Hanes D.,Clinical Nurse Specialist |
Jefferson-Gordon J.,Clinic Nurse Manager |
Lindsey A.,Mental Health Clinical Nurse Specialist |
O'Connor S.,Clinical Educator |
And 5 more authors.
Clinical Nurse Specialist | Year: 2013
PURPOSE/OBJECTIVES:: The purpose of this study was to better predict and assess pruritus in inpatients and outpatients with sickle cell disease. The aims were to describe the incidence and severity of pruritus using the visual analog scale (VAS) and the National Cancer Institute Common Toxicity Criteria (CTC) scale and to predict pruritus from common complications. DESIGN:: This study was a prospective, cross-sectional design. SETTING:: The study was conducted at a Midwestern National Cancer Institute hospital. SAMPLE:: This prospective, cross-sectional design included patients with a diagnosis of sickle cell disease who were older than 18 years. METHODS:: A demographic data form was used to collect biographical characteristics, and the CTC scale and VAS were used to evaluate pruritus. RESULTS:: The participants (n = 56) were mostly women (62%) and outpatients (58%) and the mean number of complications was 1.9. The mean VAS score was 3.75, and the CTC score was 1.55. For inpatients, the mean VAS score was 5.17, and the CTC score was 1.65. For outpatients, the mean VAS score was 2.76, and CTC score was 1.56. The sensitivity and specificity for the VAS were 75% and 93%, respectively. The CTC scale was 56.2% and 100%, respectively. The difference in the area under the curve between the VAS and the CTC scale was 11.4% in favor of the VAS. Among complications (pulmonary hypertension, liver insufficiency, acute chest syndrome, renal insufficiency, iron overload, and chronic pain medication), chronic pain medication was the only significant predictor. CONCLUSIONS:: Pruritus is common particularly in inpatients as well as outpatients. The VAS is a more sensitive and specific tool to measure pruritus. Chronic pain medication use is a predictor of pruritus. IMPLICATIONS:: Clinicians must make patients aware that pruritus exists especially when pain medication is administered or prescribed. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Billingsley C.C.,Ohio State University |
Jacobson S.N.,Richard J Solove Research Institute |
Li Q.,Richard J Solove Research Institute |
Hade E.M.,Ohio State University |
And 6 more authors.
International Journal of Gynecological Cancer | Year: 2015
Objective We assessed the safety and efficacy of administration of pegfilgrastim on the same day compared with standard administration 24 to 72 hours after chemotherapy in patients with gynecologic malignancies. Methods A retrospective review was conducted on patients undergoing pegfilgrastim to mitigate the myelosuppressive consequences of chemotherapy. The primary outcome was incidence of grade 3 to 4 neutropenia following pegfilgrastim for same-day administration (D1) versus standard administration (D2+). Secondary outcomes included dose delay, regimen change, hospitalization due to neutropenia, and incidence of febrile neutropenia. Results Four hundred twenty-one patients with 2071 administrations of pegfilgrastim were included. Five hundred six administrations of pegfilgrastim were given on D1 compared with 1565 administrations on D2+. The most common malignancy was ovarian cancer (79.1%), followed by endometrial (14.5%). Comparing the D1 and D2+ cohorts, noninferiority was not established for the incidence of grade 3 to 4 neutropenia (2.6% vs 1.8%, adjusted relative risk [aRR], 1.6; 90% confidence interval [CI], 0.87-3.2) or dose modification (6.5% vs 4.9%; aRR, 1.3; 90% CI, 0.9-1.8). However, the rate of treatment delays (7.3% vs 9.4%; aRR, 0.8; 90% CI, 0.6-1.1) in the D1 and D2+ groups suggested that delays in the D1 group were not more common than in the D2+ group. Conclusions The incidence of hematologic toxicities and dose modification in patients receiving same-day pegfilgrastim were not as low as in those undergoing standard administration. However, treatment delays were found to be no more frequent in those receiving same-day pegfilgrastim versus standard administration. Same-day administration of pegfilgrastim is a reasonable option. © 2015 by IGCS and ESGO.