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Patient Assessment Tools for CINV

Panelists:Lee S. Schwartzberg, MD, FACP, University of Tennessee Health Science Center;Rebecca Clark-Snow, RN, BSN, OCN, University of Kansas Cancer Center;Charles L. Loprinzi, MD, Mayo Clinic;James Natale, PharmD, BCOP, UPMC Cancer Center;Eric Roeland, MD, University of California, San Diego
Published: Tuesday, Aug 09, 2016


 Transcript:

Lee S. Schwartzberg, MD:
We talked a little bit before about tools to assess patients when they’re not in the infusion center. Rebecca, can you tell us about some of the tools that are out there that we can use and that our audience can potentially access?

Rebecca Clark-Snow, RN, BSN, OCN: There are several good tools. Probably one of the first tools was a functional living index, and this is a questionnaire that was developed by Celeste Lindley many, many years ago. It’s a quality-of-life–validated tool that initially looked at patients and followed them for 3 days after chemotherapy. Then later, they developed a 5-day tool.

I think this tool, by and large, has been attached to clinical trials more so than being actually given to patients to use at home. I would like to just say that the MASCC antiemesis tool is probably a little easier for giving to patients and explaining to patients. And it’s a tool that they can use at home to keep track of the episodes and the degree of nausea and vomiting, not only during the initial 24-hours, but in the subsequent days during that delayed period. It’s an opportunity for them to provide feedback to the nurses, the physicians, and the pharmacists so that we could see how well they’re doing and to make changes to their treatment plan if necessary.

Lee S. Schwartzberg, MD: How simple is that to use, the MASCC tool?

Rebecca Clark-Snow, RN, BSN, OCN: It’s very simple. It asks the question, how much vomiting did you have? And it asks you to actually write the number. Then, there’s a visual analog scale for the nausea component: 0 being not at all, and then 10, it’s bad as it can be. It’s just simply putting a mark for the line to talk about how much nausea they’ve had. Then patients can bring that back to the clinic with them for their next visit, or the nurse can call and find out. This is available as an app so that patients can have it on their smart phone or iPhone. And that information can be transferred to the physician or healthcare professional in real-time. So, we can really have that information right away.

Lee S. Schwartzberg, MD: That’s a great use of technology.

Rebecca Clark-Snow, RN, BSN, OCN: Yes.

James Natale, PharmD, BCOP: I found our patients actually were much more comfortable with the apps than they are writing on paper.

Rebecca Clark-Snow, RN, BSN, OCN: Yes.

James Natale, PharmD, BCOP: They’re just more willing to use that, and it is invaluable information when you’re planning on chemotherapy, at least from the pharmacist’s perspective. When we’re getting things ready, like checking labs, it’s almost another lab that we’re checking and how well you tolerated your last cycle chemotherapy.

Rebecca Clark-Snow, RN, BSN, OCN: And for those institutions that don’t use the app, logs or diaries are absolutely perfect to use, as well.

Eric Roeland, MD: An added benefit to the MASCC antiemesis tool is the 24-hour validation. So, you can get those 24-hour intervals rather than the 3- and 5-day recall. When I talk to a lot of folks that are interested in this topic, I find it to be a priority that they’re capturing these data. But not necessarily with these validated tools, for fear that the tools are so just complex and take a long time. But the MASCC antiemesis tool is very short, easy to do. And if you’re going to capture that data, it’s nice to be able to compare your local data with what’s happening in the studies.

Rebecca Clark-Snow, RN, BSN, OCN: If I could just add one more point. It’s available in multiple translations, I believe 13. So, we all live in a country that has patients that have come from many other countries. It’s very easy, and it’s wonderful to have this available in the language that they can relate to.

Lee S. Schwartzberg, MD: I’m hearing that monitoring patients using a simple tool like the MASCC tool is really valuable, and it’s simple.

Rebecca Clark-Snow, RN, BSN, OCN: Yes, it’s very simple.

Lee S. Schwartzberg, MD: And patients can communicate, and we really need to do more of that.

Rebecca Clark-Snow, RN, BSN, OCN: Yes.

Transcript Edited for Clarity
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 Transcript:

Lee S. Schwartzberg, MD:
We talked a little bit before about tools to assess patients when they’re not in the infusion center. Rebecca, can you tell us about some of the tools that are out there that we can use and that our audience can potentially access?

Rebecca Clark-Snow, RN, BSN, OCN: There are several good tools. Probably one of the first tools was a functional living index, and this is a questionnaire that was developed by Celeste Lindley many, many years ago. It’s a quality-of-life–validated tool that initially looked at patients and followed them for 3 days after chemotherapy. Then later, they developed a 5-day tool.

I think this tool, by and large, has been attached to clinical trials more so than being actually given to patients to use at home. I would like to just say that the MASCC antiemesis tool is probably a little easier for giving to patients and explaining to patients. And it’s a tool that they can use at home to keep track of the episodes and the degree of nausea and vomiting, not only during the initial 24-hours, but in the subsequent days during that delayed period. It’s an opportunity for them to provide feedback to the nurses, the physicians, and the pharmacists so that we could see how well they’re doing and to make changes to their treatment plan if necessary.

Lee S. Schwartzberg, MD: How simple is that to use, the MASCC tool?

Rebecca Clark-Snow, RN, BSN, OCN: It’s very simple. It asks the question, how much vomiting did you have? And it asks you to actually write the number. Then, there’s a visual analog scale for the nausea component: 0 being not at all, and then 10, it’s bad as it can be. It’s just simply putting a mark for the line to talk about how much nausea they’ve had. Then patients can bring that back to the clinic with them for their next visit, or the nurse can call and find out. This is available as an app so that patients can have it on their smart phone or iPhone. And that information can be transferred to the physician or healthcare professional in real-time. So, we can really have that information right away.

Lee S. Schwartzberg, MD: That’s a great use of technology.

Rebecca Clark-Snow, RN, BSN, OCN: Yes.

James Natale, PharmD, BCOP: I found our patients actually were much more comfortable with the apps than they are writing on paper.

Rebecca Clark-Snow, RN, BSN, OCN: Yes.

James Natale, PharmD, BCOP: They’re just more willing to use that, and it is invaluable information when you’re planning on chemotherapy, at least from the pharmacist’s perspective. When we’re getting things ready, like checking labs, it’s almost another lab that we’re checking and how well you tolerated your last cycle chemotherapy.

Rebecca Clark-Snow, RN, BSN, OCN: And for those institutions that don’t use the app, logs or diaries are absolutely perfect to use, as well.

Eric Roeland, MD: An added benefit to the MASCC antiemesis tool is the 24-hour validation. So, you can get those 24-hour intervals rather than the 3- and 5-day recall. When I talk to a lot of folks that are interested in this topic, I find it to be a priority that they’re capturing these data. But not necessarily with these validated tools, for fear that the tools are so just complex and take a long time. But the MASCC antiemesis tool is very short, easy to do. And if you’re going to capture that data, it’s nice to be able to compare your local data with what’s happening in the studies.

Rebecca Clark-Snow, RN, BSN, OCN: If I could just add one more point. It’s available in multiple translations, I believe 13. So, we all live in a country that has patients that have come from many other countries. It’s very easy, and it’s wonderful to have this available in the language that they can relate to.

Lee S. Schwartzberg, MD: I’m hearing that monitoring patients using a simple tool like the MASCC tool is really valuable, and it’s simple.

Rebecca Clark-Snow, RN, BSN, OCN: Yes, it’s very simple.

Lee S. Schwartzberg, MD: And patients can communicate, and we really need to do more of that.

Rebecca Clark-Snow, RN, BSN, OCN: Yes.

Transcript Edited for Clarity
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