Optimizing Multidisciplinary Treatment-Related Adverse Effects Detection and Reduction in Patients Undergoing Active Cancer Treatments in Ambulatory Infusion Centers. Issue 9 (1st September 2022)

• Record Type: Journal Article
• Authors: Chung, Clement; Rome, Alison; Desai, Monica; Abanonu, Fred; De la Casas, Cesar
• Is Part Of: JCO oncology practice. Volume 18:Issue 9(2022)
• Page Start: e1553
• Page End: e1561
• Publication Date: 2022-09-01
• Subjects: Oncology -- Periodicals; Medical Oncology; Neoplasms; Oncology; Periodicals; 616.994
• DOI: 10.1200/OP.21.00910
• Languages: English
• ISSNs: 2688-1527

Abstract

Abstract : PURPOSE: The objective of this study was to describe the implementation of an interdisciplinary supportive care program for treatment-related adverse effects (TRAEs) of patients with cancer in two ambulatory infusion centers affiliated with a major health system. METHODS: A management program of TRAEs was developed on the basis of the collaboration between oncologists, infusion center oncology nurses, and a board-certified oncology clinical pharmacist for patients with cancer in two outpatient infusion centers. Patients received multidisciplinary interventions or oncologist-driven interventions on the basis of their reported symptoms during their cancer treatments. They were followed prospectively at regular intervals for further symptom management interventions. To evaluate this program, a retrospective chart review was performed, and data were collected regarding the number and nature of these TRAEs. The outcomes of their interventions were assessed up to 3 months since initial encounters. Data for patient satisfaction were also collected before and after implementation of the program. RESULTS: A total of 308 patients received 469 interventions initiated either by the multidisciplinary team or by oncologists over a 3-year period. Compared with oncologist-led interventions, multidisciplinary interventions were statistically significant in the number of interventions ( P = .004; 95% CI, 17.9 to 36.2) and in reducing occurrences of TRAEs ( P = .03; 95% CI, 33.8 to 72.4) such as dermatological toxicities, diarrhea, immune-related adverse effects, mucositis, and nausea or vomiting after 1-month follow-up. Multidisciplinary team captured approximately 40% of TRAEs of all grades that were escalated to oncologists for further management, which led to an overall improvement in management of TRAEs. CONCLUSION: Multidisciplinary care for patients in infusion centers led to improvement in treatment-related toxicities.