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Gisele Fraga Moreira



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    EP1.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 206)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.16-42 - Pharmaceutical Follow-Up Program for Patients with Driver Mutation in Non-Small Cells Lung Cancer  (Now Available) (ID 2427)

      08:00 - 18:00  |  Presenting Author(s): Gisele Fraga Moreira

      • Abstract
      • Slides

      Background

      Lung cancer has faced important changes in its recent history. With the improvement of main genetic mutations and its discovery evidences, the target-therapy oriented to specific molecular groups have revolutionized that kind of tumour. Those recent discoveries made possible oral drugs administration procedures at anti-lung cancer treatment. Compared to intravenous therapy, the oral medicine administration brought several benefits, which include the treatment in the comfort of patient’s home. However, its use can be frequently associated with some concerns as: treatment adherence, medical conciliation, collateral effects and drug cost. The purpose of this paper is to describe the best practices of follow-up lung cancer patient service model while making use of oral drugs in the household environment.

      Method

      This article presents a multidisciplinary team’s expertise acting in an oral chemotherapy program, managed by pharmacists between april of 2016 and march of 2019. All patients had driver mutations at non-small lung cancer cells and were being treated at a private medical clinic.

      Result

      We developed a service program named as Projeto Droga Oral (Oral Drug Project) (Figure 1), in order to contribute to the better management of interdisciplinary team while handling the above mentioned patients. A total number of 77 persons where identified and 9 different drugs where applied: Afatinib, Alectinib, Brigatinib, Ceritinib, Crizotinib, Erlotinib, Gefitinib, Lorlatinib and Osimertinib.

      service flowchart for oral drug project.jpg

      Figure 1: Service flowchart for Oral Drug Project

      Of the mentioned patients, 53% presented drug-drug and 43% drug-food interactions. 95% of all interventions where accepted by multidisciplinary team. No hospitalizations due to drug intoxication were registered and only 2% needed to suspend treatment definitely due to 3rd degree of non-manageable toxicity. 56% presented 1st or 2nd degree of toxicity and prematurely managed. All toxicities were identified and there were no patient abandonment during treatment.

      Conclusion

      The Oral Drug Program is a key factor to guarantee patient correct follow-ups and treatment success. The development of a support program for the patient and caregiver during the administration of target-therapy at household environment granted the main benefits: quality of life improvement, better therapeutic control, better patient adherence and caregiving management, early problem identification related to the drug use, reduction of hospitalization costs and collateral effects. To ensure the project implementation success, institutional protocol and conduct standardization is mandatory as well as qualified workforce participation and correct patient education about his or her treatment plan.

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    P1.07 - Nursing and Allied Professionals (ID 171)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Nursing and Allied Professionals
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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      P1.07-06 - Use of the Nutritional Risk Index as Screening for Malnutrition in Patients with Lung Cancer (Now Available) (ID 2641)

      09:45 - 18:00  |  Author(s): Gisele Fraga Moreira

      • Abstract
      • Slides

      Background

      Introduction: Malnutrition is a critical condition for patients with lung cancer (LC). High turnover clinics require an easy, fast and good sensitivity screening instrument. Objective: To compare Buzby's Nutritional Risk Index (NRI) tool and to correlate it with nutritional status assessment from anthropometric parameters.

      Method

      Methodology: This is a cross-sectional study, with patients with clinical stage IV lung adenocarcinoma, followed at a reference oncology clinic in Rio de Janeiro. During the first visit, data on age, sex, current weight, usual weight, height, arm circumference (AC), triceps skinfold thickness (TST) and serum albumin were collected. To assess the nutritional status, calculations of NRI (Busby et al., 1998), body mass index (BMI), AC adequacy and arm muscle circumference (AMC) adequacy were used. Patients were classified as undernourished or undernourished. The data were analyzed through the SPSS program, version 13.0.

      Result

      Results: 23 patients participated in the study, with a mean age of 66.4 ± 11.3 years, of which 52.2% were female. The percentage of patients considered malnourished by IRN was 52.2% for IRN, 21.7% for BMI, 39.1% for CB adequacy and 26.1% for WBC adequacy. The BMI was the index that most classified individuals as without malnutrition (78.3%). When the INR was crossed with the other evaluation methods used, it was found that there was a very low degree of agreement regarding BMI (Kappa = 0,1), p <0.06.

      Conclusion

      Conclusion: in this study IRN was more sensitive to identify inadequacy in nutritional status when compared to BMI, CB and CMB. The use of IRN in patients with lung cancer helps to identify the nutritional diagnosis early, favoring nutritional intervention and consequently the quality of life of the patient.

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