Mothers' supportive care guidelines of coping Pattern for the care of their children with autism

Purpose: We hypothesized that a multidisciplinary collaborative physician-pharmacist multiple myeloma clinic would improve adherence to treatment and supportive care guidelines as well as reduce delays in receiving oral antimyeloma therapy. Methods: From March 2014 to February 2015, an oncology pharmacist provided consultation for all patients in a specialist myeloma clinic. This included reviewing medications, ensuring physician adherence to supportive care guidelines, managing treatment-related adverse effects, and navigating issues involving access to oral specialty medications (collaborative clinic). Results: Outcome measures were retrospectively compared with those of patients being treated by the same physician during the previous year, in which ad hoc pharmacist consultation was available upon request (traditional clinic). The collaborative clinic led to significant improvements in adherence to supportive medications, such as bisphosphonates (96% v 68%; P < .001), calcium and vitamin D (100% v 41%; P < .001), acyclovir (100% v 58%; P < .001), and Pneumocystis jirovecii pneumonia prophylaxis (100% v 50%; P < .001). Appropriate venous thromboembolism prophylaxis in immunomodulatory drug–treated patients was prescribed in 100% versus 83% of cases ( P = .0035). The median time to initiation of bisphosphonate (5.5 v 97.5 days; P < .001) and P jirovecii pneumonia prophylaxis after autologous transplantation was shortened in the collaborative clinic (11 v 40.5 days; P < .001). Furthermore, the number (85% v 21%; P < .001) and duration (7 v 15 days; P = .002) of delays in obtaining immunomodulatory drug therapy were also significantly reduced. Conclusion: Our collaborative clinic model could potentially be applied to other practice sites to improve the management of patients with multiple myeloma. Prospective studies analyzing clinical outcomes, patient satisfaction, and cost effectiveness of this approach are warranted.

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Mother’s Stress Experience towards Caring for the Children with Autism

KnE Life Sciences ◽

10.18502/kls.v4i13.5333 ◽

2019 ◽

Author(s):

Dania Relina Sitompul

Keyword(s):

Stress Level ◽

Children With Autism ◽

Study Data ◽

Standard Operating Procedures ◽

Field Recording ◽

Standard Operating ◽

Stress Experience ◽

Care Guidelines ◽

Taking Care ◽

At Home

Standard care guidelines for children with autism has not been established yet in Indonesia.Thisissuetriggersdisappropriatetreatmentforthem.Thepreviousgrounded study conducted by the researcher with the purpose to develop the framework for taking care the autism children revealed the new standard in taking care the autism children at home by the mother. One of the standard operating procedures is to reduce the stress level of the mother as the person in charge for their child at home. This research aimed to explore the mother’s stress experience towards caring for the children with autism. Formulated the information and phenomenon of mother’s stress experience towards caring for the children with autism with case study. Data were collectedin2019among7participantsbyutilizingobservation,in-depth interview,ﬁeld recording,and literature review.The result revealed the early stress level of the mother incaring the irchildren with autism.Theyreportedthefeelingofbeingdisappointment, reject the reality, desperate,and negative stigma by the surrounding. Thus they always avoid introducing their children. The mothers often feel scared and worried to bring their children in crowd area. This study provides the suggestion for pediatric nurses to improve their knowledge and skills in giving the support system to the parents of the autism children and promote the education regarding autism treatment and care and most importantly is the establishment of standard operating procedures or guidelines in primary care of autism children at home by mother.

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Availability of all-trans retinoic acid and support systems for management of acute promyelocytic leukemia in Michigan and Louisiana, USA

Hematology Reports ◽

10.4081/hr.2019.7896 ◽

2019 ◽

Vol 11 (2) ◽

Author(s):

Sheldon L. Bolds ◽

Shruthi M.K. Hassan ◽

Catherine R. Caprara ◽

Stephanie Debragga ◽

Kathryn S. Simon ◽

...

Keyword(s):

Supportive Care ◽

Acute Promyelocytic Leukemia ◽

Treatment Protocol ◽

Promyelocytic Leukemia ◽

Treatment Protocols ◽

Successful Treatment Outcome ◽

All Trans Retinoic Acid ◽

Care Guidelines ◽

One Year ◽

Cure Rates

Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia with high induction mortality in the general population despite evidence of high cure rates in the clinical trials. Aggressive supportive care is essential for ideal management of these patients. We conducted a survey to collect data on these important issues required for successful treatment/outcome of APL patients from two states (Michigan and Louisiana) due to their low one-year survival rate among the Surveillance, Epidemiology, and End Results registries. All eligible hospitals (253) were obtained from the Data Medicare online directory. Availability of ATRA, formulary process to obtain it, blood back availability and established treatment protocols for the management of APL patients were queried. Since most of the hospitals surveyed do not have a treatment protocol, we believe that outcome could be improved if a standardized and simplified set of treatment and supportive care guidelines are developed for all hospitals treating APL.

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Level of scientific evidence underlying palliative care recommendations arising from the National Comprehensive Cancer Network (NCCN) clinical practice guidelines.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e19537 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e19537-e19537

Author(s):

Felipe Melo Cruz ◽

Fernando Mauro Lima Prearo ◽

Daniel Iracema Cubero ◽

Auro Del Giglio

Keyword(s):

Palliative Care ◽

Clinical Practice ◽

Supportive Care ◽

Scientific Evidence ◽

Relative Content ◽

Level Of Evidence ◽

Nccn Guidelines ◽

Care Guidelines ◽

High Level ◽

Cancer Network

e19537 Background: The palliative care NCCN recommendations are classified according to the level of scientific evidence in four groups: category I, high level of evidence with uniform consensus; category IIA, lower level of evidence with uniform consensus; category IIB, lower level of evidence without a uniform consensus but with no major disagreement; and category III, any level of evidence but with major disagreement. Palliative care guidelines have not yet been judged as to the relative content of each of the aforementioned types of recommendations. Methods: We analyzed the distribution of categories of evidence cited in the 10 supportive care NCCN guidelines, version 2.2011. Results: Of the 2,537 recommendations found in the 10 guidelines, the proportion of category I, IIA and IIB recommendations were 2.9%, 95.7%, 1.4%, respectively. There wasn’t any category III recommendation (table 1). The fields with a higher rate of category I recommendations were fatigue (14.3%) and chemotherapy induced nausea and vomiting (12.7%). No category I recommendations were found on Senior Adult Oncology, Cancer and Chemotherapy induced Anemia and Adult Cancer Pain. Conclusions: : Palliative care NCCN recommendations are largely based on lower level of evidence, but with uniform expert opinion. This data show the urgent need to expand palliative care research in oncology. [Table: see text]

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