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Imanuely Borchardt Gonçalves
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P28 - Nursing and Allied Health Professionals - Regional Roles of Nurses and Allied Health Professionals (ID 159)
- Event: WCLC 2020
- Type: Posters
- Track: Nursing and Allied Health Professionals
- Presentations: 2
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P28.01 - The Clinical Pharmacist as a Member of a Multidisciplinary Team for Lung Cancer Patients Assistance (ID 3590)
00:00 - 00:00 | Author(s): Imanuely Borchardt Gonçalves
- Abstract
Introduction
The recent finds related to molecular biology have been modifying treatment scenarios for lung cancer patients. Along with better understanding of different genetic changes and signalling pathways, new drugs have been developed for that kind of cancer treatment. Due to broad type of clinic protocols and oncological drug combinations, the participation of clinic pharmacists working as a multiprofessional team member has increased. In this article we will describe the caregiving model developed for patient treatment by a specialized clinical pharmacist.
Methods
This article aims to provide a real case of a multiprofessional team that have been acting in specialized pharmaceutical patient monitoring. All patients were diagnosed with lung cancer and treated between november of 2018 and july of 2020, in a private oncologic clinic in the city of Rio de Janeiro, Brazil.
Results
We developed a pharmacist assistance model for lung cancer patients in order to improve its experience, safety and quality of life during all treatment scope (figure 1). 273 patients and 23 types of different oncological drugs were identified for lung cancer treatment, with 4 different types of pharmaceutical classes: 40% oral target-therapy; 30% conventional chemotherapy; 22% immunotherapy and 8% intravenous target-therapy. All patients were conducted by a previous clinical pharmacist query before begginning of treatment. Were evaluated: degree of treatment understanding of patient and caregiver; distress levels through assessment “thermometer”; identification and registration of allergies; smoking; social habits; comorbidities and drug reconciliation. Each patient received an individualized care plan, education material with guidance for drug administration and packaging of oncological medicines for home use, telephone follow-up to assess adherence and schedule of laboratory tests. Of the patients consulted by the clinical pharmacist, 67% needed pharmaceutical intervention, being referred for assessment of nutrition, psychologist or reassessment by the oncologist. 97% of pharmaceutical interventions were accepted by the multidisciplinary team. All identified drug toxicities were recorded and no patient abandoned treatment.
Conclusion
With new oncological drugs for lung cancer treatment available on the market, it has been necessary a better understanding of protocols and monitoring plans for intravenous administration or for oral administration. The clinical pharmacist is a key factor for correct patient monitoring for each different types of protocols, by helping reduce drug interactions risks, toxicity identification and developing better treatment adherence. For this method of assistance to succeed, the presence of the pharmacist is fundamental on the “tumor board” and its inclusion as a member of multidisciplinary team.
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P28.02 - Individualized Nutritional Management in Patients Eligible for Thoracic Surgery Experience of a Chest Tumor Center in Brazil (ID 1603)
00:00 - 00:00 | Presenting Author(s): Imanuely Borchardt Gonçalves
- Abstract
Introduction
Introduction
Lung cancer (LC) has an increased incidence and early diagnosis can be instituted as a curative measure for these patients. Surgery is the treatment of choice for early-stage disease, which can be combined with systemic treatment. The personalized nutritional intervention in these patients can contribute to an adequate pre and postoperative and subsequent chemotherapy treatment. Research in these areas is necessary to establish a diet that will guarantee an adequate caloric and protein intake in these patients in order to preserve nutritional status and quality of life. The objective is to describe an experience report of a nutritional intervention protocol applied pre- and postoperatively in patients undergoing thoracic surgery at a referral center.
Methods
This is a qualitative, descriptive, experience report type study carried out in an oncology clinic.
Results
Results: The protocol used in the unit consists of the application of nutritional risk tracking instruments, the Patient-Generated Subjective Global Assessment (PG-SGA) and subsequent assessment of nutritional status by anthropometric methods (weight, history of weight loss, height, body mass, calf perimeter, food history (24-hour recall for 3 consecutive days), laboratory tests (blood count, blood glucose, glycosylated hemoglobin, albumin, protein C reactive) and comorbidities. with nutritional risk, considered in our center as patients with unintentional weight loss, low force palm pressure by dynamometry according to the European Working Group on Sarcopenia in Older People (EWGSOP), low protein intake according to the guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) and American Society for Parenteral and Enteral Nutrition (ASPEN). Patients at high risk of malnutrition are chosen to receive immunomodulatory nutritional therapy between 7 and 14 days pre- and postoperatively, as shown in figure 1.
Conclusion
Conclusion: Adequate nutritional status appears to be achieved when this protocol is completed. The referral of patients with chest tumors eligible for surgery to nutrition, allows an early and more effective nutritional intervention. Having this flow as a service routine allows the patient a better response to treatment and a positive impact on their quality of life.
