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'My Choices, My Wishes' Program and Its Effect on Chemotherapy at the End of Life and Advance Care Directive Documentation. “我的选择，我的愿望”计划及其对临终化疗的影响和高级护理指导文件。
Journal of the advanced practitioner in oncology
Pub Date : 2023-09-01 DOI: 10.6004/jadpro.2023.14.6.3
Jessica Tamar Davis

Background: Oncology patients have tremendous symptom burden both physically and emotionally. Palliative care (PC) improves quality of life and prevents suffering. Advance care planning (ACP) empowers patients to articulate goals of their care. New guidelines call for palliative care to be provided and chemotherapy avoided the last 2 weeks of life. The American Society of Clinical Oncology (ASCO) recommends integrating palliative care within the oncology setting to achieve these outcomes. However, the best mode to provide this care remains unclear. A nurse practitioner/physician assistant (NP/PA)-based model from within the oncology clinic is a potential option.

Methods: A program evaluation was done to determine the effectiveness of the "My Choices, My Wishes" NP/PA-led program.

Results: From 2012 to 2018, the number of patients receiving PC/ACP visits increased from 2.6% to 19.4%. The percentage of patients receiving chemotherapy in the last 14 days of life decreased from 12.5% to 7.14%. The number of advance care directives completed increased from 17.5% to 37.5%.

Conclusion: This program was an effective way to provide PC/ACP for oncology patients. We still need to understand why patients pursue chemotherapy at the end of life. It is necessary to improve our communication techniques with patients and families in order to guarantee high-quality, high-value care.

背景：肿瘤患者在身体和情感上都有巨大的症状负担。姑息治疗（PC）可以提高生活质量，防止痛苦。预先护理计划（ACP）使患者能够明确其护理目标。新的指导方针要求提供姑息治疗，化疗避免了生命的最后两周。美国临床肿瘤学会（ASCO）建议将姑息治疗纳入肿瘤学环境中，以实现这些结果。然而，提供这种护理的最佳模式尚不清楚。肿瘤学诊所内基于执业护士/医师助理（NP/PA）的模式是一个潜在的选择。方法：进行项目评估，以确定“我的选择，我的愿望”NP/PA领导的项目的有效性。结果：从2012年到2018年，接受PC/ACP就诊的患者数量从2.6%增加到19.4%。在生命的最后14天接受化疗的患者比例从12.5%下降到7.14%。完成的预先护理指令数量从17.5%增加到37.5%。结论：该计划是为肿瘤患者提供PC/ACP的有效方法。我们仍然需要了解为什么患者在生命结束时会进行化疗。有必要改进我们与患者和家属的沟通技巧，以保证高质量、高价值的护理。
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引用次数: 0
Precautions for Patients Taking Tamoxifen or Aromatase Inhibitors. 服用三苯氧胺或芳香化酶抑制剂的患者注意事项。
Journal of the advanced practitioner in oncology
Pub Date : 2023-09-01 DOI: 10.6004/jadpro.2023.14.6.2
Mary Heery
Tamoxifen and aromatase inhibitors are widely prescribed therapies for the treatment of breast cancer. Tamoxifen is a selective estrogen receptor modulator that treats hormone-sensitive breast cancers. Research has demonstrated that tamoxifen therapy improves survival and reduces the risk of developing recurrent invasive breast cancer by up to 40%. Aromatase inhibitors are the drug of choice for the treatment of estrogen receptor– or progesterone receptor–positive breast cancer in postmenopausal women. Research on aromatase inhibitors has demonstrated improved survival in postmenopausal women, postmenopausal women with metastasis, and premenopausal women under the age of 35 with ovarian ablation. The benefits of these agents have been clearly shown through various clinical trials, yet adherence may be challenging for some patients due to issues of drug interactions, proper education, and adverse effects. Education to prevent and treat adverse effects is of the utmost importance to promote adherence and improve the effectiveness of these medications. Advanced practitioners are in a position to prescribe these therapies, review medication interactions, educate patients, impact patients’ quality of life, improve patients’ sense of control, and increase patients’ partnerships with their oncology providers.
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引用次数: 0
The Importance of Endpoints in Oncology Clinical Trials. 终点在肿瘤临床试验中的重要性。
Journal of the advanced practitioner in oncology
Pub Date : 2023-09-01 DOI: 10.6004/jadpro.2023.14.6.1
Beth Faiman
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引用次数: 0
Clinical Posters From JADPRO Live 2022 临床海报来自JADPRO Live 2022
Journal of the advanced practitioner in oncology
Pub Date : 2023-01-01 DOI: 10.6004/jadpro.2023.14.1.10
L. Kiley
OCTOBER 20 TO 23, 2022, IN AURORA, COLORADO The posters for the abstracts below can be found at JADPROLive.com
2022年10月20日至23日，在科罗拉多州奥罗拉，以下摘要的海报可以在JADPROLive.com上找到
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引用次数: 0
Introduction 介绍
Journal of the advanced practitioner in oncology
Pub Date : 2022-07-01 DOI: 10.6004/jadpro.2022.13.5.9
Beth Faiman, PhD, MSN, APRN-BC, AOCN®, BMTCN, FAAN, Tiffany Richards, PhD, ANP-BC, AOCNP
Advances in the diagnosis and management of multiple myeloma (MM) and other plasma cell disorders such as AL amyloidosis and Waldenström macroglobulinemia (WM) continue to evolve rapidly. Over the past several years, there have been significant gains in understanding disease biology, leading to improvements in diagnostic techniques, a shift towards targeted therapies, and a potential transition away from traditional chemotherapeutic agents as the standard of care.
多发性骨髓瘤(MM)和其他浆细胞疾病(如AL淀粉样变性和Waldenström巨球蛋白血症(WM))的诊断和治疗进展继续迅速发展。在过去的几年中，对疾病生物学的理解取得了重大进展，导致了诊断技术的改进，向靶向治疗的转变，以及从传统化疗药物作为标准治疗的潜在转变。
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引用次数: 0
Pull Up a Seat: Engaging Patients as Empowered Partners in Health Equity Transformation 拉一个座位:让患者参与卫生公平转型的授权合作伙伴
Journal of the advanced practitioner in oncology
Pub Date : 2022-04-01 DOI: 10.6004/jadpro.2022.13.3.3
Maimah Karmo, A. Pierre
At the JADPRO Live Virtual 2021 keynote interview, Maimah Karmo, CEO and Founder of the Tigerlily Foundation, spoke with Amy Pierre, MSN, ANP-BC, on her breast cancer experience and drive to establish an organization that educates, advocates for, and empowers young women of color at every stage of their breast cancer journey. Ms. Karmo and Ms. Pierre also discussed the role of the advanced practitioner in furthering patient-centered, equitable care.
在JADPRO Live Virtual 2021主题访谈中，Tigerlily基金会首席执行官兼创始人Maimah carmo与MSN、ANP-BC的Amy Pierre交谈了她的乳腺癌经历，并推动建立一个组织，在乳腺癌治疗的每个阶段教育、倡导和赋予有色人种年轻女性权力。Karmo女士和Pierre女士还讨论了高级执业医师在促进以患者为中心的公平护理方面的作用。
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引用次数: 0
Mental Health in the Oncology Setting: General Considerations and Treatment Tips. 肿瘤环境下的心理健康：一般注意事项和治疗技巧。
Journal of the advanced practitioner in oncology
Pub Date : 2022-04-01 Epub Date: 2022-05-23 DOI: 10.6004/jadpro.2022.13.3.12
Lisa W Goldstone

Patients with comorbid mental health and substance use disorders are at greater risk for mortality and have higher cancer care costs. At JADPRO Live Virtual 2021, Lisa W. Goldstone, MS, PharmD, BCPS, BCPP, talked through general considerations in the oncology setting for persons with comorbid mental health or substance use disorders, strategies for recognizing when patients with new or preexisting mental health symptoms or disorders may benefit from treatment and/or referral, and first and second-line pharmacotherapy options.

患有精神健康和药物使用障碍共病的患者死亡率更高，癌症护理费用也更高。在2021年JADPRO Live Virtual上，Lisa W.Goldstone，MS，PharmD，BCPS，BCPP，谈到了肿瘤学环境中对共病精神健康或物质使用障碍患者的一般考虑，识别新的或先前存在的精神健康症状或障碍患者何时可以从治疗和/或转诊中受益的策略，以及一线和二线药物治疗选项。
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引用次数: 0
Molecular Testing in Hematologic Malignancies 血液恶性肿瘤的分子检测
Journal of the advanced practitioner in oncology
Pub Date : 2022-04-01 DOI: 10.6004/jadpro.2022.13.3.29
L. Zitella
Molecular testing technologies have been increasingly integrated into clinical research and are essential tools in the care of patients with hematologic malignancies. During this session at JADPRO Live Virtual 2021, Laura J. Zitella, MS, RN, ACNP-BC, AOCN®, reviewed key concepts for diagnostic testing with a focus on molecular testing (including cytogenetics, FISH, PCR, and next-generation sequencing) and discussed how to interpret the results for hematologic malignancies to inform prognosis as well as treatment.
分子检测技术已越来越多地融入临床研究，是治疗血液恶性肿瘤患者必不可少的工具。在JADPRO Live Virtual 2021的会议上，Laura J. Zitella, MS, RN, ACNP-BC, AOCN®，回顾了诊断检测的关键概念，重点是分子检测(包括细胞遗传学，FISH, PCR和下一代测序)，并讨论了如何解释血液恶性肿瘤的结果，以告知预后和治疗。
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引用次数: 0
ASH Highlights and Commentary: Myeloid Malignancies ASH亮点和评论:髓系恶性肿瘤
Journal of the advanced practitioner in oncology
Pub Date : 2022-03-01 DOI: 10.6004/jadpro.2022.13.2.11
Lindsey Lyle, MS, PA-C
This supplement to JADPRO provides an overview of several abstracts that were presented at the 2021 ASH Annual Meeting, along with expert commentary that aims to contextualize the information presented at ASH for the advanced practitioner. Lindsey Lyle, MS, PA-C, of University of Colorado Anschutz Medical Campus, considers promising results in the myeloid malignancies space. Ms. Lyle highlights long-term data on the combination of eprenetapopt (APR-246) and azacitidine in patients with TP53-mutated acute myeloid leukemia/myelodysplastic syndromes, a new option for patients with paroxysmal nocturnal hemoglobinuria, and valuable insights into Black and non-Black patient preferences regarding their treatment and communication with their providers.
JADPRO的这一补充提供了2021 ASH年会上发表的几篇摘要的概述，以及旨在将ASH上为高级从业者提供的信息背景化的专家评论。科罗拉多大学安舒茨医学院的Lindsey Lyle，MS，PA-C，认为在髓系恶性肿瘤领域取得了有希望的结果。Lyle女士重点介绍了在TP53突变的急性髓细胞白血病/骨髓增生异常综合征患者中联合应用epenetopot（APR-246）和阿扎胞苷的长期数据，这是阵发性夜间血红蛋白尿患者的一种新选择，以及对黑人和非黑人患者在治疗和与提供者沟通方面的偏好的宝贵见解。
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引用次数: 0
Incorporating Scientific Advances and Improving Access to Care: Meeting Abstracts From the 2021 ASH Annual Meeting and Exposition 融合科学进步，改善获得护理的机会：2021 ASH年会和博览会会议摘要
Journal of the advanced practitioner in oncology
Pub Date : 2022-03-01 DOI: 10.6004/jadpro.2022.13.2.9
S. Kurtin
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引用次数: 0
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Journal of the advanced practitioner in oncology
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