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Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy

BACKGROUND: Cancer patients treated with neurotoxic chemotherapy are at risk of developing neurological symptoms that can impact functional capacity and quality of life. However, there are no standardised pathways to assess and manage chemotherapy-induced peripheral neurotoxicity (CIPN). This study...

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Autores principales: Mizrahi, David, Goldstein, David, Kiernan, Matthew C., Robinson, Louisa, Pitiyarachchi, Omali, McCullough, Susan, Mendoza-Jones, Phil, Grimison, Peter, Boyle, Frances, Park, Susanna B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135801/
https://www.ncbi.nlm.nih.gov/pubmed/35394563
http://dx.doi.org/10.1007/s00520-022-07024-3
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author Mizrahi, David
Goldstein, David
Kiernan, Matthew C.
Robinson, Louisa
Pitiyarachchi, Omali
McCullough, Susan
Mendoza-Jones, Phil
Grimison, Peter
Boyle, Frances
Park, Susanna B.
author_facet Mizrahi, David
Goldstein, David
Kiernan, Matthew C.
Robinson, Louisa
Pitiyarachchi, Omali
McCullough, Susan
Mendoza-Jones, Phil
Grimison, Peter
Boyle, Frances
Park, Susanna B.
author_sort Mizrahi, David
collection PubMed
description BACKGROUND: Cancer patients treated with neurotoxic chemotherapy are at risk of developing neurological symptoms that can impact functional capacity and quality of life. However, there are no standardised pathways to assess and manage chemotherapy-induced peripheral neurotoxicity (CIPN). This study aimed to determine consensus on statements regarding a CIPN assessment and management clinical pathway. METHODS: A CIPN clinical pathway (CIPN-path) was developed and reviewed by an expert multi-disciplinary panel and consumers. Agreement with 18 statements regarding four content themes (pretreatment review, screening and assessment, management and referral, and CIPN-path feasibility) were assessed by 70 Australian respondents (68 health professionals, 2 consumers), using a 2-stage Delphi survey process to reach consensus. Respondents rated statements using a 5-point Likert scale to determine the level of agreement, with consensus defined as ≥ 80% of respondents agreeing with each statement. RESULTS: The consensus was reached for 14 of 18 items after stage 1 and all items after stage 2. Feedback was obtained for all items to refine the CIPN-path. There was an agreement on important characteristics of the CIPN-path, including pretreatment screening, regular patient-reported assessment, and a stepped-care approach to investigating and managing symptom burden. There was a lack of agreement on who should oversee CIPN assessment, which may differ according to the structure and resources of each site. CONCLUSIONS: There was an overall agreement concerning the CIPN-path to assess and manage CIPN, which may be adapted accordingly to the resources of each clinic. The CIPN-path may assist teams across different health services in identifying CIPN symptoms, aiding decision-making, and reducing morbidity from CIPN. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00520-022-07024-3.
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spelling pubmed-91358012022-05-28 Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy Mizrahi, David Goldstein, David Kiernan, Matthew C. Robinson, Louisa Pitiyarachchi, Omali McCullough, Susan Mendoza-Jones, Phil Grimison, Peter Boyle, Frances Park, Susanna B. Support Care Cancer Original Article BACKGROUND: Cancer patients treated with neurotoxic chemotherapy are at risk of developing neurological symptoms that can impact functional capacity and quality of life. However, there are no standardised pathways to assess and manage chemotherapy-induced peripheral neurotoxicity (CIPN). This study aimed to determine consensus on statements regarding a CIPN assessment and management clinical pathway. METHODS: A CIPN clinical pathway (CIPN-path) was developed and reviewed by an expert multi-disciplinary panel and consumers. Agreement with 18 statements regarding four content themes (pretreatment review, screening and assessment, management and referral, and CIPN-path feasibility) were assessed by 70 Australian respondents (68 health professionals, 2 consumers), using a 2-stage Delphi survey process to reach consensus. Respondents rated statements using a 5-point Likert scale to determine the level of agreement, with consensus defined as ≥ 80% of respondents agreeing with each statement. RESULTS: The consensus was reached for 14 of 18 items after stage 1 and all items after stage 2. Feedback was obtained for all items to refine the CIPN-path. There was an agreement on important characteristics of the CIPN-path, including pretreatment screening, regular patient-reported assessment, and a stepped-care approach to investigating and managing symptom burden. There was a lack of agreement on who should oversee CIPN assessment, which may differ according to the structure and resources of each site. CONCLUSIONS: There was an overall agreement concerning the CIPN-path to assess and manage CIPN, which may be adapted accordingly to the resources of each clinic. The CIPN-path may assist teams across different health services in identifying CIPN symptoms, aiding decision-making, and reducing morbidity from CIPN. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00520-022-07024-3. Springer Berlin Heidelberg 2022-04-08 2022 /pmc/articles/PMC9135801/ /pubmed/35394563 http://dx.doi.org/10.1007/s00520-022-07024-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Mizrahi, David
Goldstein, David
Kiernan, Matthew C.
Robinson, Louisa
Pitiyarachchi, Omali
McCullough, Susan
Mendoza-Jones, Phil
Grimison, Peter
Boyle, Frances
Park, Susanna B.
Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy
title Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy
title_full Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy
title_fullStr Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy
title_full_unstemmed Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy
title_short Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy
title_sort development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135801/
https://www.ncbi.nlm.nih.gov/pubmed/35394563
http://dx.doi.org/10.1007/s00520-022-07024-3
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