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Challenges associated with the integration of immuno-oncology agents in clinical practice.

Publication ,  Journal Article
Lazure, P; Parikh, AR; Ready, NE; Davies, MJ; Péloquin, S; Caterino, JM; Lewandowski, R; Lazar, AJ; Murray, S
Published in: BMC Med Educ
November 12, 2022

BACKGROUND: The availability of new immuno-oncology therapeutics markedly impacts oncology clinicians' treatment decision-making. To effectively support healthcare professionals (HCPs) in their practice, it is important to better understand the challenges and barriers that can accompany the introduction of these agents. This study aimed to establish the types and causes of clinical challenges posed by the introduction of new immuno-oncology agents. METHODS: The mixed-methods design included qualitative in-depth interviews and group discussions with HCPs, in which participants discussed clinical challenges and potential underlying reasons for these challenges. Qualitative findings informed a quantitative survey. This survey investigated the extent and distribution of challenges using HCPs' self-rating of knowledge, skill, confidence, and exposure to system-level effects. These two phases were conducted sequentially with distinctly stratified samples of oncologists, nurse practitioners (NPs), physician assistants (PAs), pathologists, clinical pharmacists, interventional radiologists, rheumatologists, pulmonologists, and emergency department physicians. Participants were from the United States and had various levels of clinical experience and represented both academic and community-based settings. RESULTS: The final sample included 107 HCPs in the qualitative phase and 554 in the quantitative phase. Analyses revealed clinical challenges related to the use of pharmacodiagnostics. For example, 47% of pathologists and 42% of oncologists reported skill gaps in identifying the appropriate marker and 46% of oncologists, 61% of PAs, 66% of NPs, 74% of pulmonologists and 81% of clinical pharmacists reported skill gaps in selecting treatment based on test results. Challenges also emerged regarding the integration of immuno-oncology agents, as oncologists, rheumatologists, pulmonologists, clinical pharmacists, PAs, and NPs reported knowledge gaps (74-81%) of the safety profiles of recently approved agents. In addition, 90% of clinical pharmacists reported skill gaps weighing the risks and benefits of treating patients with immuno-oncology agents while affected by lupus. Finally, patient communication challenges were identified: HCPs reported difficulties discussing essential aspects of immunotherapy to patients as well as how they might compare to other types of therapies. CONCLUSION: The challenges highlighted in this study reveal substantial educational gaps related to the integration of immuno-oncology agents into practice for various groups of HCPs. These findings provide a strong base of evidence for future educational initiatives.

Duke Scholars

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Published In

BMC Med Educ

DOI

EISSN

1472-6920

Publication Date

November 12, 2022

Volume

22

Issue

1

Start / End Page

781

Location

England

Related Subject Headings

  • Nurse Practitioners
  • Neoplasms
  • Medical Oncology
  • Medical Informatics
  • Humans
  • Health Personnel
  • Communication
  • 3904 Specialist studies in education
  • 3901 Curriculum and pedagogy
  • 3202 Clinical sciences
 

Citation

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Lazure, P., Parikh, A. R., Ready, N. E., Davies, M. J., Péloquin, S., Caterino, J. M., … Murray, S. (2022). Challenges associated with the integration of immuno-oncology agents in clinical practice. BMC Med Educ, 22(1), 781. https://doi.org/10.1186/s12909-022-03847-0
Lazure, Patrice, Aparna R. Parikh, Neal E. Ready, Marianne J. Davies, Sophie Péloquin, Jeffrey M. Caterino, Robert Lewandowski, Alexander J. Lazar, and Suzanne Murray. “Challenges associated with the integration of immuno-oncology agents in clinical practice.BMC Med Educ 22, no. 1 (November 12, 2022): 781. https://doi.org/10.1186/s12909-022-03847-0.
Lazure P, Parikh AR, Ready NE, Davies MJ, Péloquin S, Caterino JM, et al. Challenges associated with the integration of immuno-oncology agents in clinical practice. BMC Med Educ. 2022 Nov 12;22(1):781.
Lazure, Patrice, et al. “Challenges associated with the integration of immuno-oncology agents in clinical practice.BMC Med Educ, vol. 22, no. 1, Nov. 2022, p. 781. Pubmed, doi:10.1186/s12909-022-03847-0.
Lazure P, Parikh AR, Ready NE, Davies MJ, Péloquin S, Caterino JM, Lewandowski R, Lazar AJ, Murray S. Challenges associated with the integration of immuno-oncology agents in clinical practice. BMC Med Educ. 2022 Nov 12;22(1):781.
Journal cover image

Published In

BMC Med Educ

DOI

EISSN

1472-6920

Publication Date

November 12, 2022

Volume

22

Issue

1

Start / End Page

781

Location

England

Related Subject Headings

  • Nurse Practitioners
  • Neoplasms
  • Medical Oncology
  • Medical Informatics
  • Humans
  • Health Personnel
  • Communication
  • 3904 Specialist studies in education
  • 3901 Curriculum and pedagogy
  • 3202 Clinical sciences