|The following article features coverage from the European Society of Medical Oncology (ESMO) Congress 2021. Click here to read more of Hematology Advisor’s conference coverage.|
A follow-up protocol involving advanced practice nurse (APN) management is beneficial for patients with multiple myeloma treated with oral chemotherapy, according to study results presented at the European Society of Medical Oncology (ESMO) Congress 2021.
The APN intervention was developed to improve oral chemotherapy safety and coordination at a cancer center in France. The study authors assessed original management of patients with multiple myeloma treated with lenalidomide and dexamethasone (LD) and the impact of the APN protocol on the patients’ ambulatory care.
A total of 42 patients with multiple myeloma who had recently been treated with LD in the medical hematology department from April 2017 to September 2020 participated in the oncology APN intervention. Telephone calls and specific consultations were conducted in a complementary way and involved a medical delegation of chemotherapy renewal and associated therapies as well as management of drug toxicities with dosage adjustment or discontinuation.
From the cohort, 32 patients received first-line therapy, 6 were in relapse (Xth line), and 4 received maintenance therapy. The APN intervention included 1240 telephone calls and 162 consultations; 82 calls were referred with 45 consultations triggered. Among outgoing APN calls, most were for treatment (26%) or coordination (24%). Regarding incoming APN calls from the patient or family, most (43%) were for reassurance and information.
Before the protocol, patients receiving first-line LD had an average of 4.34 phone calls per month, those receiving Xth-line LD had an average of 4.83 phone calls per month, and those receiving maintenance therapy had an average of 1.33 phone calls per month. After the intervention, participants receiving first-line LD had an average of 1.21 phone calls per month, those receiving Xth-line LD had an average of 1.45 phone calls per month, and those receiving maintenance LD had an average of 0.76 phone calls per month.
“The APN was on the front line, with a direct line, enabling better coordination between the primary care team and the hospital,” stated the study authors. “The APN was able to manage multiple side effects, organizing hospitalizations and transfusions, saving full time in a physician job thanks to his or her knowledge and prescription skills.”
The study highlights the critical role of APN management of patients receiving LD treatment, according to the researchers.
“The needs are different between anxious patients with a demand for psychological support and answers to questions, and poly-pathological patients who need clinical reassessment and therapeutic adaptation/monitoring and control of physical symptoms,” the investigators commented. “Due to an aging population and increasing use of oral chemotherapy, an APN should be one of the answers to current and future health issues.”
Sapet M, Migala C, Daguenet E, et al. Advanced practice nurse management in multiple myeloma treated with lenalidomide dexamethasone: a new challenge? Presented at: European Society of Medical Oncology (ESMO) Congress 2021; September 16-21, 2021. Abstract CN41.