The role of the cancer nurse is evolving rapidly as immuno-modulating drugs such as immune checkpoint inhibitors (ICIs) become more widely available for use in different disease states, in differing doses and in numerous combinations.
These drugs are generally considered to have a lower level of side effects than traditional chemotherapy. Significantly, the ease of administration combined with consumer demand, has led to the administration of these drugs being outsourced to community nursing programs.
However, ICIs do have very specific immune related adverse events (irAEs)s, which can be sudden, severe and occasionally fatal. For this reason, it is not only imperative that nurses stay abreast of new drugs and regimens as they come to market, but that patients also understand and recognise possible adverse events.
There is an urgent requirement for an operational framework for community based chemotherapy/immunotherapy administration clinical pathways in this rapidly evolving practice area.
Edith Cowan University, in conjunction with chemo@home (a West Australian home infusion service) has commenced research seeking to enable patients being treated with checkpoint inhibitor immunotherapies in a domiciliary environment to better manage their own treatment.
Patients referred to the home chemotherapy service will be followed from pre-admission to 12 months post discharge from the service to establish adverse events and management of same.
Results and Conclusion:
Outcomes will be based around four domains: (1) Educational requirements of patients (2) Evidence-based mechanisms to improve Patient Reported Outcomes, (3) Identification of collaboration pathways between patients, carers and nursing staff, (4) Quantitative analysis of data to determine safety and reported irAEs.
Results will be used to inform evidenced based practice in domiciliary care of patients treated with ICIs.