Journal of the Advanced Practitioner in Oncology最新文献_第5页

Advanced Practitioners in Hematology and Oncology: State of the Workforce 血液学和肿瘤学高级医师：从业人员现状

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-11-01 DOI: 10.6004/jadpro.2023.14.7.10

Sandra Kurtin, PhD, ANP-BC, AOCN, FAPO, Carolyn Grande, CRNP, AOCNP, Megan May, PharmD, BCOP, FAPO, FHOPA, Andrea Edwards, PA-C, Steven Wei, EdD, MS, MPH, PA-C, DFAPPA, Brianna Hoffner, MSN, ANP-BC, AOCNP, FAPO, Wendy Vogel, MSN, FNP, AOCNP, FAPO

{"title":"Advanced Practitioners in Hematology and Oncology: State of the Workforce","authors":"Sandra Kurtin, PhD, ANP-BC, AOCN, FAPO, Carolyn Grande, CRNP, AOCNP, Megan May, PharmD, BCOP, FAPO, FHOPA, Andrea Edwards, PA-C, Steven Wei, EdD, MS, MPH, PA-C, DFAPPA, Brianna Hoffner, MSN, ANP-BC, AOCNP, FAPO, Wendy Vogel, MSN, FNP, AOCNP, FAPO","doi":"10.6004/jadpro.2023.14.7.10","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.10","url":null,"abstract":"Advanced practitioners (APs), including nurse practitioners (NP), physician assistants (PA), pharmacists, and nurses with advanced degrees, including advanced practice registered nurses (APRNs), play a critical role in quality, timely, and expert cancer care. Burnout, retention, and resilience have been studied in physician groups. However, there is a paucity of data specific to APs in hematology and oncology. The Advanced Practitioner Society for Hematology and Oncology (APSHO) conducted an online survey that used validated tools to measure burnout and work-life balance among APs who are members of APSHO. Among the 366 respondents completing all items of the Maslach Burnout Inventory (MBI) and the Areas of Worklife Survey (AWS), participants felt engaged (34.2%) but overextended (37.4%) and reported burnout (17.8%). These results indicate a need to evaluate workloads, improve communication, and deploy strategies for support and advocacy to improve work-life balance within this group. The stability of the AP workforce is essential to excellence in patient care, provider resilience, and cancer outcomes. Creating a culture of open communication and strong AP leadership with data streams and metrics specific to the hematology and oncology workforce will help to inform health systems, consumers of health care, professional societies, educational institutions, and APs. Systematic and regular assessment of burnout and barriers to work-life balance for APs is essential to sustained adaptation of strategies to reduce burnout and retain APs.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterization and Management of Adverse Reactions in Patients With Unresectable Hepatocellular Carcinoma Treated With Lenvatinib 伦伐替尼治疗无法切除的肝细胞癌患者不良反应的特征与管理

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-11-01 DOI: 10.6004/jadpro.2023.14.7.4

Anna Jones, FNP-C, Paola Degregorio, PA-C, Max W. Sung, MD, Zahra Ramji, BSN, Min Ren, PhD, Ari D. Baron, MD

{"title":"Characterization and Management of Adverse Reactions in Patients With Unresectable Hepatocellular Carcinoma Treated With Lenvatinib","authors":"Anna Jones, FNP-C, Paola Degregorio, PA-C, Max W. Sung, MD, Zahra Ramji, BSN, Min Ren, PhD, Ari D. Baron, MD","doi":"10.6004/jadpro.2023.14.7.4","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.7.4","url":null,"abstract":"Aims: Advanced practice providers (APPs) play a vital role in monitoring for and managing adverse reactions (ARs). As lenvatinib ARs can resemble cirrhosis (commonly presenting with hepatocellular carcinoma [HCC]), APP input is important for timely detection and management of ARs and to promote medication adherence. Design: The goal of this post-hoc analysis of the REFLECT trial was to characterize key ARs associated with lenvatinib, and to discuss management strategies. Methods: In REFLECT, patients with unresectable HCC were randomized to either daily lenvatinib (12 mg/day for patients who weighed ≥ 60 kg or 8 mg/day for those < 60 kg) or sorafenib 400 mg twice daily. Adverse events in the lenvatinib arm were grouped into ARs (hypertension, fatigue, palmar-plantar erythrodysesthesia syndrome, proteinuria, and decreased appetite) per the United States Prescribing Information (USPI) for lenvatinib. Results: Key ARs in the lenvatinib arm (n = 476) generally occurred within months of starting lenvatinib. Some cases of proteinuria, decreased appetite, and diarrhea were first reported at about 2 years of treatment. Conclusions: The onset of key ARs associated with lenvatinib treatment can be predicted and generally be managed (per the lenvatinib USPI and REFLECT) by withholding lenvatinib and resuming it at a reduced dose after the severity decreases. However, lenvatinib should generally be discontinued if the AR is life-threatening.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139296692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early-Stage Breast Cancer, EGFR-Mutated NSCLC, and High-Risk Melanoma: 2023 ASCO Annual Meeting Highlights for the Advanced Practitioner 早期乳腺癌，egfr突变的非小细胞肺癌和高风险黑色素瘤:2023年ASCO年会重点关注高级从业者

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-09-01 DOI: 10.6004/jadpro.2023.14.6.10

Lisa Kottschade, APRN, MSN, CNP, FAPO

引用次数: 0

Racial Disparities, Advanced Ovarian Cancer, and HER2 Expression: 2023 ASCO Annual Meeting Highlights for the Advanced Practitioner 种族差异，晚期卵巢癌和HER2表达:2023年ASCO年会的高级从业者重点

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-09-01 DOI: 10.6004/jadpro.2023.14.6.9

Andrew S. Guinigundo, MSN, RN, CNP, ANP-BC

引用次数: 0

Knowing Your Target: Altered Mental Status From an Unsuspected Source 了解你的目标:从一个未知的来源改变精神状态

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-09-01 DOI: 10.6004/jadpro.2023.14.6.8

Sarah Hemstetter, MSN, CRNP, AOCNP

{"title":"Knowing Your Target: Altered Mental Status From an Unsuspected Source","authors":"Sarah Hemstetter, MSN, CRNP, AOCNP","doi":"10.6004/jadpro.2023.14.6.8","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.6.8","url":null,"abstract":"Daratumumab is a human monoclonal antibody targeting CD38 that is used in the treatment of multiple myeloma. In addition to being a target for cancer-related treatment, CD38 also plays a significant role in the immune response to infection. CD38 deficiency can increase susceptibility to several bacterial infections. This article discusses the case of a 52-year-old female with a history of IgG multiple myeloma status post autologous stem cell transplant with relapse who was receiving therapy with daratumumab, lenalidomide, and dexamethasone. She presented to the emergency department with a history of 3 to 4 days of generalized weakness, poor appetite, nausea, vomiting, watery stools, and fevers. Her symptoms did not improve with initial fluid resuscitation and broad-spectrum antimicrobials; instead, she experienced progressive neurological decline. This case illustrates how utilizing targets for cancer-directed treatments can also affect immune function, which may leave patients susceptible to unique infections that may not otherwise be commonly encountered. Therefore, advanced practitioners must understand the functional role of these targets and the sequelae that could occur when expression is altered by pharmacological therapies to allow for expeditious recognition and management.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135688274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relapsed/Refractory Multiple Myeloma, DLBCL, and CLL: 2023 ASCO Annual Meeting Highlights for the Advanced Practitioner 复发/难治性多发性骨髓瘤，DLBCL和CLL: 2023 ASCO年度会议的高级从业者重点

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-09-01 DOI: 10.6004/jadpro.2023.14.6.11

Oxana Megherea, PharmD, BCOP

引用次数: 1

Providing Care During Cancer Drug Shortages. 在癌症药物短缺期间提供护理。

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-07-01 DOI: 10.6004/jadpro.2023.14.5.1

Beth Faiman

引用次数: 0

Quality of Life in Adult Cancer Patients With Underage Children: An Integrative Review. 有未成年子女的成年癌症患者的生活质量:一项综合综述。

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-07-01 DOI: 10.6004/jadpro.2023.14.5.4

Gabriela Mota-George, Ashley Martinez, Joyce E Dains

{"title":"Quality of Life in Adult Cancer Patients With Underage Children: An Integrative Review.","authors":"Gabriela Mota-George, Ashley Martinez, Joyce E Dains","doi":"10.6004/jadpro.2023.14.5.4","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.5.4","url":null,"abstract":"As many as 24.7% of cancer patients are also parents to children younger than 18 years of age. This population faces unique challenges, and quality of life in parental cancer patients has not been well studied. This integrative review assessed parental cancer patients' quality of life. PubMed and Scopus were searched using the following terms: quality of life, distress, anxiety, coping, emotion, social support, employment, work, psychosocial, physical, function, parental cancer, and parents with cancer. English publications conducted within the past 15 years that used an objective instrument to measure quality of life in adult cancer patients with children 18 years of age or younger were included. Studies with an intervention focus were excluded. After review of 672 articles, nine studies met the criteria for inclusion. Several instruments were utilized to measure quality of life. Some parental cancer patients reported decreased quality of life when compared with other cancer patients and the general population at diagnosis and years after. Parental cancer patients may be at an increased risk of decreased quality of life. With this understanding, health-care providers should complete comprehensive assessments routinely so that these patients' unique needs may be more adequately addressed.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"14 5","pages":"390-402"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/54/jadpro-14-390.PMC10414533.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Managing Drug Interactions With Oral Anticancer Treatments. 管理药物相互作用与口服抗癌治疗。

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-07-01 DOI: 10.6004/jadpro.2023.14.5.7

Lisa K Lohr, Kimball T Blake, Cindy M Chan, Sabrina Sturm, Gavyn T Walsh

{"title":"Managing Drug Interactions With Oral Anticancer Treatments.","authors":"Lisa K Lohr, Kimball T Blake, Cindy M Chan, Sabrina Sturm, Gavyn T Walsh","doi":"10.6004/jadpro.2023.14.5.7","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.5.7","url":null,"abstract":"The use of oral anticancer treatments is widespread and vital to modern cancer treatment. Novel oral chemotherapy and targeted therapy treatments continue to receive US Food and Drug Administration approval every year, making knowledge of these agents a necessity for practitioners working in oncology. Many oral anticancer agents are prone to drug interactions that can contribute to adverse effects and decrease therapy efficacy. Potential drug-drug interactions include (1) interactions with CYP3A4 inhibitors and inducers, (2) interactions related to gastric acid suppression, (3) interactions related to prolongation of the cardiac QT interval, (4) interactions related to anticoagulant medications, and (5) drug-food and drug-herb interactions. Identifying potential drug interactions and appropriately managing them is key to preventing adverse effects and ensuring maximum efficacy while on oral anticancer therapy. Management of adverse effects increases patient compliance, ensures medication safety, and allows patients to remain on therapy. This article discusses the mechanisms of interactions and types of interacting medications. Specific recommendations are discussed.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"14 5","pages":"419-438"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/46/jadpro-14-419.PMC10414528.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10053336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Can You Establish the Cause of This Patient's Shortness of Breath? 你能确定这个病人呼吸短促的原因吗?

Journal of the Advanced Practitioner in Oncology Pub Date : 2023-07-01 DOI: 10.6004/jadpro.2023.14.5.8

Allison Trail, Jane Rogers, Jaffer Ajani

{"title":"Can You Establish the Cause of This Patient's Shortness of Breath?","authors":"Allison Trail, Jane Rogers, Jaffer Ajani","doi":"10.6004/jadpro.2023.14.5.8","DOIUrl":"https://doi.org/10.6004/jadpro.2023.14.5.8","url":null,"abstract":"Mr. B is a 56-year-old man diagnosed with metastatic HER2-positive gastroesophageal adenocarcinoma. He received front-line leucovorin, 5-fluorouracil, and oxaliplatin (FOLFOX) and trastuzumab for 10 months before restaging imaging revealed progressive disease. He then received second-line trastuzumab deruxtecan. His treatment was complicated by several admissions felt to be unrelated to his cancer therapy. He was discharged after an episode of pneumonia on a steroid taper with prophylactic trimethoprim/sulfamethoxazole. Once he recovered, he was given a fourth dose of chemotherapy. About a week later, wheezes were noticed on physical exam, and he was given a 5-day course of levofloxacin. Around the same time, he also finished his steroid taper. Twelve days after his dose of chemotherapy, he presented to the emergency room with 3 to 4 days of progressive shortness of breath and dry cough following the completion of levofloxacin without symptom improvement. A CT scan showed increasing airspace opacities and multifocal areas of consolidation. Blood, nasal, and sputum cultures were negative. A bronchoscopy was performed that did not reveal findings concerning for capillaritis. He was ultimately diagnosed with drug-induced pneumonitis/interstitial lung disease (ILD). Mr. B continued to experience worsening hypoxic respiratory failure despite continuous IV steroids. He was discharged to an inpatient hospice facility where he passed away 2 weeks later. Drug-induced pneumonitis/ILD should be considered in all patients receiving trastuzumab deruxtecan who develop progressive shortness of breath or other respiratory complaints.","PeriodicalId":17176,"journal":{"name":"Journal of the Advanced Practitioner in Oncology","volume":"14 5","pages":"440-443"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/40/jadpro-14-440.PMC10414527.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10305113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0