Pub Date : 2024-09-11DOI: 10.6004/jadpro.2024.15.8.14
Lisa Stewart, Linda D Ward
Molecular profiling (MP), which involves testing tissue, blood, or other body fluids to identify biomarkers, has become increasingly important in cancer treatment. Genomic tumor sequencing, a specific type of MP, is commonly used to identify specific gene variants or proteins that can be targeted for treatment. Germline testing is also routinely recommended for certain cancers. Low levels of genomic literacy among cancer patients, coupled with increasingly complex test results, challenge clinicians to communicate results and provide appropriate education. In addition, patients may have varying preferences for the level of information they desire and are able to process. This state-of-the-art review explores cancer patients' expectations, attitudes, knowledge, satisfaction, and concerns as they undergo molecular profiling. A search was conducted through four databases to identify studies from 2016 to 2022 to explore cancer patients' knowledge and preferences regarding genomic testing. Nineteen studies met the inclusion criteria. Most studies revealed that people with cancer have low levels of knowledge regarding MP, albeit with significant variability. Patients primarily desired MP to identify new treatment options and increase survival. While patients relied on their providers to interpret test results, they wanted to be informed of all results, mainly if those results might guide treatment decisions or future care planning. Most patients, especially those with low genomic/genetic knowledge, tended to overestimate the personal benefits of MP. Further study is needed to provide tailored education to fulfill patients' information needs.
{"title":"What Do Patients With Cancer Know, or Want to Know, About Genomic Tumor Sequencing and Genetic Testing? A State-of-the-Art Review.","authors":"Lisa Stewart, Linda D Ward","doi":"10.6004/jadpro.2024.15.8.14","DOIUrl":"10.6004/jadpro.2024.15.8.14","url":null,"abstract":"<p><p>Molecular profiling (MP), which involves testing tissue, blood, or other body fluids to identify biomarkers, has become increasingly important in cancer treatment. Genomic tumor sequencing, a specific type of MP, is commonly used to identify specific gene variants or proteins that can be targeted for treatment. Germline testing is also routinely recommended for certain cancers. Low levels of genomic literacy among cancer patients, coupled with increasingly complex test results, challenge clinicians to communicate results and provide appropriate education. In addition, patients may have varying preferences for the level of information they desire and are able to process. This state-of-the-art review explores cancer patients' expectations, attitudes, knowledge, satisfaction, and concerns as they undergo molecular profiling. A search was conducted through four databases to identify studies from 2016 to 2022 to explore cancer patients' knowledge and preferences regarding genomic testing. Nineteen studies met the inclusion criteria. Most studies revealed that people with cancer have low levels of knowledge regarding MP, albeit with significant variability. Patients primarily desired MP to identify new treatment options and increase survival. While patients relied on their providers to interpret test results, they wanted to be informed of all results, mainly if those results might guide treatment decisions or future care planning. Most patients, especially those with low genomic/genetic knowledge, tended to overestimate the personal benefits of MP. Further study is needed to provide tailored education to fulfill patients' information needs.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.6004/jadpro.2024.15.8.12
Kristin Neves
Cancer treatments induce multiple unwanted side effects that often go unrelieved, resulting in emergency room (ER) visits. Oncology clinics have established triage clinics (TCs) for symptom management, thereby improving access to care and decreasing ER utilization. In addition, evidence proves that validated patient-reported outcome (PRO) tools support improved symptom management and decreased ER visits. This quality improvement project aimed to determine if or to what degree implementing the MD Anderson Symptom Inventory (MDASI) tool decreases emergency room visits, with or without hospitalizations, in a South Florida outpatient oncology clinic. The MDASI tool was implemented in a TC during symptom management telephone triage. A statistically significant difference was observed in community ER visits and hospitalizations using a significance level of p < .05. The pre-implementation (n = 14, 29.8%) and post-implementation (n = 10, 23%) values (χ2 [N = 47] = 12.66, p = .008) confirmed a reduction in ER visits by 6.8 percentage points. In addition, pre-implementation (n = 8, 17%) and post-implementation (n = 10, 21%) values (χ2 [N = 47] = 25.69, p = .006) confirmed a mean increase of two more hospitalizations (4%) in patients after MDASI implementation, likely reflecting an improved patient understanding of appropriate ER utilization. The MDASI tool supported early symptom assessment and management while identifying patient knowledge gaps. This project confirms that PRO tools allow patients to assign meaning to their symptoms, improve communication, and reduce unnecessary ER visits.
{"title":"Implementing a Validated Multi-Symptom Assessment Tool During Telephone Triage to Reduce Oncology Patient Emergency Room Visits.","authors":"Kristin Neves","doi":"10.6004/jadpro.2024.15.8.12","DOIUrl":"10.6004/jadpro.2024.15.8.12","url":null,"abstract":"<p><p>Cancer treatments induce multiple unwanted side effects that often go unrelieved, resulting in emergency room (ER) visits. Oncology clinics have established triage clinics (TCs) for symptom management, thereby improving access to care and decreasing ER utilization. In addition, evidence proves that validated patient-reported outcome (PRO) tools support improved symptom management and decreased ER visits. This quality improvement project aimed to determine if or to what degree implementing the MD Anderson Symptom Inventory (MDASI) tool decreases emergency room visits, with or without hospitalizations, in a South Florida outpatient oncology clinic. The MDASI tool was implemented in a TC during symptom management telephone triage. A statistically significant difference was observed in community ER visits and hospitalizations using a significance level of <i>p</i> < .05. The pre-implementation (<i>n</i> = 14, 29.8%) and post-implementation (<i>n</i> = 10, 23%) values (χ<sup>2</sup> [<i>N</i> = 47] = 12.66, <i>p</i> = .008) confirmed a reduction in ER visits by 6.8 percentage points. In addition, pre-implementation (<i>n</i> = 8, 17%) and post-implementation (<i>n</i> = 10, 21%) values (χ<sup>2</sup> [<i>N</i> = 47] = 25.69, <i>p</i> = .006) confirmed a mean increase of two more hospitalizations (4%) in patients after MDASI implementation, likely reflecting an improved patient understanding of appropriate ER utilization. The MDASI tool supported early symptom assessment and management while identifying patient knowledge gaps. This project confirms that PRO tools allow patients to assign meaning to their symptoms, improve communication, and reduce unnecessary ER visits.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.6004/jadpro.2024.15.8.13
Heidi Mason, April Bigelow, Christina Conrad, Karen Harden, Deborah Price, Diane Bohn, Natasha Mason
Purpose: Initiation of early palliative care (PC) is vital in order to assure that the physical, psychological, spiritual, and social needs of patients and their families are addressed before, during, and after treatment for a serious illness. According to the World Health Organization, PC is patient-and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. It is holistic care that addresses the physical, psychosocial, and spiritual needs of patients and their families.
Methods: To improve early PC in the oncology setting, a free educational series was established for advanced practice providers (APPs). Evaluations were obtained and a post-survey was completed.
Results: Evaluation results were positive; staff liked the case presentations and the topics covered. A post-survey was completed. Results demonstrated that most APPs were familiar with basic concepts of symptom management as well as the holistic needs of patients and their families. One area that did not improve was the concept that PC is compatible with aggressive treatment.
Conclusions: A PC lecture series for APPs was well received by participants. Participants were able to demonstrate knowledge regarding delivery of PC but failed to understand that PC can be delivered simultaneously with aggressive therapy.
Recommendations: Education regarding PC through the disease process and appropriate referrals to PC specialty need to be reinforced. Educating APPs in early PC is beneficial, and creative methods of teaching need to be further explored.
目的:早期启动姑息关怀(PC)对于确保病人及其家属在重病治疗前、治疗期间和治疗后的生理、心理、精神和社会需求得到满足至关重要。根据世界卫生组织的定义,姑息关怀是以病人和家属为中心的护理,通过预测、预防和治疗痛苦来优化生命质量。它是一种整体护理,能满足患者及其家属在身体、社会心理和精神方面的需求:方法:为了改善肿瘤科的早期 PC,我们为高级医疗服务提供者(APP)开设了免费的系列教育课程。结果:评估结果是积极的:评估结果是积极的;员工们喜欢案例演示和所涉及的主题。完成了一项事后调查。结果显示,大多数 APP 熟悉症状管理的基本概念以及病人及其家属的整体需求。一个没有得到改善的方面是,他们不知道 PC 与积极治疗是相容的:为 APP 举办的 PC 系列讲座深受参与者欢迎。与会者能够展示有关 PC 传播的知识,但未能理解 PC 传播可与积极治疗同时进行:建议:需要加强有关 PC 在疾病过程中的作用以及适当转诊至 PC 专科的教育。对 APP 进行早期 PC 教育是有益的,需要进一步探索创造性的教学方法。
{"title":"Expanding the Toolbox: A Palliative Care Lecture Series for Oncology Advanced Practice Providers.","authors":"Heidi Mason, April Bigelow, Christina Conrad, Karen Harden, Deborah Price, Diane Bohn, Natasha Mason","doi":"10.6004/jadpro.2024.15.8.13","DOIUrl":"10.6004/jadpro.2024.15.8.13","url":null,"abstract":"<p><strong>Purpose: </strong>Initiation of early palliative care (PC) is vital in order to assure that the physical, psychological, spiritual, and social needs of patients and their families are addressed before, during, and after treatment for a serious illness. According to the World Health Organization, PC is patient-and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering. It is holistic care that addresses the physical, psychosocial, and spiritual needs of patients and their families.</p><p><strong>Methods: </strong>To improve early PC in the oncology setting, a free educational series was established for advanced practice providers (APPs). Evaluations were obtained and a post-survey was completed.</p><p><strong>Results: </strong>Evaluation results were positive; staff liked the case presentations and the topics covered. A post-survey was completed. Results demonstrated that most APPs were familiar with basic concepts of symptom management as well as the holistic needs of patients and their families. One area that did not improve was the concept that PC is compatible with aggressive treatment.</p><p><strong>Conclusions: </strong>A PC lecture series for APPs was well received by participants. Participants were able to demonstrate knowledge regarding delivery of PC but failed to understand that PC can be delivered simultaneously with aggressive therapy.</p><p><strong>Recommendations: </strong>Education regarding PC through the disease process and appropriate referrals to PC specialty need to be reinforced. Educating APPs in early PC is beneficial, and creative methods of teaching need to be further explored.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.6004/jadpro.2024.15.6.2
Kristen L Dalton, Meredith R Johnson
Background: Proper nutrition is known to hasten healing, reduce treatment-related morbidity, and improve outcomes. Children with high-risk solid tumors often have gastrostomy tubes (GTs) placed for supplemental nutrition during cancer therapy. Gastrostomy tubes, however, are not without risks, and many patients develop erythema concerning for infection at the stoma site. Gastrostomy complications are described in the literature, but knowledge regarding this topic is limited.
Methods: In this retrospective descriptive study, the authors reviewed 3 years of clinical data regarding pediatric patients with solid tumors who had GTs at a pediatric medical center. Descriptive statistics were used to describe the incidence of erythema concerning for infection, identify factors most likely to be associated with this complication, and understand how erythema impacts the completion of cancer therapy.
Results: In a sample of 58 children with high-risk solid tumors who had GTs placed between 2018 and 2021, 53% developed erythema concerning for infection. More subjects who experienced episodes of GT erythema had neuroblastoma (48%), tubes placed after the start of cancer therapy (74%), and erythema during periods of neutropenia (71%). Only one subject experienced a treatment delay due to GT erythema.
Discussion: Despite the rate of GT erythema among study subjects, most completed cancer therapy without delay related to this complication. Additionally, the incidence of stoma site erythema was notably less when tubes were placed prior to the start of cancer therapy. Therefore, the authors recommend GT placement prior to therapy start when possible and further attention be paid to this complication during cancer therapy.
{"title":"Is it Cellulitis Again? Erythema Concerning for Infection in Children With High-Risk Solid Tumors Who Have a Gastrostomy Tube.","authors":"Kristen L Dalton, Meredith R Johnson","doi":"10.6004/jadpro.2024.15.6.2","DOIUrl":"https://doi.org/10.6004/jadpro.2024.15.6.2","url":null,"abstract":"<p><strong>Background: </strong>Proper nutrition is known to hasten healing, reduce treatment-related morbidity, and improve outcomes. Children with high-risk solid tumors often have gastrostomy tubes (GTs) placed for supplemental nutrition during cancer therapy. Gastrostomy tubes, however, are not without risks, and many patients develop erythema concerning for infection at the stoma site. Gastrostomy complications are described in the literature, but knowledge regarding this topic is limited.</p><p><strong>Methods: </strong>In this retrospective descriptive study, the authors reviewed 3 years of clinical data regarding pediatric patients with solid tumors who had GTs at a pediatric medical center. Descriptive statistics were used to describe the incidence of erythema concerning for infection, identify factors most likely to be associated with this complication, and understand how erythema impacts the completion of cancer therapy.</p><p><strong>Results: </strong>In a sample of 58 children with high-risk solid tumors who had GTs placed between 2018 and 2021, 53% developed erythema concerning for infection. More subjects who experienced episodes of GT erythema had neuroblastoma (48%), tubes placed after the start of cancer therapy (74%), and erythema during periods of neutropenia (71%). Only one subject experienced a treatment delay due to GT erythema.</p><p><strong>Discussion: </strong>Despite the rate of GT erythema among study subjects, most completed cancer therapy without delay related to this complication. Additionally, the incidence of stoma site erythema was notably less when tubes were placed prior to the start of cancer therapy. Therefore, the authors recommend GT placement prior to therapy start when possible and further attention be paid to this complication during cancer therapy.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"15 6","pages":"365-371"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.6004/jadpro.2024.15.6.1
Beth Faiman
{"title":"How Do We Achieve Value-Based, Patient-Centered Care?","authors":"Beth Faiman","doi":"10.6004/jadpro.2024.15.6.1","DOIUrl":"https://doi.org/10.6004/jadpro.2024.15.6.1","url":null,"abstract":"","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"15 6","pages":"340-341"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.6004/jadpro.2024.15.6.3
Nicole Kuhnly, Jessica Shank Coviello, Catherine A Kobza, Devesh A Patel, Jacqueline S Lagoy, Mary-Ann L Cyr
Carcinoid heart disease (CHD) is a rare cardiac complication that occurs most commonly in patients with advanced neuroendocrine tumors and is a known sequela of carcinoid syndrome. Neuroendocrine tumors most widely associated with CHD include tumors in the small bowel, followed by lung, large bowel, pancreatic, appendiceal, and ovarian neoplasms. Carcinoid syndrome is a paraneoplastic syndrome caused by the release of serotonin and other substances from neuroendocrine tumors. It results in a spectrum of symptoms, including diarrhea, flushing, bronchospasm, and symptoms of congestive heart failure. Without treatment and for patients with advanced heart failure, the prognosis of CHD can be less than a year. Management of CHD is often challenging as patients typically present late, and the disease can progress rapidly. Therefore, optimal management of these patients requires close collaboration among various specialties to quantify disease burden, delay the progression of valvular disease, and determine the most effective surgical and medical management strategies depending on the cardiac manifestations to improve quality of life and reduce mortality. This involves a collaborative team, including cardiology and oncology, and often involves many other disciplines, including hepatobiliary and cardiovascular surgeons, endocrinologists, anesthesiologists, and gastroenterologists.
{"title":"Carcinoid Heart Disease.","authors":"Nicole Kuhnly, Jessica Shank Coviello, Catherine A Kobza, Devesh A Patel, Jacqueline S Lagoy, Mary-Ann L Cyr","doi":"10.6004/jadpro.2024.15.6.3","DOIUrl":"10.6004/jadpro.2024.15.6.3","url":null,"abstract":"<p><p>Carcinoid heart disease (CHD) is a rare cardiac complication that occurs most commonly in patients with advanced neuroendocrine tumors and is a known sequela of carcinoid syndrome. Neuroendocrine tumors most widely associated with CHD include tumors in the small bowel, followed by lung, large bowel, pancreatic, appendiceal, and ovarian neoplasms. Carcinoid syndrome is a paraneoplastic syndrome caused by the release of serotonin and other substances from neuroendocrine tumors. It results in a spectrum of symptoms, including diarrhea, flushing, bronchospasm, and symptoms of congestive heart failure. Without treatment and for patients with advanced heart failure, the prognosis of CHD can be less than a year. Management of CHD is often challenging as patients typically present late, and the disease can progress rapidly. Therefore, optimal management of these patients requires close collaboration among various specialties to quantify disease burden, delay the progression of valvular disease, and determine the most effective surgical and medical management strategies depending on the cardiac manifestations to improve quality of life and reduce mortality. This involves a collaborative team, including cardiology and oncology, and often involves many other disciplines, including hepatobiliary and cardiovascular surgeons, endocrinologists, anesthesiologists, and gastroenterologists.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"15 6","pages":"378-386"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.6004/jadpro.2024.15.6.4
Mark Reid, Bethany A Fedutes Henderson
Cold agglutinin disease (CAD) is a rare type of autoimmune hemolytic anemia (AIHA) distinct from warm antibody AIHA. One of the ways it is distinct is that CAD is usually not responsive to corticosteroids compared with warm antibody AIHA. Historically, CAD therapy has been limited to immunotherapy or chemoimmunotherapy with varying responses. Cold agglutinin disease also poses a risk for thrombosis and mortality. For patients, fatigue tends to be a common symptom of CAD. The hallmark of CAD is complement-mediated hemolysis, which makes complement inhibitors a critical therapeutic option for patients. Previously, eculizumab, a C5 inhibitor, had limited therapeutic effect for CAD. More recently, sutimlimab, a C1s inhibitor, was shown in two phase III studies to be an efficacious treatment for CAD, improving hemoglobin, hemolysis, and fatigue. However, there is a paucity of medical literature on CAD and on sutimlimab in particular that is geared toward advanced practice providers (APPs). This article aims to provide APPs with a background in CAD and a focus on sutimlimab, assisting these providers in caring for patients with CAD receiving this therapy.
{"title":"Sutimlimab for Cold Agglutinin Disease.","authors":"Mark Reid, Bethany A Fedutes Henderson","doi":"10.6004/jadpro.2024.15.6.4","DOIUrl":"https://doi.org/10.6004/jadpro.2024.15.6.4","url":null,"abstract":"<p><p>Cold agglutinin disease (CAD) is a rare type of autoimmune hemolytic anemia (AIHA) distinct from warm antibody AIHA. One of the ways it is distinct is that CAD is usually not responsive to corticosteroids compared with warm antibody AIHA. Historically, CAD therapy has been limited to immunotherapy or chemoimmunotherapy with varying responses. Cold agglutinin disease also poses a risk for thrombosis and mortality. For patients, fatigue tends to be a common symptom of CAD. The hallmark of CAD is complement-mediated hemolysis, which makes complement inhibitors a critical therapeutic option for patients. Previously, eculizumab, a C5 inhibitor, had limited therapeutic effect for CAD. More recently, sutimlimab, a C1s inhibitor, was shown in two phase III studies to be an efficacious treatment for CAD, improving hemoglobin, hemolysis, and fatigue. However, there is a paucity of medical literature on CAD and on sutimlimab in particular that is geared toward advanced practice providers (APPs). This article aims to provide APPs with a background in CAD and a focus on sutimlimab, assisting these providers in caring for patients with CAD receiving this therapy.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"15 6","pages":"389-395"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.6004/jadpro.2024.15.5.1
Beth Faiman
{"title":"Artificial Intelligence: How Is it Relevant to Advanced Practitioners?","authors":"Beth Faiman","doi":"10.6004/jadpro.2024.15.5.1","DOIUrl":"https://doi.org/10.6004/jadpro.2024.15.5.1","url":null,"abstract":"","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"15 5","pages":"293-294"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-22DOI: 10.6004/jadpro.2024.15.8.5
Kristi Kay Orbaugh, Sandra Cuellar, Lisa Kennedy Sheldon
Background: Neutropenia and febrile neutropenia (FN) are serious complications of myelosuppressive chemotherapy and present a considerable burden to patients with cancer. Febrile neutropenia is associated with increased risks of infection and hospitalization, a particular concern during the coronavirus disease 2019 (COVID-19) pandemic. Oncology nurses and advanced practice providers (APPs; including nurse practitioners, physician assistants, advanced practice nurses, and pharmacists) play a vital role in the management of patients with cancer and the prevention of infections.
Objectives: The objectives of this article are to summarize the burden of chemotherapy-related neutropenia and FN in patients with cancer in the US and to evaluate the role of oncology nurses and APPs in preventing and managing FN.
Methods: This article provides a narrative review of US studies reporting on the burden of FN, FN during COVID-19, adherence to guidelines for the use of prophylactic granulocyte colony-stimulating factors (G-CSFs), the involvement of oncology nurses in FN prevention, management, and patient quality of life, and inappropriate and/or incomplete G-CSF treatment.
Findings: Despite advances in supportive care for patients with cancer receiving myelosuppressive chemotherapy, neutropenia and FN present a considerable burden to patients, particularly during the COVID-19 pandemic. Oncology nurses and APPs play a vital role in the appropriate and timely delivery of supportive care, which can improve patient outcomes and minimize treatment costs.
{"title":"How Can Oncology Nurses and Advanced Practice Providers Reduce the Burden of Chemotherapy-Induced Febrile Neutropenia in the US?","authors":"Kristi Kay Orbaugh, Sandra Cuellar, Lisa Kennedy Sheldon","doi":"10.6004/jadpro.2024.15.8.5","DOIUrl":"10.6004/jadpro.2024.15.8.5","url":null,"abstract":"<p><strong>Background: </strong>Neutropenia and febrile neutropenia (FN) are serious complications of myelosuppressive chemotherapy and present a considerable burden to patients with cancer. Febrile neutropenia is associated with increased risks of infection and hospitalization, a particular concern during the coronavirus disease 2019 (COVID-19) pandemic. Oncology nurses and advanced practice providers (APPs; including nurse practitioners, physician assistants, advanced practice nurses, and pharmacists) play a vital role in the management of patients with cancer and the prevention of infections.</p><p><strong>Objectives: </strong>The objectives of this article are to summarize the burden of chemotherapy-related neutropenia and FN in patients with cancer in the US and to evaluate the role of oncology nurses and APPs in preventing and managing FN.</p><p><strong>Methods: </strong>This article provides a narrative review of US studies reporting on the burden of FN, FN during COVID-19, adherence to guidelines for the use of prophylactic granulocyte colony-stimulating factors (G-CSFs), the involvement of oncology nurses in FN prevention, management, and patient quality of life, and inappropriate and/or incomplete G-CSF treatment.</p><p><strong>Findings: </strong>Despite advances in supportive care for patients with cancer receiving myelosuppressive chemotherapy, neutropenia and FN present a considerable burden to patients, particularly during the COVID-19 pandemic. Oncology nurses and APPs play a vital role in the appropriate and timely delivery of supportive care, which can improve patient outcomes and minimize treatment costs.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-22DOI: 10.6004/jadpro.2024.15.8.4
Shelby Jones, Alison Edie, Emily Troop, Joshua S Hill, Julie A Thompson
Purpose: Low anterior resection (LAR) is the preferred surgical treatment of rectosigmoid or rectal cancers. However, it is often associated with bowel dysfunction, which is termed low anterior resection syndrome (LARS). Daily bowel dysfunction symptoms have a detrimental effect on quality of life (QOL). Pelvic floor rehabilitation (PFR) can improve pelvic floor function and QOL among patients with LARS. This quality improvement (QI) project seeks to assess the prevalence of LARS and develop and incorporate PFR for the treatment and prevention of LARS.
Methods: A convenience sample of 20 patients met project inclusion. Thirteen patients participated. Individuals were categorized by diagnostic risk: low risk, high risk, and established. The intervention included 1-hour PFR sessions with the physical therapist (PT) and 5 minutes of daily self-led pelvic floor muscle exercises. Outcomes questionnaires included the LARS Score and Fecal Incontinence Quality of Life (FIQOL) Scale. Data were collected both pre- and post-colorectal cancer treatment.
Results: The overall prevalence of LARS was 76.9%, which was significantly higher than the retrospective cohort comparison rate of 21.8% (p < .001). The prevalence of major LARS was 89%, 83%, and 50% at the initial, second, and third sessions, respectively, representing a 44% relative decrease. Embarrassment was significantly affected among individuals with major LARS, although ongoing PFR facilitated improvement.
Conclusion: PFR is a valuable adjunct therapy for LARS, with continued sessions decreasing the overall prevalence among the cohort. Major LARS negatively impacts QOL measures early on in treatment but improves with continued PFR.
{"title":"The Effect of Pelvic Floor Rehabilitation on Low Anterior Resection Syndrome After Colorectal Cancer Treatment.","authors":"Shelby Jones, Alison Edie, Emily Troop, Joshua S Hill, Julie A Thompson","doi":"10.6004/jadpro.2024.15.8.4","DOIUrl":"10.6004/jadpro.2024.15.8.4","url":null,"abstract":"<p><strong>Purpose: </strong>Low anterior resection (LAR) is the preferred surgical treatment of rectosigmoid or rectal cancers. However, it is often associated with bowel dysfunction, which is termed low anterior resection syndrome (LARS). Daily bowel dysfunction symptoms have a detrimental effect on quality of life (QOL). Pelvic floor rehabilitation (PFR) can improve pelvic floor function and QOL among patients with LARS. This quality improvement (QI) project seeks to assess the prevalence of LARS and develop and incorporate PFR for the treatment and prevention of LARS.</p><p><strong>Methods: </strong>A convenience sample of 20 patients met project inclusion. Thirteen patients participated. Individuals were categorized by diagnostic risk: low risk, high risk, and established. The intervention included 1-hour PFR sessions with the physical therapist (PT) and 5 minutes of daily self-led pelvic floor muscle exercises. Outcomes questionnaires included the LARS Score and Fecal Incontinence Quality of Life (FIQOL) Scale. Data were collected both pre- and post-colorectal cancer treatment.</p><p><strong>Results: </strong>The overall prevalence of LARS was 76.9%, which was significantly higher than the retrospective cohort comparison rate of 21.8% (<i>p</i> < .001). The prevalence of major LARS was 89%, 83%, and 50% at the initial, second, and third sessions, respectively, representing a 44% relative decrease. Embarrassment was significantly affected among individuals with major LARS, although ongoing PFR facilitated improvement.</p><p><strong>Conclusion: </strong>PFR is a valuable adjunct therapy for LARS, with continued sessions decreasing the overall prevalence among the cohort. Major LARS negatively impacts QOL measures early on in treatment but improves with continued PFR.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}