Congress Abstracts 2006

5

CLINICAL BENEFIT OF USING A COMPUTER-BASED RISK ASSESSMENT MODEL TO IDENTIFY PATIENTS AT RISK FOR CHEMOTHERAPY-INDUCED NEUTROPENIA. Kevin Miller, RN, BSN, OCN^®, CCRC, Mid-Ohio Oncology/Hematology, Inc., Westerville, OH.

Risk assessment for chemotherapy-induced neutropenia enables the identification of patients who would benefit from being given growth factor support starting in the first cycle of chemotherapy. A computer-based risk assessment tool can be integrated into the electronic medical records system, assisting in the clinical decision-making process. The consistent use of this tool in patients initiating chemotherapy could contribute to an improvement in the quality of care provided to patients.

To demonstrate the utility of a computer-based risk assessment for neutropenia in ensuring the consistent delivery of supportive care to high-risk patients initiating myelosuppressive chemotherapy regimens

The results of a review of 100 consecutive electronic medical records from before the implementation of the computerized risk assessment tool will be compared with the results of a review of 100 consecutive electronic medical records from after implementation. This IRB-approved protocol will gather data from 4 clinical sites. The study will be restricted to adult patients (>18 years) initiating myelosuppressive chemotherapy for neoadjuvant, adjuvant, or first-line metastatic breast cancer or for adjuvant or first-line metastatic non-small cell lung cancer who are not enrolled in chemotherapy clinical trials. Data will be collected for the first 2 cycles of chemotherapy.

The primary endpoint for this study will be the percentage of documented risk assessments conducted before and after the implementation of the tool. As secondary endpoints, the number of subjects who are given first-cycle growth factor support, the rates of febrile neutropenia, and the number of dose reductions and dose delays from before the tool's implementation will be compared to data collected after the tool's implementation. Data collection and analysis for this ongoing study will be completed in 2006. Preliminary data will be presented.

The use of electronic medical records technology can lead to standardized neutropenia risk assessments. This nurse-initiated project can lead to a more streamlined process for the identification of the risk for neutropenia in patients initiating myelosuppressive chemotherapy. Data collected in this pilot study may be used to design a larger study of the utility of the computerized neutropenia assessment tool in clinical practice.