Supportive care guidelines

Nephrology ◽  
2014 ◽  
Vol 19 (3) ◽  
pp. 174-174
Author(s):  
Steve May
Keyword(s):  
Supportive Care ◽  
Care Guidelines

scholarly journals ANZSN Renal Supportive Care Guidelines 2013

Nephrology ◽  
2013 ◽  
Vol 18 (6) ◽  
pp. 401-454 ◽  
Author(s):  
Mark A Brown ◽  
Susan M Crail ◽  
Rosemary Masterson ◽  
Celine Foote ◽  
Jennifer Robins ◽  
...  
Keyword(s):  
Supportive Care ◽  
Care Guidelines

scholarly journals Collaborative Physician-Pharmacist–Managed Multiple Myeloma Clinic Improves Guideline Adherence and Prevents Treatment Delays

2018 ◽  
Vol 14 (11) ◽  
pp. e674-e682 ◽  
Author(s):  
Karen Sweiss ◽  
Scott M. Wirth ◽  
Lisa Sharp ◽  
Irene Park ◽  
Helen Sweiss ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Supportive Care ◽  
Ad Hoc ◽  
Autologous Transplantation ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Thromboembolism Prophylaxis ◽  
Time To Initiation ◽  
Care Guidelines ◽  
Immunomodulatory Drug ◽  
Physician Adherence

Purpose: We hypothesized that a multidisciplinary collaborative physician-pharmacist multiple myeloma clinic would improve adherence to treatment and supportive care guidelines as well as reduce delays in receiving oral antimyeloma therapy. Methods: From March 2014 to February 2015, an oncology pharmacist provided consultation for all patients in a specialist myeloma clinic. This included reviewing medications, ensuring physician adherence to supportive care guidelines, managing treatment-related adverse effects, and navigating issues involving access to oral specialty medications (collaborative clinic). Results: Outcome measures were retrospectively compared with those of patients being treated by the same physician during the previous year, in which ad hoc pharmacist consultation was available upon request (traditional clinic). The collaborative clinic led to significant improvements in adherence to supportive medications, such as bisphosphonates (96% v 68%; P < .001), calcium and vitamin D (100% v 41%; P < .001), acyclovir (100% v 58%; P < .001), and Pneumocystis jirovecii pneumonia prophylaxis (100% v 50%; P < .001). Appropriate venous thromboembolism prophylaxis in immunomodulatory drug–treated patients was prescribed in 100% versus 83% of cases ( P = .0035). The median time to initiation of bisphosphonate (5.5 v 97.5 days; P < .001) and P jirovecii pneumonia prophylaxis after autologous transplantation was shortened in the collaborative clinic (11 v 40.5 days; P < .001). Furthermore, the number (85% v 21%; P < .001) and duration (7 v 15 days; P = .002) of delays in obtaining immunomodulatory drug therapy were also significantly reduced. Conclusion: Our collaborative clinic model could potentially be applied to other practice sites to improve the management of patients with multiple myeloma. Prospective studies analyzing clinical outcomes, patient satisfaction, and cost effectiveness of this approach are warranted.

scholarly journals Availability of all-trans retinoic acid and support systems for management of acute promyelocytic leukemia in Michigan and Louisiana, USA

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Sheldon L. Bolds ◽  
Shruthi M.K. Hassan ◽  
Catherine R. Caprara ◽  
Stephanie Debragga ◽  
Kathryn S. Simon ◽  
...  
Keyword(s):  
Supportive Care ◽  
Acute Promyelocytic Leukemia ◽  
Treatment Protocol ◽  
Promyelocytic Leukemia ◽  
Treatment Protocols ◽  
Successful Treatment Outcome ◽  
All Trans Retinoic Acid ◽  
Care Guidelines ◽  
One Year ◽  
Cure Rates

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia with high induction mortality in the general population despite evidence of high cure rates in the clinical trials. Aggressive supportive care is essential for ideal management of these patients. We conducted a survey to collect data on these important issues required for successful treatment/outcome of APL patients from two states (Michigan and Louisiana) due to their low one-year survival rate among the Surveillance, Epidemiology, and End Results registries. All eligible hospitals (253) were obtained from the Data Medicare online directory. Availability of ATRA, formulary process to obtain it, blood back availability and established treatment protocols for the management of APL patients were queried. Since most of the hospitals surveyed do not have a treatment protocol, we believe that outcome could be improved if a standardized and simplified set of treatment and supportive care guidelines are developed for all hospitals treating APL.

Level of scientific evidence underlying palliative care recommendations arising from the National Comprehensive Cancer Network (NCCN) clinical practice guidelines.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19537-e19537
Author(s):  
Felipe Melo Cruz ◽  
Fernando Mauro Lima Prearo ◽  
Daniel Iracema Cubero ◽  
Auro Del Giglio
Keyword(s):  
Palliative Care ◽  
Clinical Practice ◽  
Supportive Care ◽  
Scientific Evidence ◽  
Relative Content ◽  
Level Of Evidence ◽  
Nccn Guidelines ◽  
Care Guidelines ◽  
High Level ◽  
Cancer Network

e19537 Background: The palliative care NCCN recommendations are classified according to the level of scientific evidence in four groups: category I, high level of evidence with uniform consensus; category IIA, lower level of evidence with uniform consensus; category IIB, lower level of evidence without a uniform consensus but with no major disagreement; and category III, any level of evidence but with major disagreement. Palliative care guidelines have not yet been judged as to the relative content of each of the aforementioned types of recommendations. Methods: We analyzed the distribution of categories of evidence cited in the 10 supportive care NCCN guidelines, version 2.2011. Results: Of the 2,537 recommendations found in the 10 guidelines, the proportion of category I, IIA and IIB recommendations were 2.9%, 95.7%, 1.4%, respectively. There wasn’t any category III recommendation (table 1). The fields with a higher rate of category I recommendations were fatigue (14.3%) and chemotherapy induced nausea and vomiting (12.7%). No category I recommendations were found on Senior Adult Oncology, Cancer and Chemotherapy induced Anemia and Adult Cancer Pain. Conclusions: : Palliative care NCCN recommendations are largely based on lower level of evidence, but with uniform expert opinion. This data show the urgent need to expand palliative care research in oncology. [Table: see text]

scholarly journals Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

2020 ◽  
Vol 82 (6) ◽  
pp. 1553-1567 ◽  
Author(s):  
Lucia Seminario-Vidal ◽  
Daniela Kroshinsky ◽  
Stephen J. Malachowski ◽  
James Sun ◽  
Alina Markova ◽  
...  
Keyword(s):  
Supportive Care ◽  
Toxic Epidermal Necrolysis ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Care Guidelines

Implementation of electronic chemotherapy ordering: An opportunity to improve evidence-based oncology care.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 323-323 ◽  
Author(s):  
Kerin Adelson ◽  
Randall F. Holcombe ◽  
Kristine Lutkowski ◽  
Damaris Peralta-Hernandez ◽  
Michael McLean ◽  
...  
Keyword(s):  
Patient Safety ◽  
Supportive Care ◽  
Improve Patient Safety ◽  
Medical Center ◽  
Evidence Based ◽  
Safety Issues ◽  
Oncology Nurse ◽  
Care Guidelines ◽  
Oncology Practice ◽  
The Impact

323 Background: On April 20, 2012, Mount Sinai Medical Center was the 63rd site to go-live with the Beacon chemotherapy module of the EPIC EMR. EPIC support reports that ours was one of the most successful launches to date. Previously, all our chemotherapy orders were handwritten with variable adherence to evidence-based chemotherapy and supportive care guidelines. Our goals were 1) reduce errors and improve patient safety, 2) increase use of evidence-based treatment, 3) optimize supportive care and 4) improve practice efficiency. Methods: Fourteen months prior to the go-live we formed a Chemotherapy Council, made up of Oncology physician, nursing and pharmacy leadership and a Beacon-trained Build Team, including an oncology nurse and two chemotherapy pharmacists. Individual disease groups submitted lists of their regimens with references, which were used to create paper orders. The council met weekly to review the orders, references, nursing communications, and NCCN treatment, antiemetic and supportive care guidelines. Once approved, these paper orders served as templates for more than 400 electronic protocols. Each protocol was validated by a utilizing physician. Results: 98% of patients had electronic orders entered prior to go-live (394 chemotherapy and 116 supportive). There were no patient safety issues during the go-live period. In a survey one-month post go-live, 72% of users felt that Beacon had improved their day-to-day efficiency and 72% of users felt that the quality of patient care had improved. Conclusions: The transition to electronic chemotherapy ordering offers an institution the chance to develop evidence-based oncology practice, standardize supportive care and enhance patient safety. It is essential to develop procedures to avoid electronically immortalizing unproven regimens or chemotherapy dosing errors. The key elements that made our Beacon transition so successful were: 1) extensive involvement of oncology leadership, 2) use of a chemotherapy council to enforce evidence-based practice, 3) clinician validation of every protocol and 4) ongoing collaboration between clinical operations and IT regarding the impact of electronic ordering on downstream operations.

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