Key elements for the education and counselling of patients treated with oral anticancer drugs

Kinnaer, Lise-Marie; Coster, Sandra De; Coolbrandt, Annemarie; Decoene, Elsie; Hecke, Ann Van; Foulon, Veerle

doi:10.1016/j.ejon.2019.06.010

Cited by 14 publications

(19 citation statements)

References 44 publications

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“…One study on developing a quality instrument for assessing the spontaneous reports of ADR/ADE had the following definitions of disagreement: indicators whose mean score was <3.0 and had a coefficient of variation of >0.25 were rejected ( Chen et al, 2016 ). Clinical medication guidelines for high-dose methotrexate in China set the definitions of consensus in the first Delphi round as “mean score was ≥4, and the coefficient of variation was ≤0.15.” In another study, the items were retained if at least 80% of the respondents in all groups considered them important or if 90% consensus was reached in at least one group ( Kinnaer et al, 2019 ). Considering the settings for the earlier study, the definitions of consensus for this study were a combination of an average score of ≥4, the percentage of experts rating the scores at >4 points, and the coefficient of variation of the scores.…”

Section: Discussionmentioning

confidence: 99%

Development of the Practice of Pharmaceutical Care for Cancer Pain Management in Outpatient Clinics Using the Delphi Method

Zhang

Ren²,

Huang³

et al. 2022

Front. Pharmacol.

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Background: There exists no broad agreement of experts on the practice of pharmaceutical care for cancer pain management in outpatient clinics.Objectives: This study aimed to use the Delphi consensus process to provide expert recommendations on the practice of cancer pain management in outpatient clinics from the point of view of pharmaceutical care in clinical practice and future clinical trials.Methods: A comprehensive literature review was conducted to draft the initial practice. In this process, 30–40 senior experts from various provinces in China were invited to rank the items of practice during the two Delphi consultations. The definitions of consensus included a combination with an average score of ≥4, the percentage of experts rating the scores at >4 points, and the coefficient of variation of the scores.Results: The expert panel comprised 18 pharmacists, 3 anesthesiologists, 6 oncologists, and 9 nurses. As a result of a comprehensive review, 33 items were initially formed. Among them, the consensus was reached for 27 items after the first Delphi round. The other six items and a total of five items for supplementation entered the second round, among which consensus was reached for eight items and three items were excluded. Expert consensus was achieved on 35 items after two rounds of consultation, which involved the collection of patient basic information, comprehensive pain assessment, breakthrough or neuropathic pain assessment, analgesic treatment evaluation, out-of-hospital follow-up, medical records, and evidence-based documents for reference.Conclusion: The final list of 35 items could be used to develop the practice of pharmaceutical care for cancer pain management in outpatient clinics in China. The practice may aid in the standardization of pharmaceutical care for pain, relieve pain to the greatest extent possible, and enhance the level of pain management in China.

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Section: Discussionmentioning

confidence: 99%

Development of the Practice of Pharmaceutical Care for Cancer Pain Management in Outpatient Clinics Using the Delphi Method

Zhang

Ren²,

Huang³

et al. 2022

Front. Pharmacol.

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“…13 Drug-specific wallet cards and educational apps may be used as part of the toolkit to reinforce the information provided and to remind patients and caregivers to watch for irAEs that can occur even after stopping treatment with immunotherapeutic agents. 14 As irAEs are quite distinct from adverse effects of chemotherapeutic agents, this approach can also be used to inform the patients' local healthcare providers about toxic effects associated with immunotherapy and symptom monitoring requirements. Online social networks, such as Facebook, Twitter, Instagram, and YouTube, and support groups serve as platforms for patients and caregivers to provide and consume information on irAE management that can empower them to make informed decisions.…”

Section: Providing Patient Educationmentioning

confidence: 99%

“…Currently, there is no standard protocol on how to provide patient education that is tailored to the individual need of the patient. 14 As a "one size fits all" approach to patient education may not produce the desired outcome, other need-based approaches, such as the 3Ws and an H process, in which four questions are discussed: (i) "who specifically is this resource for? "; (ii) "why should they read it?…”

Section: Providing Patient Educationmentioning

confidence: 99%

Strategies for improving the management of immune-related adverse events

Naing

Hajjar

Gulley

et al. 2020

J Immunother Cancer

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With the advent of immunotherapeutic agents, durable and dramatic responses have been observed in several hard-to-treat malignancies, outlining a roadmap to conquering cancer. Immune checkpoint inhibitors (ICPi) are a class of immunotherapeutic agents that attack the tumor cells by reinvigorating the suppressed immune system. However, the unbridled T-cell activity disrupts the immune homeostasis and induces a unique spectrum of side effects called immune-related adverse events (irAEs) in a significant proportion of patients. These irAEs are distinct from the side effects produced by traditional chemotherapeutic agents. Although majority of irAEs are manageable with corticosteroids and other immunosuppressive agents, life-threatening and fatal events have been reported. In the absence of predictive biomarkers to identify patients at risk for irAEs and standardized approach to detect, report, and treat irAEs, management of irAEs has been challenging to the patients, caregivers and the healthcare providers alike. With increasing use of ICPis for treatment of various cancers, the incidence of irAEs will undoubtedly increase. There is a compelling need to develop measures to effectively manage irAEs, both in the community settings and in cancer centers alike. To this end, in this paper, we propose several strategies, such as providing patient education, harmonizing irAE management guidelines, standardizing reporting of irAEs, optimizing the choice of immunosuppressive agents, conducting preclinical, clinical and translational studies to better understand irAEs, including high-risk patients, incorporating diagnostic tools to personalize irAE management using wireless technology and digital health, providing a platform to hear the missing patient’s voice, and sharing evolving data to improve the management of irAEs.

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“…Além disso, poder ser administrada no ambiente domiciliar, pela família, o que implica mais tempo de convivência com os familiares e menos tempo em hospitais, promovendo, assim, maior qualidade de vida desse público. 3,4 Já as desvantagens são as variações na absorção da dose terapêutica; o risco de acidentes com superdosagem; a necessidade de autocuidado eficiente e a dificuldade de manejo dos efeitos colaterais. Esses riscos podem potencializar as chances de não adesão à terapêutica oral e gerar efeitos prejudiciais.…”

Section: Introductionunclassified

“…Assim, esse tipo de tratamento pode transformar-se em um enorme problema se os familiares não forem, adequadamente, orientados e preparados para efetuá-lo. 3,4 Compreender como armazenar, preparar, manusear, administrar e descartar, adequadamente, os antineoplásicos orais é necessário para reduzir o risco de exposição e garantir que a criança e o adolescente recebam a dose terapêutica adequada. Estudo de revisão sistemática da literatura avaliou a gestão de pacientes e cuidadores sobre os antineoplásicos orais, identificando a necessidade de desenvolver estratégias de educação que abordem a administração neste cenário, pois muitos não conseguem realizar tarefas essenciais de segurança, como lavar as mãos antes e após a administração, a eliminação dos resíduos e dúvidas quanto à manipulação.…”

Section: Introductionunclassified

Necessidades de aprendizagem de familiares de crianças e adolescentes em tratamento com quimioterápicos antineoplásicos orais

et al. 2022

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RESUMO Objetivo descrever as necessidades de aprendizagem de familiares de crianças e adolescentes com câncer quanto ao tratamento com quimioterápicos antineoplásicos orais. Método pesquisa qualitativa descritiva desenvolvida em um hospital federal do Rio de Janeiro, Brasil. Os dados foram coletados nos meses de julho a setembro de 2020 a partir de entrevistas semiestruturadas com vinte e três familiares de crianças e adolescentes com câncer em quimioterapia antineoplásica oral. Os dados foram processados no software Interface de R pour Analyses Multidimensionnelles de Textes et de Questionnaires pela Classificação Hierárquica Descendente. Resultados dentre os temas que demandam aprendizagem pelos familiares estão administração oral, armazenamento e manipulação dos quimioterápicos orais, além dos efeitos adversos e emergências que demandam atendimento hospitalar. Conclusão e implicações para a prática no tratamento com quimioterápicos orais, as necessidades de aprendizagem dos familiares de crianças e adolescentes precisam ser problematizadas em práticas educativas dialógicas para, assim, favorecer a segurança, a adesão e a eficácia do tratamento.

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Key elements for the education and counselling of patients treated with oral anticancer drugs

Cited by 14 publications

References 44 publications

Development of the Practice of Pharmaceutical Care for Cancer Pain Management in Outpatient Clinics Using the Delphi Method

Development of the Practice of Pharmaceutical Care for Cancer Pain Management in Outpatient Clinics Using the Delphi Method

Strategies for improving the management of immune-related adverse events

Necessidades de aprendizagem de familiares de crianças e adolescentes em tratamento com quimioterápicos antineoplásicos orais

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