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美国肿瘤护士和高级执业提供者如何减轻化疗引起的发热性中性粒细胞减少症的负担?

How Can Oncology Nurses and Advanced Practice Providers Reduce the Burden of Chemotherapy-Induced Febrile Neutropenia in the US?

作者信息

Orbaugh Kristi Kay, Cuellar Sandra, Sheldon Lisa Kennedy

机构信息

From Community Hospital Oncology Physicians, Indianapolis, Indiana.

University of Illinois Chicago College of Pharmacy, Chicago, Illinois.

出版信息

J Adv Pract Oncol. 2024 May 22:1-15. doi: 10.6004/jadpro.2024.15.8.5.

Abstract

BACKGROUND

Neutropenia and febrile neutropenia (FN) are serious complications of myelosuppressive chemotherapy and present a considerable burden to patients with cancer. Febrile neutropenia is associated with increased risks of infection and hospitalization, a particular concern during the coronavirus disease 2019 (COVID-19) pandemic. Oncology nurses and advanced practice providers (APPs; including nurse practitioners, physician assistants, advanced practice nurses, and pharmacists) play a vital role in the management of patients with cancer and the prevention of infections.

OBJECTIVES

The objectives of this article are to summarize the burden of chemotherapy-related neutropenia and FN in patients with cancer in the US and to evaluate the role of oncology nurses and APPs in preventing and managing FN.

METHODS

This article provides a narrative review of US studies reporting on the burden of FN, FN during COVID-19, adherence to guidelines for the use of prophylactic granulocyte colony-stimulating factors (G-CSFs), the involvement of oncology nurses in FN prevention, management, and patient quality of life, and inappropriate and/or incomplete G-CSF treatment.

FINDINGS

Despite advances in supportive care for patients with cancer receiving myelosuppressive chemotherapy, neutropenia and FN present a considerable burden to patients, particularly during the COVID-19 pandemic. Oncology nurses and APPs play a vital role in the appropriate and timely delivery of supportive care, which can improve patient outcomes and minimize treatment costs.

摘要

背景

中性粒细胞减少症和发热性中性粒细胞减少症(FN)是骨髓抑制性化疗的严重并发症,给癌症患者带来了相当大的负担。发热性中性粒细胞减少症与感染和住院风险增加相关,在2019冠状病毒病(COVID-19)大流行期间尤其令人担忧。肿瘤学护士和高级执业提供者(APPs;包括执业护士、医师助理、高级执业护士和药剂师)在癌症患者管理和感染预防中发挥着至关重要的作用。

目的

本文的目的是总结美国癌症患者中化疗相关中性粒细胞减少症和FN的负担,并评估肿瘤学护士和APPs在预防和管理FN中的作用。

方法

本文对美国关于FN负担、COVID-19期间的FN、预防性使用粒细胞集落刺激因子(G-CSFs)指南的依从性、肿瘤学护士在FN预防、管理及患者生活质量方面的参与情况以及G-CSF治疗不当和/或不完整的研究进行了叙述性综述。

结果

尽管接受骨髓抑制性化疗的癌症患者的支持性护理取得了进展,但中性粒细胞减少症和FN给患者带来了相当大的负担,尤其是在COVID-19大流行期间。肿瘤学护士和APPs在适当及时地提供支持性护理方面发挥着至关重要的作用,这可以改善患者预后并使治疗成本最小化。

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