Standardization of toxicity related dose modification in oncology electronic health record (EHR)

Autor: Amit Sanyal, Daniel Wellner, James Thomas, Matthew Mattila
Rok vydání: 2022
Předmět:
Zdroj: Journal of Clinical Oncology. 40:e18616-e18616
ISSN: 1527-7755
0732-183X
DOI: 10.1200/jco.2022.40.16_suppl.e18616
Popis: e18616 Background: Inappropriate antineoplastic drug dosing can cause excessive toxicities or impaired efficacy. Chemotherapy dose delays and reduced dose intensity are common in community oncology practices[1]. Electronic tools can improve quality and safety of chemotherapy. Methods: A quality improvement project to standardize toxicity related dose modifications was initiated in January 2021. A dose modification section was created in BEACON (Epic Systems, Verona, WI) chemotherapy protocols. Dose modifications used in primary source studies were added to the protocols (Table, illustrative). An embedded link to relevant section of the study protocol allowed detailed review. Similarly, a link to the relevant CTCAE grading was embedded for reference. A user experience survey was conducted in August 2021 to evaluate adoption and perceived utility. Results: Dose modifications recommendations have been introduced in 104 protocols to date. Of the 70 survey respondents, there were 18 physicians and 5 advance practice providers, remainder being oncology nurses and pharmacists. Pre-implementation, 29% (8/27) of respondents whose role required performing dose modifications indicated using personal clinical judgement for hematological toxicity related dose modifications. 34% (9/26) did the same for non-hematological toxicities. Post-implementation, 87% respondents indicated awareness of the recommendations. 47% indicated that recommendations saved timed and 60% found these useful. 7.2% felt recommendations were impractical for clinical use. Conclusions: Embedding evidence-based dose modification recommendations into EHR based treatment protocols is feasible with widespread user adoption. References Denduluri, N., et al., Dose Delays, Dose Reductions, and Relative Dose Intensity in Patients With Cancer Who Received Adjuvant or Neoadjuvant Chemotherapy in Community Oncology Practices. J Natl Compr Canc Netw, 2015. 13(11): p. 1383-93. Illustrative Dose Modification Table. Reference Links 1. Grothey et al. Dose Modifications 2. CTCAE Grading. Refer to Reference Link for Detailed Instructions. Decrease Oxaliplatin and 5 FU one dose level for ANC
Databáze: OpenAIRE
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