden of self-administrated medication; perceived importance of the medication; management of side effects; and the desire for consistent physician communication. Common misperceptions expressed in the health care professional interviews included high adherence to oral medications and a belief that cost was the biggest barrier to adherence. CONCLUSION: Almost half of the patients surveyed reported equivocal or nonadherence to their oral anticancer agent. The qualitative interviews identified several important themes, many of which were not recognized by physicians and nurse practitioners. These findings highlight the need for patient and health care professional interventions to improve patient adherence.
Authors
Watson, CH; Fish, LJ; Falkovic, M; Monuszko, K; Lorenzo, A; Havrilesky, LJ; Secord, AA; Davidson, BA
MLA Citation
Watson, Catherine H., et al. “Adherence to Oral Anticancer Therapeutics in the Gynecologic Oncology Population.Obstet Gynecol, vol. 136, no. 6, Dec. 2020, pp. 1145–53. Pubmed, doi:10.1097/AOG.0000000000004170.
URI
https://scholars.duke.edu/individual/pub1464268
PMID
33156183
Source
pubmed
Published In
Obstet Gynecol
Volume
136
Published Date
Start Page
1145
End Page
1153
DOI
10.1097/AOG.0000000000004170