Background: Because of the increasing prevalence of the use of oncolytic orally to patients with malignancies, implementation and monitoring strategies to improve patient safety has become a necessity. Our focus is on the American Society of Oncology Quality Oncology Practice Initiative (QOPI) clinical standards of care, standards of 2.3, and the need for counseling patients before the first administration of oral oncolytic therapy.
Objective: To assess the implementation of strategies for improving the workflow to determine their effect on the number of patients reached for pharmacist counseling prior to the first dose of oral oncolytic drugs. Methods: In this study a quasi-experimental quality improvement, we formed a multidisciplinary group to develop and implement processes workflow improvements. This process is focused on the redistribution of workflow and application of new technology in EPIC Beacon.
Results: A total of 86 patients were identified as eligible for counseling (38 pre-intervention, post-intervention 48). There was a statistically significant increase in the number of eligible patients counseled in the post-intervention period compared to the pre-intervention period (100% vs 86.84%; 95% CI = -0.212, -0.205; P = 0.017). No significant difference was observed in the number of in-person advising patients or advising patients before the first dose.
Conclusion: Our intervention shows the level of 100% of the advice in the post-intervention period. Further work needs to be done to increase the number of patients we reach before they take their first dose of the drug, as well as the number of patients we can advice face to face.
The relationship between in-line filtration and Type I hypersensitivity reactions in pediatric oncology patients who receive intravenous etoposide
The purpose of this study was to describe hypersensitivity reactions with and without the use of in-line filter for intravenous etoposide therapy in pediatric oncology patients. This is a retrospective review of all patients who were treated in the Division of Oncology / Hematology / Bone Marrow Transplant at Children’s Hospital of British Columbia with intravenous etoposide between December 1, 2013 and February 1, 2018. hypersensitivity and anaphylactic reactions associated with infusion of etoposide compared over time, including 12 months earlier, 27 months for use, and for 12 months after the cessation of in-line filtration.
There were 192 patients (average age of 6.0 (IQR 2.8 to 13.0) years were treated with etoposide and etoposide infusion 486 including 137 (28%) previously, 261 (54%) for and 88 (18%) after use filter in-line at our center. twenty-six of 486 (5%) and 13/486 (3%) of infusions resulted in type I hypersensitivity reactions and anaphylaxis, respectively.
There were 2/137 (1%), 36 / 261 (14%.) and 1/88 (1%) infusion reactions before, during and after an in-line filter, each infusion reaction during the period-line filter is higher than during the pre-filter (Z = 3.978; p <0.001) and post-filter (Z = 3.335 ;. p <0.001) in the period of research data show that the use of in-line filtration may be associated with an increased frequency of hypersensitivity reaction to etoposide in pediatric cancer patients.
Improving direct pharmacist counseling rates for oral oncolytic medications at an outpatient oncology clinic
Why Racial Justice Matters in Radiation Oncology
The recent events have reaffirmed that racism is a pervasive disease disrupt the United States and the infiltration of the fabric of this nation. As health care professionals dedicated to understanding and reduce disease, many radiation oncologists have failed to recognize how structural racism affect the health and well-being of patients we aim to serve. Literature is full of descriptive statistics which show a higher incidence and mortality experienced by the Black population’s health conditions ranging from infant mortality to infectious diseases, including the coronavirus disease in 2019 (COVID-19).
The recognition that the roots of health inequalities experienced by Black people in this country based on racism is essential to move the nation and advanced the field of radiation oncology. With this lens, a brief overview of the structural and institutional racism shape the discussion about what radiation oncologists and their representative organizations can do to cope with this disaster. As a member of the technology, we often use the power of data to improve human health and disease challenge with optimism that approach multidisciplinary effort can result in healing. Some principles to reduce the old problem of the Black marginalization in the field has been recommended by ATIP (Recognition, transparency, intentionality, and representation) and lead (Learn, Engage, Advocate, Advocate, Support) approach.
However, additional introspection recommended. Just like individuals, practices and organizations rallied to determine how best to address the problems associated with the 19th COVID pandemic, studied the same spirit should be applied to the issue of racism to combat this evil and often deadly disease.
Nurse-led oral and maxillofacial oncology clinic: a review
The oral and maxillofacial (OMFS) head “nurse-led” and neck (H & N) clinics have been introduced and developed over the last decade, and we are now close to the point that this effort could potentially be applied nationally. This paper is a systematic review of the proposed clinical models OMFS H & N nurse-led.
The literature on the topic is limited: only eight papers were eligible were identified and reviewed. The rated focuses on four domains: requirements / needs, actual costs, patient safety and outcomes, and education and training. Most of the advantages / benefits of the proposed clinic had previously been discussed. The current review has revealed that the published evidence available on the clinical concept OMFS H & N nurse led indicate that they may not be necessary.
