Congress Abstracts 2006

154

TREATMENT RESPONSE WORKSHEET (TRW), A TOOL FOR NURSES IN MANAGING AND EVALUATING PATIENTS WITH MYELODYSPLASTIC SYNDROME (MDS) RECEIVING AZACITIDINE TREATMENT. Rosalie Odchimar-Reissig, RN, MSN, OCN^®, CCRC, Erin Demakos, RN, CCRC, Lewis Silverman, MD, and Barbara Rawlerson, RN, OCN^®, Mount Sinai Hospital, New York, NY.

The nurse's level of knowledge and experience in caring for patients with myelodysplastic syndrome (MDS) has an impact on the quality of patient outcomes. Nurses caring for MDS patients on azacitidine treatment are bombarded with a plethora of clinical data from different sources over a short period of time. Nurses need a tool to help organize clinical data thus allowing them to effectively perform their critical role in managing and evaluating patients receiving azacitidine treatment.

The Treatment Response Worksheet (TRW) was developed by the MDS Team at this institution to help manage patient's clinical data. The information on the TRW is a snapshot-in-time of a patient's disease status and clinical picture while receiving azacitidine treatment. Nurses use this worksheet, a grid with rows and columns, by entering clinical data for each treatment cycle along each row across several columns. Using this worksheet, nurses can effectively assess, intervene, and evaluate patient's response to treatment.

Baseline data (i.e., date of diagnosis, FAB classification, IPSS, Cytogenetics, blood counts, blasts percentage in the blood/bone marrow, target value to determine each cell lineage response, and quality of life data including episodes of infection and blood transfusion) are entered before the patient starts azacitidine treatment. Additional clinical data (i.e., drug dose and start date, nadir/recovered/peak blood counts, length of a cycle, and history of blood transfusion and antibiotic use) are entered and tracked during each treatment cycle.

By comparing baseline with treatment data, nurses can anticipate and facilitate plans for the next treatment cycle (start on schedule versus delay treatment or give the same/reduce/increase dose) and determine if a patient can continue with azacitidine treatment after four cycles depending on the overall response (Hematologic Improvement, Partial Response, Complete Response, Improvement in Quality of Life). As a tool, the TRW guides the nurse to efficiently manage patient's disease and symptoms, and evaluate response to azacitidine treatment.

The TRW can help nurses become informed on the progress of a patient's treatment history thus empowering them to become effective clinicians, patient advocates, educators, and researchers. This tool has general application with other drugs for MDS therapy with appropriate modification.