Poster Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Clinician and nurse reporting habits for chemotherapy-induced peripheral neuropathy (#247)

J. Matt McCrary 1 , Susanna Park 2 , David Goldstein 1 , IN FOCUS Investigators
  1. Prince of Wales Clinical School (UNSW Australia), Randwick, NSW, Australia
  2. Discipline of Physiology, The University of Sydney, Sydney, NSW, Australia

Aims: Multiple tools and strategies for assessing chemotherapy-induced peripheral neuropathy (CIPN) have been developed, yet there remains a knowledge gap regarding the usage of CIPN assessment strategies in the clinical setting. The aim of this investigation was to determine the frequency and detail of CIPN reporting in a hospital setting.

Methods: Retrospective assessment of patient notes was undertaken in 29 patients who received taxane or platinum-based chemotherapy. Oncology flow sheets, clinical notes, and clinician letters were scanned for notes regarding neuropathic symptoms. The detail, neuropathy grade (if available), and author of these notes was noted during each cycle of active treatment and at follow-up.

Results: The majority of patients (23 of 29; 79.3%) presented with neuropathic symptoms during treatment. The maximal reported neuropathy grade was grade 1 in 18 of 23 patients (78.3%), grade 2 in 3 of 23 patients (13.0%) with no grade reported in 2 of 23 patients (8.7%). 24.1% (9 of 29) patients experienced a dose reduction or cessation due to severity of neuropathic symptoms; neuropathy grade was not correlated with dose reduction or cessation (p=0.14). Neuropathy status was reported in patient notes for 199 of 369 (53.9%) analysed cycles of chemotherapy; neuropathy status was recorded during follow up for 14 of 29 patients (48.2%). However there was much variation in neuropathy reporting across chemotherapy cycles, with the frequency of reporting in patient notes varying from between 0% to 92% of chemotherapy cycles for individual patients. Neuropathy notes were most commonly found in the clinical notes (33.9%), although neuropathy status was also reported in antineoplastic drug patient assessment tools (25.5%), and oncology flow sheets (16.1%). Notes regarding patient neuropathy were most commonly written by oncologists (24.0%) and nurses (15.6%); authors of 41.1% of neuropathy notes were unclearly specified. 

Conclusions: Despite a majority of patients presenting with CIPN during treatment with platinum and taxane-based chemotherapy, CIPN assessment and reporting remains inconsistent in both detail and frequency.