Pub Date : 2023-11-01DOI: 10.6004/jadpro.2023.14.7.3
Renata Block, MMS, PA-C, Deborah Patterson, MMS, PA-C, Jennifer J. Siegel, PhD, Brian Martin, PhD, Ann P. Quick, PhD, Jillian Hunt, MSN, APRN, FNP-C, AOCNP
Objective: The 31-gene expression profile (31-GEP) can predict the risk of recurrence and metastasis in cutaneous melanoma (CM). We assessed the viewpoints and use of 31-GEP testing by physician assistants (PAs) and nurse practitioners (NPs) for patients with CM. Methods: NPs and PAs (n = 369) completed an 18-question online survey about their viewpoints and use of the 31-GEP risk-stratification test. Results: Most practitioners (n = 334, 90.5%) felt prognostic testing improved patient care and would recommend the 31-GEP to a colleague (n = 333, 90.2%) or a friend or family member (n = 289, 78.3%) who was diagnosed with CM. The 31-GEP test was used by 176 respondents in the preceding 12 months (53%). Among users of the 31-GEP test, 78% stated that the results would impact follow-up schedule and referral, 66% overall treatment decisions, 62% sentinel lymph node biopsy recommendations, and 50% surveillance imaging. In thin tumors (″ 1 mm), 82% of 31-GEP users and 44% of nonusers stated that the 31-GEP results would impact their treatment plan decisions. Conclusion: The 31-GEP test significantly impacts treatment plans in CM, particularly for thin and stage I melanomas. Importantly, even nonusers stated that 31-GEP test results would impact treatment plans as well as recommendations to a friend or family member.
{"title":"Clinical Utility of the 31-Gene Expression Profile Test on the Management of Cutaneous Melanoma by Nurse Practitioners and Physician Assistants","authors":"Renata Block, MMS, PA-C, Deborah Patterson, MMS, PA-C, Jennifer J. Siegel, PhD, Brian Martin, PhD, Ann P. Quick, PhD, Jillian Hunt, MSN, APRN, FNP-C, AOCNP","doi":"10.6004/jadpro.2023.14.7.3","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.3","url":null,"abstract":"Objective: The 31-gene expression profile (31-GEP) can predict the risk of recurrence and metastasis in cutaneous melanoma (CM). We assessed the viewpoints and use of 31-GEP testing by physician assistants (PAs) and nurse practitioners (NPs) for patients with CM. Methods: NPs and PAs (n = 369) completed an 18-question online survey about their viewpoints and use of the 31-GEP risk-stratification test. Results: Most practitioners (n = 334, 90.5%) felt prognostic testing improved patient care and would recommend the 31-GEP to a colleague (n = 333, 90.2%) or a friend or family member (n = 289, 78.3%) who was diagnosed with CM. The 31-GEP test was used by 176 respondents in the preceding 12 months (53%). Among users of the 31-GEP test, 78% stated that the results would impact follow-up schedule and referral, 66% overall treatment decisions, 62% sentinel lymph node biopsy recommendations, and 50% surveillance imaging. In thin tumors (″ 1 mm), 82% of 31-GEP users and 44% of nonusers stated that the 31-GEP results would impact their treatment plan decisions. Conclusion: The 31-GEP test significantly impacts treatment plans in CM, particularly for thin and stage I melanomas. Importantly, even nonusers stated that 31-GEP test results would impact treatment plans as well as recommendations to a friend or family member.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139299158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advanced practitioners are key members of the oncology care team, and their numbers and significance continue to expand. While the role of the AP has become well defined in everyday clinical practice, there is still space to define the AP role in clinical research. In accordance with its mission, the Advanced Practitioner Society for Hematology for Oncology (APSHO) recognizes the significance of addressing the role of the AP in clinical research. This article discusses three key projects related to APs and clinical research (a 2020 benchmarking survey, a 2021 summit, and a 2023 collaboration) and addresses how APSHO is working to continually support the AP role in clinical research through advocacy, committees, formal education, publications, and mentoring.
高级医师是肿瘤治疗团队的重要成员，他们的人数和重要性都在不断扩大。虽然高级医师在日常临床实践中的作用已得到明确界定，但在临床研究中仍有界定高级医师作用的空间。根据其使命，肿瘤血液学高级医师协会（APSHO）认识到在临床研究中发挥高级医师作用的重要性。本文讨论了与 AP 和临床研究相关的三个关键项目（2020 年基准调查、2021 年峰会和 2023 年合作），并探讨了 APSHO 如何通过宣传、委员会、正规教育、出版物和指导等方式，不断支持 AP 在临床研究中发挥作用。
{"title":"Role of the Advanced Practitioner in Clinical Research","authors":"Christa Marie Braun-Inglis, DNP, APRN, FNP-BC, AOCNP, Brianna Hoffner, MSN, ANP-BC, AOCNP, FAPO, Lisa Kottschade, APRN, MSN, CNP, FAPO, Erin Pierce, MSN, APRN, FNP-C, Sandra Kurtin, PhD, ANP-BC, AOCN, FAPO","doi":"10.6004/jadpro.2023.14.7.14","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.14","url":null,"abstract":"Advanced practitioners are key members of the oncology care team, and their numbers and significance continue to expand. While the role of the AP has become well defined in everyday clinical practice, there is still space to define the AP role in clinical research. In accordance with its mission, the Advanced Practitioner Society for Hematology for Oncology (APSHO) recognizes the significance of addressing the role of the AP in clinical research. This article discusses three key projects related to APs and clinical research (a 2020 benchmarking survey, a 2021 summit, and a 2023 collaboration) and addresses how APSHO is working to continually support the AP role in clinical research through advocacy, committees, formal education, publications, and mentoring.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139293932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.6004/jadpro.2023.14.7.8
Shannon Holloway, PA-C, Kelly McConn, PA-C, Roy Borchardt, PA-C, PhD, Victor E. Mulanovich, MD, Javier A. Adachi, MD
Burnout among health-care workers is highly prevalent and profoundly impacts the quality of patient care. In addition to affecting patient safety, burnout results in higher staff turnover, revenue deficits due to decreased productivity, financial risk, and diminished organization viability because of the impact on quality of care, patient satisfaction, and safety. Culmination of external and internal stressors in health-care worker populations is associated with a higher probability of burnout and workers who reported perceived low workplace flexibility. In addition, workplace flexibility is associated with reduced odds of experiencing burnout. Workplace flexibility plays a critical role in potentially reducing the occurrence of burnout in the health-care worker population. Individually focused solutions are important to mitigate burnout, however, comprehensive organizational change ensures durable and sustainable solutions. There is a correlation between a positive employee outlook and reduced stress when there is a perceived level of control over one’s work schedule. The goal of this article is to showcase the process of a successful implementation of a condensed work schedule for an advanced practice provider workforce in infectious diseases in response to burnout and workload shifts. This chronicles the steps of design, rationale, procuring buy-in by stakeholders, and operational implementation of the new schedules. Advanced practice provider satisfaction and burnout were measured by periodic surveys at timepoints along the way.
{"title":"Mitigating Burnout: Transition to a Condensed Workweek for Advanced Practice Providers in Infectious Diseases","authors":"Shannon Holloway, PA-C, Kelly McConn, PA-C, Roy Borchardt, PA-C, PhD, Victor E. Mulanovich, MD, Javier A. Adachi, MD","doi":"10.6004/jadpro.2023.14.7.8","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.8","url":null,"abstract":"Burnout among health-care workers is highly prevalent and profoundly impacts the quality of patient care. In addition to affecting patient safety, burnout results in higher staff turnover, revenue deficits due to decreased productivity, financial risk, and diminished organization viability because of the impact on quality of care, patient satisfaction, and safety. Culmination of external and internal stressors in health-care worker populations is associated with a higher probability of burnout and workers who reported perceived low workplace flexibility. In addition, workplace flexibility is associated with reduced odds of experiencing burnout. Workplace flexibility plays a critical role in potentially reducing the occurrence of burnout in the health-care worker population. Individually focused solutions are important to mitigate burnout, however, comprehensive organizational change ensures durable and sustainable solutions. There is a correlation between a positive employee outlook and reduced stress when there is a perceived level of control over one’s work schedule. The goal of this article is to showcase the process of a successful implementation of a condensed work schedule for an advanced practice provider workforce in infectious diseases in response to burnout and workload shifts. This chronicles the steps of design, rationale, procuring buy-in by stakeholders, and operational implementation of the new schedules. Advanced practice provider satisfaction and burnout were measured by periodic surveys at timepoints along the way.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139297805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.6004/jadpro.2023.14.7.15
Wendy Vogel, MSN, FNP, AOCNP, FAPO, Yi Lisa Hwa, APRN, DNP, CNP, FAPO, Lisa Kottschade, APRN, MSN, CNP, FAPO, Megan May, PharmD, BCOP, FAPO, FHOPA
The Advanced Practitioner Society for Hematology and Oncology (APSHO) launched its first oncology and hematology advanced practitioner (AP) compensation survey in 2022. This 74-question survey surveyed nurse practitioners, pharmacists, physician assistants, clinical nurse specialists, and advanced practice nurses in oncology, investigating all aspects of compensation structure, including salary, on-call payments, incentive structures where applicable, and consulting rates to work with industry partners. Data also include a concerning rate of AP burnout and intent to alter current work status by leaving the practice, leaving the specialty, reducing work hours, or leaving health care all together. Results from this survey may be beneficial in the recruitment, retention, and promotion of the AP in hematology and oncology.
血液学和肿瘤学高级执业医师协会（APSHO）于 2022 年启动了首次肿瘤学和血液学高级执业医师（AP）薪酬调查。这项包含 74 个问题的调查对肿瘤学领域的执业护士、药剂师、医生助理、临床护理专家和高级执业护士进行了调查，调查内容涉及薪酬结构的各个方面，包括工资、值班费、适用的奖励结构以及与行业合作伙伴合作的咨询费率。数据还包括关于高级护理人员职业倦怠率以及通过离开实践、离开专业、减少工作时间或全部离开医疗保健行业来改变当前工作状态的意向。这项调查的结果可能有助于血液学和肿瘤学专业 AP 的招聘、保留和晋升。
{"title":"APSHO Oncology/Hematology Advanced Practitioner Compensation Survey","authors":"Wendy Vogel, MSN, FNP, AOCNP, FAPO, Yi Lisa Hwa, APRN, DNP, CNP, FAPO, Lisa Kottschade, APRN, MSN, CNP, FAPO, Megan May, PharmD, BCOP, FAPO, FHOPA","doi":"10.6004/jadpro.2023.14.7.15","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.15","url":null,"abstract":"The Advanced Practitioner Society for Hematology and Oncology (APSHO) launched its first oncology and hematology advanced practitioner (AP) compensation survey in 2022. This 74-question survey surveyed nurse practitioners, pharmacists, physician assistants, clinical nurse specialists, and advanced practice nurses in oncology, investigating all aspects of compensation structure, including salary, on-call payments, incentive structures where applicable, and consulting rates to work with industry partners. Data also include a concerning rate of AP burnout and intent to alter current work status by leaving the practice, leaving the specialty, reducing work hours, or leaving health care all together. Results from this survey may be beneficial in the recruitment, retention, and promotion of the AP in hematology and oncology.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139299781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.6004/jadpro.2023.14.7.2
Anna C. Cooper, PA-C, Casey A. Fazer, PA-C, Ashish V. Chintakuntlawar, MBBS, PhD, Harry E. Fuentes Bayne, MD, MS, Patrick W. McGarrah, MD, Katharine A. R. Price
Background: Patients with metastatic human papillomavirus–associated oropharyngeal cancer (HPV-OPC) have a median overall survival exceeding 2 years and are often candidates for multiple lines of palliative therapy. With the approval of immunotherapy as first-line treatment, salvage therapeutic options are limited. We describe our experience using capecitabine as salvage therapy for patients with recurrent or metastatic (R/M) HPV-OPC. Methods: We performed a retrospective study of patients with R/M HPV-OPC with distant metastatic disease. Eligible patients were identified from a medical oncology clinical database. Demographic and clinical data were abstracted from the medical record. Survival probabilities were estimated with the Kaplan-Meier method. Results: 10 patients were identified. Sites of metastatic disease included lung, liver, mediastinal lymph nodes, bone, abdominal lymph nodes, and soft tissue. Most patients received capecitabine as fourth-line treatment. The median duration from start of capecitabine therapy until death was 10.5 months. Best treatment response was as follows: partial responses (PR) were seen in 4 of 10 (40%), stable disease (SD) in 3 of 10 (30%), and progressive disease (PD) in 2 of 10 (20%). The clinical benefit rate (CR + PR + SD) was 70%. Reasons for discontinuation included disease progression (n = 8) and side effects (n = 2). One patient notably had prolonged benefit from capecitabine and continued to be on treatment for 34 months total. Conclusions: Capecitabine is a potential salvage treatment for heavily pretreated patients with R/M HPV-OPC, with some patients experiencing prolonged response. Clinical or molecular predictors of response would be helpful to identify patients likely to benefit; a larger prospective study would be useful to confirm efficacy in this patient population.
{"title":"Capecitabine for Salvage Treatment of Patients With Heavily Pretreated Human Papillomavirus–Associated Oropharynx Cancer With Distant Metastases","authors":"Anna C. Cooper, PA-C, Casey A. Fazer, PA-C, Ashish V. Chintakuntlawar, MBBS, PhD, Harry E. Fuentes Bayne, MD, MS, Patrick W. McGarrah, MD, Katharine A. R. Price","doi":"10.6004/jadpro.2023.14.7.2","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.2","url":null,"abstract":"Background: Patients with metastatic human papillomavirus–associated oropharyngeal cancer (HPV-OPC) have a median overall survival exceeding 2 years and are often candidates for multiple lines of palliative therapy. With the approval of immunotherapy as first-line treatment, salvage therapeutic options are limited. We describe our experience using capecitabine as salvage therapy for patients with recurrent or metastatic (R/M) HPV-OPC. Methods: We performed a retrospective study of patients with R/M HPV-OPC with distant metastatic disease. Eligible patients were identified from a medical oncology clinical database. Demographic and clinical data were abstracted from the medical record. Survival probabilities were estimated with the Kaplan-Meier method. Results: 10 patients were identified. Sites of metastatic disease included lung, liver, mediastinal lymph nodes, bone, abdominal lymph nodes, and soft tissue. Most patients received capecitabine as fourth-line treatment. The median duration from start of capecitabine therapy until death was 10.5 months. Best treatment response was as follows: partial responses (PR) were seen in 4 of 10 (40%), stable disease (SD) in 3 of 10 (30%), and progressive disease (PD) in 2 of 10 (20%). The clinical benefit rate (CR + PR + SD) was 70%. Reasons for discontinuation included disease progression (n = 8) and side effects (n = 2). One patient notably had prolonged benefit from capecitabine and continued to be on treatment for 34 months total. Conclusions: Capecitabine is a potential salvage treatment for heavily pretreated patients with R/M HPV-OPC, with some patients experiencing prolonged response. Clinical or molecular predictors of response would be helpful to identify patients likely to benefit; a larger prospective study would be useful to confirm efficacy in this patient population.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139295642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Scientific innovation in hematology and oncology is constant and increasingly complex, requiring individual clinicians and institutions to effectively integrate standards of care across the diverse hematology and oncology landscape into practice. Effective integration of evolving diagnostics, risk models, new therapeutics and novel treatment strategies, and practice regulation requirements requires ongoing practice improvement efforts and an infrastructure to implement change. Advanced practitioners (APs) are poised to serve as agents of change based on their clinical presence, clinical expertise, familiarity with critical members of the interdisciplinary team, communication skills, and ability to envision and actualize optimized workflows. Through practice analysis, workflow optimization, role delineation, and effective utilization and tailoring of documentation in the electronic health record, APs can lead implementation strategies to improve patient outcomes. In this article, we will review the essential role APs play as agents of change to implement best practice models using quality improvement (QI) processes. The principles of QI as a strategy for practice improvement, including strategies and tools for successful practice analysis, workflow optimization, outcome analysis, implementation, and sustainability of change, will be reviewed. Proposed elements of a QI and practice integration toolkit for APs and a series of QI exemplars, including an Advanced Practitioner Society for Hematology and Oncology (APSHO)-led QI initiative and AP-led QI initiatives, will be summarized.
{"title":"Advanced Practitioners as Agents of Change: Leveraging Quality Improvement to Improve Practice","authors":"Sandra Kurtin, PhD, ANP-BC, AOCN, FAPO, Andrea Edwards, PA-C, Heather Koniarczyk, MSN, APRN-CNP, AOCNP, Camille Petraitis, DNP, FNP-BC, Lisa Nodzon, PhD, APRN, AOCNP, Nicole Deline, MSN, APRN, FNP-C, AOCNP, Tajuana Bradley, FNP-BC, Megan May, PharmD, BCOP, FAPO, FHOPA, Molly Thompson-Coffey, Jessica Tamasi, Wendy Vogel, MSN, FNP, AOCNP, FAPO","doi":"10.6004/jadpro.2023.14.7.13","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.13","url":null,"abstract":"Scientific innovation in hematology and oncology is constant and increasingly complex, requiring individual clinicians and institutions to effectively integrate standards of care across the diverse hematology and oncology landscape into practice. Effective integration of evolving diagnostics, risk models, new therapeutics and novel treatment strategies, and practice regulation requirements requires ongoing practice improvement efforts and an infrastructure to implement change. Advanced practitioners (APs) are poised to serve as agents of change based on their clinical presence, clinical expertise, familiarity with critical members of the interdisciplinary team, communication skills, and ability to envision and actualize optimized workflows. Through practice analysis, workflow optimization, role delineation, and effective utilization and tailoring of documentation in the electronic health record, APs can lead implementation strategies to improve patient outcomes. In this article, we will review the essential role APs play as agents of change to implement best practice models using quality improvement (QI) processes. The principles of QI as a strategy for practice improvement, including strategies and tools for successful practice analysis, workflow optimization, outcome analysis, implementation, and sustainability of change, will be reviewed. Proposed elements of a QI and practice integration toolkit for APs and a series of QI exemplars, including an Advanced Practitioner Society for Hematology and Oncology (APSHO)-led QI initiative and AP-led QI initiatives, will be summarized.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139304564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Patients with cancer often pursue nutrition as an avenue to positively impact their care management and disease outcomes. Nutritional interventions are increasing in popularity, especially intermittent fasting as an adjunct to chemotherapy. However, limited research is available on the impact of intermittent fasting on patients with cancer. Methods: A comprehensive literature search was conducted using Ovid MEDLINE, Ovid EMBASE, and CINAHL databases. Results: 514 articles were identified from the three databases. Seven studies remained after applying inclusion and exclusion criteria. The seven studies included in this review examined fasting compliance, malnutrition, therapy side effects, endocrine parameters, quality of life measures, and cancer outcomes. Data suggest overall good compliance, no malnutrition, minimal side effects, a trend toward improved endocrine parameters, unchanged quality of life (QOL), and mixed results for cancer outcomes. Conclusion: Intermittent fasting as an adjunct to chemotherapy in normal-weight patients with cancer has potential as a safe, tolerable, and feasible nutritional intervention that could positively impact treatment outcomes and QOL. Large-scale randomized controlled trials are needed to validate these findings and determine what future role intermittent fasting may play in cancer management.
{"title":"Impact of Fasting on Patients With Cancer: An Integrative Review","authors":"Samantha Thompson, MPH, MCHS, PA-C, Lydia T. Madsen, PhD, RN, AOCNS, FNAP, Angela Bazzell, DNP, APRN, FNP-BC, AOCNP","doi":"10.6004/jadpro.2023.14.7.5","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.5","url":null,"abstract":"Background: Patients with cancer often pursue nutrition as an avenue to positively impact their care management and disease outcomes. Nutritional interventions are increasing in popularity, especially intermittent fasting as an adjunct to chemotherapy. However, limited research is available on the impact of intermittent fasting on patients with cancer. Methods: A comprehensive literature search was conducted using Ovid MEDLINE, Ovid EMBASE, and CINAHL databases. Results: 514 articles were identified from the three databases. Seven studies remained after applying inclusion and exclusion criteria. The seven studies included in this review examined fasting compliance, malnutrition, therapy side effects, endocrine parameters, quality of life measures, and cancer outcomes. Data suggest overall good compliance, no malnutrition, minimal side effects, a trend toward improved endocrine parameters, unchanged quality of life (QOL), and mixed results for cancer outcomes. Conclusion: Intermittent fasting as an adjunct to chemotherapy in normal-weight patients with cancer has potential as a safe, tolerable, and feasible nutritional intervention that could positively impact treatment outcomes and QOL. Large-scale randomized controlled trials are needed to validate these findings and determine what future role intermittent fasting may play in cancer management.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"2009 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139300872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.6004/jadpro.2023.14.7.9
Sandra Kurtin, PhD, ANP-BC, AOCN, FAPO
The hematology and oncology field is experiencing a wave of challenges in the form of workforce shortages, increasing complexity of care, and a growing population of cancer survivors. These factors all contribute to pressure on oncology practices to improve efficiency. Advanced practitioners (APs) in hematology and oncology have become integral members of the interdisciplinary team. They represent a specialty workforce critical to the delivery of timely, quality, expert cancer care across a broad range of services. With the growth in the AP profession in terms of numbers and services provided, it is critical for AP organizations and leaders to accurately measure AP contributions to care, describe fair compensation for AP services, deploy strategies to assess and reduce burnout among APs, and support continuous process improvement. This series of articles in the Journal of the Advanced Practitioner in Oncology provides data describing the growing role of the AP along with recommendations to further advance the profession and improve patient care.
{"title":"Advanced Practitioners in Hematology and Oncology: A Call to Action","authors":"Sandra Kurtin, PhD, ANP-BC, AOCN, FAPO","doi":"10.6004/jadpro.2023.14.7.9","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.9","url":null,"abstract":"The hematology and oncology field is experiencing a wave of challenges in the form of workforce shortages, increasing complexity of care, and a growing population of cancer survivors. These factors all contribute to pressure on oncology practices to improve efficiency. Advanced practitioners (APs) in hematology and oncology have become integral members of the interdisciplinary team. They represent a specialty workforce critical to the delivery of timely, quality, expert cancer care across a broad range of services. With the growth in the AP profession in terms of numbers and services provided, it is critical for AP organizations and leaders to accurately measure AP contributions to care, describe fair compensation for AP services, deploy strategies to assess and reduce burnout among APs, and support continuous process improvement. This series of articles in the Journal of the Advanced Practitioner in Oncology provides data describing the growing role of the AP along with recommendations to further advance the profession and improve patient care.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"104 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139292436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the advent of high-throughput next-generation sequencing (NGS) and multigene panel testing, genetic testing and interpretations have become increasingly complex. Specifically, reports demonstrating “variant of uncertain significance” (VUS) present interpretative challenges. Misinterpretation of a VUS may result in clinical harm, emotional distress for patients and family members, and potential health-care provider liability. The following article and deidentified case study illustrate how a lack of health-care provider and patient understanding of a germline VUS resulted in a negative patient outcome and unnecessary surgery.
{"title":"When Germline Genetic Testing Results Are Unclear: Highlighting Variants of Uncertain Significance","authors":"Patricia Kelly, DNP, APRN, CNS, AGN-BC, AOCN, Suzanne Mahon, DNS, RN, AOCN, AGN-BC, FAAN, Patricia Friend, PhD, APRN-CNS, AOCNS, AGN-BC","doi":"10.6004/jadpro.2023.14.7.7","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.7","url":null,"abstract":"With the advent of high-throughput next-generation sequencing (NGS) and multigene panel testing, genetic testing and interpretations have become increasingly complex. Specifically, reports demonstrating “variant of uncertain significance” (VUS) present interpretative challenges. Misinterpretation of a VUS may result in clinical harm, emotional distress for patients and family members, and potential health-care provider liability. The following article and deidentified case study illustrate how a lack of health-care provider and patient understanding of a germline VUS resulted in a negative patient outcome and unnecessary surgery.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139296727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The 2023 JADPRO Live conference was held in person from November 9 through 12 in sunny Orlando, Florida. It was wonderful reconnecting with advanced practitioners (APs) from around the country to catch up on the latest advances in hematology/oncology, along with their implications for advanced practice.
{"title":"JADPRO Live 2023: Shaping the Future of Oncology","authors":"Beth Faiman, PhD, MSN, APRN-BC, AOCN, BMTCN, FAAN, FAPO","doi":"10.6004/jadpro.2023.14.7.1","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.1","url":null,"abstract":"The 2023 JADPRO Live conference was held in person from November 9 through 12 in sunny Orlando, Florida. It was wonderful reconnecting with advanced practitioners (APs) from around the country to catch up on the latest advances in hematology/oncology, along with their implications for advanced practice.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"2000 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139297496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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