Home Medication Regimen Complexity in Newly Diagnosed Pediatric Oncology Patients.

IF 2.4 3区医学 Q1 NURSING

Cancer Nursing Pub Date : 2025-01-07 DOI:10.1097/NCC.0000000000001452

K Elizabeth Skipper, Aman Wadhwa, Marti Rice, Jocelyn York, Smita Bhatia, Wendy Landier

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引用次数: 0

Abstract

Background: Parents of children newly diagnosed with cancer require specialized education to provide care for their child at home, including the management of complex medication regimens.

Objective: To assess the complexity of home medication regimens in a cohort of newly diagnosed pediatric oncology patients.

Methods: We inventoried and categorized all discharge medications for each patient and used the Medication Regimen Complexity Index (MRCI) to quantify the complexity of the prescribed medication regimens. We used logistic regression to identify patient sociodemographic and clinical characteristics significantly (P < .05) associated with higher medication burden (ie, higher total MRCI scores).

Results: The cohort consisted of 105 newly diagnosed pediatric oncology patients initially hospitalized between December 2016 and February 2019 (61.9% male, 65.7% non-Hispanic White, 65.7% leukemia or lymphoma; median [range] age at diagnosis, 7.1 [0.4-17.7] years; median [range] number of discharge medications, 9 [1-14]). The proportion of patients prescribed ≥1 medication in each pharmacologic category was as follows: antiemetics, 94.3%; antimicrobials, 93.3%; pain management, 88.6%; oral care, 86.7%; stool softeners/laxatives, 81.0%; gastrointestinal protectants, 60.0%; cancer-directed therapy, 51.5%, other supportive therapies, 49.5%, other, 27.6%. Characteristics associated with ≥ median (≥33.0) MRCI score included a diagnosis of leukemia or lymphoma (odds ratio, 2.7; 95% confidence interval, 1.1-6.6; P = .027; comparison: solid tumor) and older age (odds ratio, 1.1 per year; 95% confidence interval, 1.0-1.2; P = .020).

Conclusions: Most children newly diagnosed with cancer are discharged with complex medication regimens that parents/caregivers must manage at home.

Implications for practice: Nurses can use these findings to develop tailored medication education plans for parents/caregivers of newly diagnosed pediatric oncology patients.

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新诊断儿科肿瘤患者家庭用药方案的复杂性。

背景：新诊断为癌症的儿童的父母需要专门的教育来在家照顾他们的孩子，包括复杂的药物治疗方案的管理。目的：评估新诊断儿科肿瘤患者家庭用药方案的复杂性。方法：对每位患者的出院药物进行盘点和分类，并采用药物方案复杂性指数（MRCI）量化处方药物方案的复杂性。我们使用逻辑回归来确定患者的社会人口学和临床特征与较高的药物负担（即较高的MRCI总评分）显著相关（P < 0.05）。结果：该队列包括105名2016年12月至2019年2月期间首次住院的新诊断儿科肿瘤患者(61.9%为男性，65.7%为非西班牙裔白人，65.7%为白血病或淋巴瘤；诊断年龄中位数为7.1[0.4-17.7]岁；出院用药中位数[范围]为9[1-14])。各药理学类别中处方≥1种药物的患者比例如下：止吐药占94.3%；抗菌素,93.3%;疼痛管理占88.6%；口腔护理占86.7%；大便软化剂/泻药占81.0%；胃肠保护剂，60.0%；癌症导向治疗占51.5%，其他支持治疗占49.5%，其他占27.6%。MRCI评分≥中位数（≥33.0）的相关特征包括白血病或淋巴瘤的诊断(优势比，2.7；95%置信区间为1.1-6.6；P = 0.027；对比：实体瘤)和年龄较大(优势比，1.1 /年；95%置信区间1.0-1.2；P = .020)。结论：大多数新诊断为癌症的儿童出院时都有复杂的药物治疗方案，父母/照顾者必须在家管理。对实践的启示：护士可以利用这些发现为新诊断的儿科肿瘤患者的父母/照顾者制定量身定制的药物教育计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Nursing 医学-护理

CiteScore

4.80

自引率

3.80%

发文量

244

审稿时长

6-12 weeks

期刊介绍： Each bimonthly issue of Cancer Nursing™ addresses the whole spectrum of problems arising in the care and support of cancer patients--prevention and early detection, geriatric and pediatric cancer nursing, medical and surgical oncology, ambulatory care, nutritional support, psychosocial aspects of cancer, patient responses to all treatment modalities, and specific nursing interventions. The journal offers unparalleled coverage of cancer care delivery practices worldwide, as well as groundbreaking research findings and their practical applications.