RESUMO
PURPOSE: Venetoclax combined with a hypomethylating agent (HMA) has become the standard of care for elderly/unfit patients with newly diagnosed acute myeloid leukemia (AML). This study is aimed at characterizing the impact of an interdisciplinary team on the length of stay (LOS) of patients with newly diagnosed AML receiving venetoclax with an HMA. METHODS: This retrospective observational study included patients with AML who received HMA with venetoclax as an initial treatment between December 2015 and July 2021. The primary outcome was the median LOS during induction stratified by HMA. Secondary outcomes included barriers to hospital discharge, incidence of tumor lysis syndrome (TLS), response rates, and utilization of the institution's prescription assistance program (PAP). RESULTS: Seventy-eight patients were included in our analysis: 51 received azacitidine/venetoclax, and 27 received decitabine/venetoclax. The median LOS from therapy initiation was eight days (range 7-38) for the azacitidine group and six days (range 5-26) for the decitabine group. The most common barriers to discharge were transfusion dependence (33 patients, 42.3%) and insurance coverage (12 patients, 15.4%). Twelve patients (15.3%) had tumor lysis syndrome during hospital admission, and 20 (25.6%) were readmitted during induction. Twenty-three patients (29.5%) required financial assistance for AML care, and a pharmacy-led PAP generated approximately $342,646 in cost savings. CONCLUSION: The utilization of an interdisciplinary AML team to target early hospital discharge proved to be safe and effective and led to a reduction in costs for the health system. Future research may identify select patients who may be suitable for earlier discharge or outpatient induction.
Assuntos
Leucemia Mieloide Aguda , Síndrome de Lise Tumoral , Humanos , Idoso , Decitabina/farmacologia , Decitabina/uso terapêutico , Resultado do Tratamento , Síndrome de Lise Tumoral/etiologia , Alta do Paciente , Quimioterapia de Indução , Azacitidina/uso terapêutico , Leucemia Mieloide Aguda/patologia , Equipe de Assistência ao Paciente , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversosRESUMO
Background: A project team was formulated by the Oncology Nursing Society (ONS) to create evidence-based oncology nurse generalist (ONG) competencies to establish best practices in competency development, including high-risk tasks, critical thinking criteria, and measurement of key areas for oncology nurses. Objectives: This article aims to describe the process and the development of ONG competencies. Methods: This article describes how the ONG competencies were accomplished, and includes outcomes and suggestions for use in clinical practice. Findings: Institutions can use the ONG competencies to assess and develop competency programs, offer unique educational strategies to measure and appraise proficiency, and establish processes to foster a workplace environment committed to mentoring and teaching future oncology nurses.
RESUMO
BACKGROUND: A project team was formulated to create evidence-based oncology nurse generalist competencies (ONGCs) to establish best practices in competency development, including high-risk tasks, critical thinking criteria, and measurement of key areas for oncology nurses.â©. OBJECTIVES: This article aims to describe the process and the development of ONGCs. â©. METHODS: This article explains how the ONGCs were accomplished, and includes outcomes and suggestions for use in clinical practice. â©. FINDINGS: Institutions can use the ONGCs to assess and develop competency programs, offer educational strategies to measure proficiency, and establish processes to foster a workplace committed to mentoring and teaching future oncology nurses.