Multidisciplinary care for patients receiving immunotherapy can help recognize adverse events (AEs) early and keep them out of the hospital, as well as educate patients on how to advocate for themselves, according to Massey Nematollahi, MScN, CNS, RN, OCN®, CON©.
During a nursing track at the 37th Annual Chemotherapy Foundation Symposium, hosted by Physicians Education Resource®, Nematollahi, an immunotherapy clinical nurse specialist in the William Osler Health System in Canada, presented updates from the Osler Cancer Immunotherapy Program (OSIP), the health system’s first immunotherapy oncology (IO) clinic in Toronto, to a room full of nurses.
OSIP, which is led by Parneet K. Cheema, MD, MBiotech, FRCPC, since 2018, has put immunotherapy under one roof for patients with cancer receiving immunotherapy as part of their treatment. The program has cultivated a network of subspecialty physicians such as rheumatologists, gastroenterologists, and eye specialists, to help manage patients’ side effects to give them a better quality of life.
The program also looks to help patients with their treatment through education. A patient educator, such as Nematollahi, who is also the lead oncology nurse at OSIP, is assigned to each patient to educate them on what AEs to look out for and how to talk about them. Through this initial process, nurses can identify patients at high risk for immune-related adverse events (irAEs).
Using this initial time with their patients, the patient educator can also provide patients with education resources. For instance, through OSIP, healthcare professionals use a video made in house to explain what immunotherapy is to the patient. “The video has been translated in [French, Spanish, Cantonese, Punjabi, Italian,] and Japanese and German translations are near completion. We’ve worked with whole other cancer centers, medical oncologists, nurses, pharmacists, and, most importantly, the patient advisory council that reviewed the video and found it easy to understand for patients,” Nematollahi said. She added that a study is underway to evaluate the video and educational benefits of the program and halfway through, results show it has significantly improved patient comprehension despite their education levels.
Nurses within the OSIP IO clinic follow a standardized monitoring system that allows them to approve orders for missing blood work and ensure that they are following up with their patients regularly asking the right questions to investigate how they’re feeling and catch any AEs patients may be unsure of. These come with 2 easy to read documents for a nurse covering for another nurse to see the patient’s previous answers and which questions the nurse should follow up with.
Nematollahi also highlighted that the OSIP program works with every patient’s family doctor to discuss the realities of immunotherapy and how they can help spot and treat their patient’s irAEs. They do this by sending a letter to each family doctor and providing them with access to the clinic and the nurses and physicians treating their patient.
For Nematollahi, the OSIP shows the benefits of collaborating across disciplines to help improve patient’s quality of life, but also allow them to advocate for themselves through the course of treatment with the right education. “Managing [immunotherapy and irAEs] you need the whole village, it’s not just the oncologist,” Nematollahi said. “You need other multidisciplinary professionals to be involved and with that, we will minimize the complications for patients by getting them involved—patient education, healthcare professional education, providing close follow-ups, and making sure everyone knows who they are responsible for.”