在美国,肿瘤护士和高级执业医生如何减轻化疗引起的发热性中性粒细胞减少症的负担?

Kristi Kay Orbaugh, Sandra Cuellar, Lisa Kennedy Sheldon
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摘要

背景:中性粒细胞减少和发热性中性粒细胞减少(FN)是骨髓抑制化疗的严重并发症,给癌症患者带来了相当大的负担。发热性中性粒细胞减少症与感染和住院风险增加有关,这在2019年冠状病毒病(COVID-19)大流行期间尤其令人担忧。肿瘤护士和高级实践提供者(APPs);包括执业护士、医师助理、高级执业护士和药剂师)在管理癌症患者和预防感染方面发挥着至关重要的作用。目的:本文的目的是总结美国癌症患者化疗相关中性粒细胞减少症和FN的负担,并评估肿瘤护士和app在FN预防和管理中的作用。方法:本文对美国有关FN负担、COVID-19期间FN、预防性粒细胞集落刺激因子(G-CSF)使用指南的依从性、肿瘤科护士参与FN预防、管理和患者生活质量、不适当和/或不完整G-CSF治疗的研究进行了叙述性回顾。研究结果:尽管对接受骨髓抑制性化疗的癌症患者的支持治疗取得了进展,但中性粒细胞减少症和FN给患者带来了相当大的负担,特别是在COVID-19大流行期间。肿瘤科护士和应用程序在适当和及时提供支持性护理方面发挥着至关重要的作用,这可以改善患者的预后并最大限度地降低治疗成本。
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How Can Oncology Nurses and Advanced Practice Providers Reduce the Burden of Chemotherapy-Induced Febrile Neutropenia in the US?

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.

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