Medical Oncology/Hematology, William Osler Health System, Brampton, ON L6R 3J7, Canada.
Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
Curr Oncol. 2022 Feb 4;29(2):869-880. doi: 10.3390/curroncol29020074.
The increased use of immune checkpoint inhibitors across cancer programs has created the need for standardized patient assessment, education, monitoring, and management of immune-related adverse events (irAEs). At William Osler Health System in Brampton, Ontario, a practical step-wise approach detailing the implementation of cancer immunotherapy in routine practice was developed. The approach focuses on four key steps: (1) identification of patient educators; (2) development of patient education materials; (3) development of patient monitoring tools; (4) involvement and education of multidisciplinary teams. Here, we provide an in-depth description of what was included in each step and how we integrated the different elements of the program. For each step, resources, tools, and materials that may be useful for patients, healthcare providers, and multidisciplinary teams were developed or modified based on existing materials. At our centre, the program led to improved patient comprehension of irAEs, the ability to act on symptoms (patient self-efficacy), and low rates of emergency room visits at first presentation for irAEs. We recognize that centres may need to tailor the approaches to their institutional policies and encourage centres to adapt and modify the forms and tools according to their needs and requirements.
随着免疫检查点抑制剂在癌症治疗中的广泛应用，需要对免疫相关不良反应（irAEs）进行标准化的患者评估、教育、监测和管理。在安大略省宾顿的威廉·奥瑟尔健康系统（William Osler Health System），我们制定了一种实用的逐步方法，详细介绍了癌症免疫疗法在常规实践中的实施。该方法侧重于四个关键步骤：（1）确定患者教育者；（2）开发患者教育材料；（3）开发患者监测工具；（4）多学科团队的参与和教育。在这里，我们深入描述了每个步骤中包含的内容，以及我们如何整合该计划的不同要素。对于每个步骤，我们都根据现有材料开发或修改了针对患者、医疗保健提供者和多学科团队可能有用的资源、工具和材料。在我们中心，该计划提高了患者对 irAEs 的理解、对症状采取行动的能力（患者自我效能），并且 irAEs 首次就诊时急诊就诊的比例较低。我们认识到，各个中心可能需要根据自己的机构政策来调整这些方法，并鼓励中心根据自己的需求和要求来改编和修改表格和工具。
