[Implementation of a nurse-driven educational program improves management of sorafenib's toxicities in hepatocellular carcinoma]. / Les infirmières cliniciennes améliorent la gestion des toxicités des patients traités par sorafénib pour carcinome hépatocellulaire.
Bull Cancer
; 103(11): 941-948, 2016 Nov.
Article
em Fr
| MEDLINE
| ID: mdl-27817860
ABSTRACT
BACKGROUND:
Sorafenib is the standard treatment for advanced hepatocellular carcinoma (HCC). Due to its peculiar toxicities, improving patient's tolerance may need close follow-up. Nurses can play a crucial role, by driving a patient education program (EP). We aimed to prove that adding EP to usual care (UC) improves patient's care.METHODS:
Since 2011, oncologists referred patients treated by sorafenib to the EP, driven by clinical nurses. It consisted in a visit before first administration, weekly telephone calls and a visit before each oncologist consultation. We retrospectively compared patients followed by the EP to those followed by oncologist in usual care (UC) and patients included in a clinical trial (CT).RESULTS:
Since 2005, 129 patients were treated with sorafenib for HCC, 31 (24%) in the EP, 22 (17%) in CT and 76 (59%) with UC. Seventy-one percent of patients in the EP had toxicities identified during a telephone call, which prompted symptomatic measures in 65% of patients, leading to treatment modification before the planned on-site visit in 29% of patients. EP patients required less dose reductions (39% vs. 61% for UC, P=0.04), and median time to first dose reduction was shorter with EP than with UC (25 days vs. 45 days, P=0.036).CONCLUSION:
This study suggests a clinical benefit of EP, with a better toxicity's management of sorafenib, leading to less dose reduction. Different types of EP should be compared prospectively, focusing on quality of life.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Compostos de Fenilureia
/
Niacinamida
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Carcinoma Hepatocelular
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Inibidores de Proteínas Quinases
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Padrões de Prática em Enfermagem
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Neoplasias Hepáticas
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Antineoplásicos
Tipo de estudo:
Observational_studies
/
Sysrev_observational_studies
Aspecto:
Implementation_research
/
Patient_preference
Limite:
Aged
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Female
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Humans
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Male
Idioma:
Fr
Revista:
Bull Cancer
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
França